The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials

By J. Brugts, T. Yetgin, S. Hoeks, A. Gotto, J. Shepherd, R. Westendorp, A. J. Craen, R. Knopp, H. Nakamura, P. Ridker and 2 more. British medical journal, 2009

820 citations recorded by the source corpus.

Objectives To investigate whether statins reduce all cause mortality and major coronary and cerebrovascular events in people without established cardiovascular disease but with cardiovascular risk factors, and whether these effects are similar in men and women, in young and older (>65 years) people, and in people with diabetes mellitus. Design Meta-analysis of randomised trials. Data sources Cochrane controlled trials register, Embase, and Medline. Data abstraction Two independent investigators identified studies on the clinical effects of statins compared with a placebo or control group and with follow-up of at least one year, at least 80% or more participants without established cardiovascular disease, and outcome data on mortality and major cardiovascular disease events. Heterogeneity was assessed using the Q and I2 statistics. Publication bias was assessed by visual examination of funnel plots and the Egger regression test. Results 10 trials enrolled a total of 70 388 people, of whom 23 681 (34%) were women and 16 078 (23%) had diabetes mellitus. Mean follow-up was 4.1 years. Treatment with statins significantly reduced the risk of all cause mortality (odds ratio 0.88, 95% confidence interval 0.81 to 0.96), major coronary events (0.70, 0.61 to0.81), and major cerebrovascular events (0.81, 0.71 to 0.93). No evidence of an increased risk of cancer was observed. There was no significant heterogeneity of the treatment effect in clinical subgroups. Conclusion In patients without established cardiovascular disease but with cardiovascular risk factors, statin use was associated with significantly improved survival and large reductions in the risk of major cardiovascular events.

Subfields: Cancer Research, Endocrinology, Diabetes and Metabolism, Surgery

View Paper: https://www.semanticscholar.org/paper/742ab88d39523851cb0af10a3b1ff70ca95b3e5b

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In Cancer Research

1. Marja-Riitta Taskinen
2. I. Graham
3. Ulrich Laufs

In Endocrinology, Diabetes and Metabolism

1. Marja-Riitta Taskinen
2. I. Graham
3. Alberico L. Catapano
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In Surgery

1. I. Graham
2. Marja-Riitta Taskinen
3. Alberico L. Catapano
4. Ulrich Laufs

Citations in the corpus

• ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). (2011, background): “A more recent meta-analysis that included the large female subgroup from the JUPITER trial reported a 12% relative risk reduction (RRR) of total mortality with statin use in high risk subjects without established CVD, with no heterogeneity in treatment effect between men and women.(16) Thus, statin ”
• 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. (2019, background): “It is recommended that a high-intensity statin is prescribed up to the highest tolerated dose to reach the goals set for the specific level of risk.(32,34,38) I A”