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

Abstract

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 followup 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 I 2 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.

2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology

“…5 In addition to early detection, patient viewing of the CAC scan has been shown to increase adherence to statin and ASA treatment, to diet and exercise 32e34 and to improve lipids, BP and weight. 35 Since treatment of high risk patients with statins improves their outcomes, 36 and CAC accurately detects high risk patients, one could project that the reduction in events could be expected to be as high as 30% based on primary prevention trials. 36 A randomized controlled outcome trial of CAC in 39,000 asymptomatic patients, the ROBINSCA (Risk Or Benefit In Screening for Cardiovascular Disease Risk) 37 trial, has recently been implemented in Holland, and may address lingering questions.…”

Can Intensive Lipid-Lowering Therapy Improve the Carotid Intima-Media Thickness in Japanese Subjects Under Primary Prevention for Cardiovascular Disease?: The JART and JART Extension Subanalysis

“…According to a metaanalysis of 20 randomized primary prevention studies with statins that included a total of 63,899 subjects, statin therapy reduced both CVD mortality and the incidence of major cardiovascular events in the study populations 14) . Another meta-analysis of 10 primary prevention studies that included 70,388 subjects found that statins significantly reduced the risk of allcause mortality 16) . The findings of the present subanalysis support those of previous reports and suggest that intensive lipid-lowering therapy with rosuvastatin The box plots provide the median levels (middle horizontal line in each box).…”

“…Numerous meta-analyses of primary prevention studies using statins have clearly demonstrated that these drugs provide cardiovascular benefits [14][15][16] . According to a metaanalysis of 20 randomized primary prevention studies with statins that included a total of 63,899 subjects, statin therapy reduced both CVD mortality and the incidence of major cardiovascular events in the study populations 14) .…”

Efficacy and Safety of Alirocumab 150 mg Every 4 Weeks in Patients With Hypercholesterolemia Not on Statin Therapy: The ODYSSEY CHOICE II Study

“…Statins lower low‐density lipoprotein cholesterol (LDL‐C) by inhibiting 3‐hydroxy‐3‐methylglutaryl‐coenzyme A reductase and consistently reduce cardiovascular disease (CVD) risk by 30% to 40% 1, 2, 3. Therefore, statin therapy is currently the recommended standard‐of‐care treatment for lowering LDL‐C in patients at increased CVD risk 2, 3.…”