Financiado en parte por Pfizer
Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis
Briel M, Ferreira-Gonzalez I, You JJ, Karanicolas PJ, Akl EA, Wu P, Blechacz B, Bassler D, Wei X, Sharman A, Whitt I, Alves da Silva S, Khalid Z, Nordmann AJ, Zhou Q, Walter SD, Vale N, Bhatnagar N, O'Regan C, Mills EJ, Bucher HC, Montori VM, Guyatt GH
BMJ (Clinical research ed.) · 325 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
- Pfizer
- Gobierno
- Ontario Ministry of Health and Long-Term Care
Según 2 financiadores declarados.
Publicación
- Publicado
- 2009-02-16 · BMJ · vol. 338 · número feb16 1 · pág. b92
- Citado
- 491 citas · más que el 99% de estudios similares · 9.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 70 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Acute Myocardial Infarction Research · Cholesterol and Lipid Metabolism
- Palabras clave
- LDL cholesterol, cardiovascular mortality, coronary artery disease, myocardial infarction, LDL/HDL ratio, statins, fibrates, ezetimibe, cardiovascular risk reduction, lipid-lowering therapy, LDL cholesterol lowering, drug class effect, cardiovascular morbidity and mortality
- MeSH
- humans, cardiovascular diseases, regression analysis, cholesterol, hdl, clinical trials as topic, hypolipidemic agents
23 autores
- Matthias Briel🇨🇭🇨🇦 · autor de correspondenciaUniversity of Basel; University Hospital of Basel; McMaster University
- Ignacio Ferreira‐González🇪🇸Vall d'Hebron Hospital Universitari; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
- John J. You🇨🇦McMaster University
- P. J Karanicolas🇨🇦Western University
- Elie Akl🇺🇸University at Buffalo, State University of New York
- Ping Wu🇨🇦Canadian College of Naturopathic Medicine
- Boris R. A. Blechacz🇺🇸Mayo Clinic
- Dirk Bassler🇩🇪University Children's Hospital Tübingen; University of Tübingen
- X. Wei🇨🇦McMaster University
- Asheer Sharman🇨🇦McMaster University
- Irene Z. Whitt🇺🇸Mayo Clinic
- S. Alves da Silva🇧🇷Hospital Pró-Cardíaco
- Zara Khalid🇨🇦McMaster University
- Alain J. Nordmann🇨🇭University of Basel; University Hospital of Basel
- Qi Xin Zhou🇨🇦McMaster University
- Stephen D. Walter🇨🇦McMaster University
- Noah Vale🇨🇦McMaster University
- Neera Bhatnagar🇨🇦McMaster University
- Chris O’Regan🇬🇧Pfizer (United Kingdom)
- Edward J. Mills🇨🇦St. Paul's Hospital; BC Centre for Excellence in HIV/AIDS
- Heiner C. Bucher🇨🇭University of Basel; University Hospital of Basel
- Víctor M. Montori🇺🇸Mayo Clinic
- Gordon Henry Guyatt🇨🇦McMaster University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To investigate the association between treatment induced change in high density lipoprotein cholesterol and total death, coronary heart disease death, and coronary heart disease events (coronary heart disease death and non-fatal myocardial infarction) adjusted for changes in low density lipoprotein cholesterol and drug class in randomised trials of lipid modifying interventions.
Design
Systematic review and meta-regression analysis of randomised controlled trials.
Data sources
Medline, Embase, Central, CINAHL, and AMED to October 2006 supplemented by contact with experts in the field.
Study selection
In teams of two, reviewers independently determined eligibility of randomised trials that tested lipid modifying interventions to reduce cardiovascular risk, reported high density lipoprotein cholesterol and mortality or myocardial infarctions separately for treatment groups, and treated and followed participants for at least six months.
Data extraction and synthesis
Using standardised, pre-piloted forms, reviewers independently extracted relevant information from each article. The change in lipid concentrations for each trial and the weighted risk ratios for clinical outcomes were calculated.
Results
The meta-regression analysis included 108 randomised trials involving 299 310 participants at risk of cardiovascular events. All analyses that adjusted for changes in low density lipoprotein cholesterol showed no association between treatment induced change in high density lipoprotein cholesterol and risk ratios for coronary heart disease deaths, coronary heart disease events, or total deaths. With all trials included, change in high density lipoprotein cholesterol explained almost no variability (<1%) in any of the outcomes. The change in the quotient of low density lipoprotein cholesterol and high density lipoprotein cholesterol did not explain more of the variability in any of the outcomes than did the change in low density lipoprotein cholesterol alone. For a 10 mg/dl (0.26 mmol/l) reduction in low density lipoprotein cholesterol, the relative risk reduction was 7.2% (95% confidence interval 3.1% to 11%; P=0.001) for coronary heart disease deaths, 7.1% (4.5% to 9.8%; P<0.001) for coronary heart disease events, and 4.4% (1.6% to 7.2%; P=0.002) for total deaths, when adjusted for change in high density lipoprotein cholesterol and drug class.
Conclusions
Available data suggest that simply increasing the amount of circulating high density lipoprotein cholesterol does not reduce the risk of coronary heart disease events, coronary heart disease deaths, or total deaths. The results support reduction in low density lipoprotein cholesterol as the primary goal for lipid modifying interventions.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC).
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