The relationship between reduction in low-density lipoprotein cholesterol by statins and reduction in risk of cardiovascular outcomes: an updated meta-analysis
Delahoy PJ, Magliano DJ, Webb K, Grobler M, Liew D
Clinical therapeutics · 121 citas
Etiquetas de revisión
Financiación no declaradaDatos 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
- Financiación no declarada
Publicación
- Publicado
- 2009-02-01 · Clin Ther · vol. 31 · número 2 · págs. 236–244
- Editorial
- Elsevier BV
- Citado
- 168 citas · más que el 100% de estudios similares · 20.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 37 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cancer, Lipids, and Metabolism · Blood Pressure and Hypertension Studies
- Palabras clave
- statins, LDL cholesterol lowering, cardiovascular risk, cardiovascular events, vascular death, major coronary events, stroke, pravastatin, simvastatin, atorvastatin, rosuvastatin, fluvastatin, lovastatin
- MeSH
- humans, cardiovascular diseases, anticholesteremic agents, hydroxymethylglutaryl-coa reductase inhibitors, risk factors, regression analysis, cholesterol, ldl, clinical trials as topic
5 autores
- Philippa J. Delahoy🇦🇺Pfizer (Australia)
- Dianna J. Magliano🇦🇺 · autor de correspondenciaBaker Heart and Diabetes Institute; Monash University
- Kate Webb🇦🇺Pfizer (Australia)
- Mendel P. Grobler🇦🇺Pfizer (Australia)
- Danny Liew🇦🇺The University of Melbourne; St Vincent's Hospital Melbourne
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
In 2005, the Cholesterol Treatment Trialists' Collaboration (CTTC) quantified the relationship between reduction in low-density lipoprotein cholesterol (LDL-C) achieved by statin treatment and reduction in cardiovascular risk. Since this publication, several large statin trials have been reported.
Objective
The objective of our analysis was to extend the CTTC results by including active-controlled trials and other trials published since 2005.
Methods
A literature search in English (1966-December 2008) was undertaken of MEDLINE, EMBASE, Derwent drug file databases, and the Cochrane library using standard MESH terms (cardiovascular disease, death, fatal outcome, pravastatin, simvastatin, atorvastatin, rosuvastatin, fluvastatin, lovastatin, and hydroxymethylglutaryl coenzyme A reductase inhibitors) to identify randomized trials of statins (placebo controlled, active controlled, or usual care) that reported clinical outcomes, enrolled >1000 subjects, and followed them up for > or =1 year. Random effects meta-regression was used to analyze the relationship between absolute changes in LDL-C and risk for cardiovascular events.
Results
Twenty-five trials were included in a primary analysis involving 155,613 subjects, 6321 vascular deaths, 23,791 major vascular events, 11,357 major coronary events, and 4717 strokes. For every 25-mg/dL (0.65-mmol/L) reduction in LDL-C, the relative risk (95% CI) for various cardiovascular outcomes was as follows: vascular mortality, 0.89 (0.87-0.92); major vascular events, 0.86 (0.84-0.88); major coronary events, 0.84 (0.82-0.86); and stroke, 0.90 (0.86-0.94).
Conclusions
Based on meta-regression analysis of these trials, there was a significant positive relationship between reduction in LDL-C and reduction in the risk for major cardiovascular events. These results support and extend the findings of the CTTC.
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