Literature DB >> 12879636

[How relevant is statin therapy for clinical practice?].

Johannes Bonelli1.   

Abstract

In the time of evidenced-based medicine results of randomised controlled trials with statins mostly are presented in terms of relative risk reduction and commonly declare this treatment to be "lifesaving". The way, how research data are presented, however, influences health care decisions and can greatly affect a physicians perception of treatment benefits and his willingness to prescribe. In addition, arguments for a lifesaving by statins are not supported by the underlying data, but show that in real terms the effect of the treatment is reduced to a relative short gain in lifetime depending also on age. E.g. the expected lifetime gain of a 45 year old high-risk patient due to therapy with statins is 2.3 years and only 0.7 years of a 70 year old patient. The lifetime gain is even much smaller in low risk patients (month only). From this point of view it is of note that lifelong treatment with statins must focus not only on risk reduction but also on the welfare of the patient in a comprehensive fashion. Therefore a small gain in lifespan may be sacrificed if the "price" gets too high (e.g. side effects of the drug, risks, troubles with compliance, reduced quality of life).

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Year:  2003        PMID: 12879636     DOI: 10.1046/j.1563-258x.2003.03032.x

Source DB:  PubMed          Journal:  Wien Med Wochenschr        ISSN: 0043-5341


  12 in total

1.  American Heart Association 2001 scientific sessions: late-breaking science-statins: the new aspirin?

Authors:  R Fox
Journal:  Circulation       Date:  2001-11-20       Impact factor: 29.690

2.  Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease.

Authors:  M H Frick; O Elo; K Haapa; O P Heinonen; P Heinsalmi; P Helo; J K Huttunen; P Kaitaniemi; P Koskinen; V Manninen
Journal:  N Engl J Med       Date:  1987-11-12       Impact factor: 91.245

3.  Expected gains in life expectancy from various coronary heart disease risk factor modifications.

Authors:  J Tsevat; M C Weinstein; L W Williams; A N Tosteson; L Goldman
Journal:  Circulation       Date:  1991-04       Impact factor: 29.690

4.  Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial.

Authors:  James Shepherd; Gerard J Blauw; Michael B Murphy; Edward L E M Bollen; Brendan M Buckley; Stuart M Cobbe; Ian Ford; Allan Gaw; Michael Hyland; J Wouter Jukema; Adriaan M Kamper; Peter W Macfarlane; A Edo Meinders; John Norrie; Chris J Packard; Ivan J Perry; David J Stott; Brian J Sweeney; Cillian Twomey; Rudi G J Westendorp
Journal:  Lancet       Date:  2002-11-23       Impact factor: 79.321

5.  Effects of walking on mortality among nonsmoking retired men.

Authors:  A A Hakim; H Petrovitch; C M Burchfiel; G W Ross; B L Rodriguez; L R White; K Yano; J D Curb; R D Abbott
Journal:  N Engl J Med       Date:  1998-01-08       Impact factor: 91.245

6.  Communication, compliance, and concordance between physicians and patients with prescribed medications.

Authors:  B S Hulka; J C Cassel; L L Kupper; J A Burdette
Journal:  Am J Public Health       Date:  1976-09       Impact factor: 9.308

7.  Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.

Authors: 
Journal:  N Engl J Med       Date:  1998-11-05       Impact factor: 91.245

8.  The benefits of treating hyperlipidemia to prevent coronary heart disease. Estimating changes in life expectancy and morbidity.

Authors:  S A Grover; M Abrahamowicz; L Joseph; C Brewer; L Coupal; S Suissa
Journal:  JAMA       Date:  1992-02-12       Impact factor: 56.272

9.  Cholesterol reduction and life expectancy. A model incorporating multiple risk factors.

Authors:  W C Taylor; T M Pass; D S Shepard; A L Komaroff
Journal:  Ann Intern Med       Date:  1987-04       Impact factor: 25.391

10.  MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial.

Authors: 
Journal:  Lancet       Date:  2002-07-06       Impact factor: 79.321

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