Modeling Statin-Induced Reductions of Cardiovascular Events in Primary Prevention: A VOYAGER Meta-Analysis

Abstract

Objective: We used individual patient data from the VOYAGER database to estimate cardiovascular (CV) risk reduction with commonly used high-intensity statins. Methods: In patients with known atherosclerotic CV disease (ASCVD) treated with high-intensity statin therapy (n = 6,735), the predicted risk reduction was estimated using the Cholesterol Treatment Trialists’ Collaboration meta-analysis, which determined risk reduction per 38.7 mg/dL statin-mediated reduction in low-density lipoprotein cholesterol. Results: The greatest reductions in risk were seen in major vascular events (estimated rate ratios ranged from 0.55 with rosuvastatin [RSV] 40 mg to 0.60 with atorvastatin [ATV] 40 mg) and coronary heart disease death (estimated rate ratios ranged from 0.58 with RSV 40 mg to 0.64 with ATV 40 mg). Conclusions: Our results show that, in individuals without clinical ASCVD, statin therapy has the potential to reduce the frequency of CV events.

Lipid-lowering Eeficacy and Safety of High Doses of Atorvastatin and Rosuvastatin

“…В прошлом десятилетии опубликовано много новых данных по эффективности, переносимости и безопасности терапии статинами, например, серия мета-анализов исследования VOYAGER [26][27][28][29][30][31][32][33][34][35]. Вся популяция исследования VOYAGER составила 32 258 пациентов, из них подгруппа пациентов с очень высоким риском развития ССЗ -67 % [26].…”

“…Средние исходные уровни липидов в популяции пациентов исследования VOYAGER были следующими: уровень ХС ЛНП 4,4 ммоль / л (достаточно высокий), ХС ЛВП -1,25 ммоль / л (достаточно высокий); медиана уровня ТГ -1,82 ммоль / л (норма) [26]. Практически все публикации исследования VOYAGER были посвящены анализу сравнительной эффективности трех статинов -симвастатина, аторвастатина и розувастатина [26][27][28][29][30][31][32][33][34][35]. В одной из первых публикаций изучалось влияние возрастающих доз этих препаратов на уровни липидов [26] (табл.…”

Melatonin May Increase Anticancer Potential of Pleiotropic Drugs

“…At present, statins are the most-widely used drugs for the treatment of hypercholesterolemia. They had become a first choice in current prescribing practice and are pivotal in the primary and secondary prevention of cardiovascular disease [213,214]. Current preclinical studies have proven the pleiotropic properties of statins that can be useful for cancer therapy and prevention.…”

Hitting Hard and Early: A Novel Paradigm for Lipid Lowering in Primary Prevention

“…The same relationship was found to also apply to ezetimibe therapy on top of a statin [12], while the pivotal studies testing monoclonal antibodies against PCSK-9 were likely too short in duration so that matching with CTT remained broad [13]. In this issue of Cardiology , based on CTT, Karlson et al[14] modeled the effect of rosuvastatin (20 and 40 mg) and atorvastatin (40 or 80 mg), respectively, in primary prevention patients using data from mechanistic phase 2 and 3 studies included in the VOYAGER database. They demonstrate a potential risk reduction displayed as odds ratios.…”