AIMS: Since 2002, there have been five major outcome trials of statins reporting findings from more than 47,000 subjects. As individual trial results differed, we performed a meta-analysis to ascertain the effectiveness and safety of statins overall and in subgroups. The aim of the study was to estimate the effect of statins on major coronary events and strokes, all-cause mortality and noncardiovascular mortality, and in different subgroups. METHODS: PubMed was searched for trials published in English. Randomized placebo-controlled statin trials with an average follow up of at least 3 years and at least 100 major coronary events were included. For each trial, the statin used, number and type of subjects, proportion of women, mean age and follow up, baseline and change in lipid profile, cardiovascular and non-cardiovascular outcomes were recorded. RESULTS: Ten trials involving 79,494 subjects were included in the meta-analysis. Due to heterogeneity, ALLHAT-LLT was excluded from some analyses. Statin therapy reduced major coronary events by 27% (95%CI 23, 30%), stroke by 18% (95%CI 10, 25%) and all-cause mortality by 15% (95%CI 8, 21%). There was a 4% (95%CI -10, 3%) nonsignificant reduction in noncardiovascular mortality. The reduction in major coronary events is independent of gender and presence of hypertension or diabetes. The risk reduction was greater in smokers (P < 0.05). Coronary events were reduced by 23% (95%CI 18, 29%) in pravastatin trials and 29% (95%CI 25, 33%) in five trials using other statins. Pravastatin reduced strokes by 12% (95%CI 1, 21%) whilst other statins reduced strokes by 24% (95%CI 16, 32%) (P = 0.04). CONCLUSIONS: Statins reduce coronary events, strokes and all-cause mortality without increasing noncoronary mortality. The benefits accrue in men and women, hypertensives and normotensives, diabetics and nondiabetics, and particularly in smokers. Pravastatin appears to have less impact on strokes.
AIMS: Since 2002, there have been five major outcome trials of statins reporting findings from more than 47,000 subjects. As individual trial results differed, we performed a meta-analysis to ascertain the effectiveness and safety of statins overall and in subgroups. The aim of the study was to estimate the effect of statins on major coronary events and strokes, all-cause mortality and noncardiovascular mortality, and in different subgroups. METHODS: PubMed was searched for trials published in English. Randomized placebo-controlled statin trials with an average follow up of at least 3 years and at least 100 major coronary events were included. For each trial, the statin used, number and type of subjects, proportion of women, mean age and follow up, baseline and change in lipid profile, cardiovascular and non-cardiovascular outcomes were recorded. RESULTS: Ten trials involving 79,494 subjects were included in the meta-analysis. Due to heterogeneity, ALLHAT-LLT was excluded from some analyses. Statin therapy reduced major coronary events by 27% (95%CI 23, 30%), stroke by 18% (95%CI 10, 25%) and all-cause mortality by 15% (95%CI 8, 21%). There was a 4% (95%CI -10, 3%) nonsignificant reduction in noncardiovascular mortality. The reduction in major coronary events is independent of gender and presence of hypertension or diabetes. The risk reduction was greater in smokers (P < 0.05). Coronary events were reduced by 23% (95%CI 18, 29%) in pravastatin trials and 29% (95%CI 25, 33%) in five trials using other statins. Pravastatin reduced strokes by 12% (95%CI 1, 21%) whilst other statins reduced strokes by 24% (95%CI 16, 32%) (P = 0.04). CONCLUSIONS: Statins reduce coronary events, strokes and all-cause mortality without increasing noncoronary mortality. The benefits accrue in men and women, hypertensives and normotensives, diabetics and nondiabetics, and particularly in smokers. Pravastatin appears to have less impact on strokes.
Authors: Peter S Sever; Björn Dahlöf; Neil R Poulter; Hans Wedel; Gareth Beevers; Mark Caulfield; Rory Collins; Sverre E Kjeldsen; Arni Kristinsson; Gordon T McInnes; Jesper Mehlsen; Markku Nieminen; Eoin O'Brien; Jan Ostergren Journal: Lancet Date: 2003-04-05 Impact factor: 79.321
Authors: A H Liem; A J van Boven; N J G M Veeger; A J Withagen; R M Robles de Medina; J G P Tijssen; D J van Veldhuisen Journal: Eur Heart J Date: 2002-12 Impact factor: 29.983
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
Authors: Vasilios G Athyros; Athanasios A Papageorgiou; Bodosakis R Mercouris; Valasia V Athyrou; Athanasios N Symeonidis; Elias O Basayannis; Dimokritos S Demitriadis; Athanasios G Kontopoulos Journal: Curr Med Res Opin Date: 2002 Impact factor: 2.580
Authors: Deborah Grady; David Herrington; Vera Bittner; Roger Blumenthal; Michael Davidson; Mark Hlatky; Judith Hsia; Stephen Hulley; Alan Herd; Steven Khan; L Kristin Newby; David Waters; Eric Vittinghoff; Nanette Wenger Journal: JAMA Date: 2002-07-03 Impact factor: 56.272
Authors: Catherine Buettner; Matthew J Rippberger; Julie K Smith; Suzanne G Leveille; Roger B Davis; Murray A Mittleman Journal: Am J Med Date: 2012-02 Impact factor: 4.965
Authors: Hannah Gardener; David Della Morte; Mitchell S V Elkind; Ralph L Sacco; Tatjana Rundek Journal: BMC Cardiovasc Disord Date: 2009-12-22 Impact factor: 2.298
Authors: Nizar Younas; Christine M Wu; Ron Shapiro; Jerry McCauley; James Johnston; Henkie Tan; Amit Basu; Heidi Schaefer; Cynthia Smetanka; Wolfgang C Winkelmayer; Mark Unruh Journal: BMC Nephrol Date: 2010-04-01 Impact factor: 2.388
Authors: Fiona Taylor; Mark D Huffman; Ana Filipa Macedo; Theresa H M Moore; Margaret Burke; George Davey Smith; Kirsten Ward; Shah Ebrahim Journal: Cochrane Database Syst Rev Date: 2013-01-31