Financiado en parte por Bristol-Myers Squibb, Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi, Daiichi-Sankyo
Meta-analysis of the relationship between non-high-density lipoprotein cholesterol reduction and coronary heart disease risk
Robinson JG, Wang S, Smith BJ, Jacobson TA
Journal of the American College of Cardiology · 262 citas
Etiquetas de revisión
Financiado por la industriaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiado por la industria
- Empresa
- Bristol-Myers Squibb
- Empresa
- Pfizer
- Empresa
- AstraZeneca
- Empresa
- GlaxoSmithKline
- Empresa
- Sanofi
- Empresa
- Daiichi-Sankyo
Según 6 financiadores declarados.
Publicación
- Publicado
- 2009-01-01 · J Am Coll Cardiol · vol. 53 · número 4 · págs. 316–322
- Editorial
- Elsevier BV
- Citado
- 369 citas · más que el 98% de estudios similares · 5.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 61 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cholesterol and Lipid Metabolism · Diabetes, Cardiovascular Risks, and Lipoproteins
- Palabras clave
- non-HDL cholesterol, coronary artery disease, lipid-lowering therapy, statins, fibrates, nicotinic acid, bile acid sequestrants, myocardial infarction, coronary heart disease mortality, relative risk
- MeSH
- humans, coronary disease, clofibric acid, niacin, hydroxymethylglutaryl-coa reductase inhibitors, risk factors, female, male, cholesterol, ldl, cholesterol, hdl
4 autores
- Jennifer G. Robinson🇺🇸 · autor de correspondenciaUniversity of Iowa
- Songfeng Wang🇺🇸University of Iowa
- Brian J. Smith🇺🇸University of Iowa
- Terry A. Jacobson🇺🇸Emory University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objectives
To determine the relationship between non-high-density lipoprotein cholesterol (HDL-C) lowering and coronary heart disease (CHD) risk reduction for various lipid-modifying therapies.
Background
Non-HDL-C is the second lipid target of therapy after low-density lipoprotein cholesterol (LDL-C).
Methods
Randomized placebo or active-controlled trials were evaluated. The effect of mean non-HDL-C reduction on the relative risk of nonfatal myocardial infarction and CHD death was estimated using Bayesian random-effects meta-analysis models adjusted for study duration. Cochrane's Q was used to test for heterogeneity.
Results
Inclusion criteria were met by 14 statin (n = 100,827), 7 fibrate (n = 21,647), and 6 niacin (n = 4,445) trials, and 1 trial each of a bile acid sequestrant (n = 3,806), diet (n = 458), and ileal bypass surgery (n = 838). For statins, each 1% decrease in non-HDL-C resulted in an estimated 4.5-year CHD relative risk of 0.99 (95% Bayesian confidence interval: 0.98 to 1.00). The fibrate model did not differ from the statin model (Bayes factor K = 0.49) with no evidence of heterogeneity. The niacin model was moderately different from the statin model (K = 7.43), with heterogeneity among the trials (Q = 11.8, 5 df; p = 0.038). The only niacin monotherapy trial (n = 3,908) had a 1:1 relationship between non-HDL-C and risk reduction. No consistent relationships were apparent for the 5 small trials of niacin in combination. The 95% confidence intervals for the single trials of diet, bile acid sequestrants, and surgery also included the 1:1 relationship.
Conclusions
Non-HDL-C is an important target of therapy for CHD prevention. Most lipid-modifying drugs used as monotherapy have an approximately 1:1 relationship between percent non-HDL-C lowering and CHD reduction.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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