Meera Jain, MD; Mark Rosenberg, MD
Does lowering low-density lipoprotein cholesterol (LDL-C) levels using statin therapy reduce major vascular events in low-risk patients?
Included studies evaluated statin therapy, included ≥ 1 intervention intended to lower LDL-C levels, enrolled ≥ 1000 patients, scheduled treatment for ≥ 2 years' duration, reported results by 2009, and provided individual patient data by June 2011. Outcomes included a composite of major vascular events (MVEs) (major coronary event [nonfatal myocardial infarction or coronary death], coronary revascularization, or stroke).
Individual patient meta-analysis of 22 trials comparing statin with control therapy (n = 134 537, mean age 63 y, 71% men, median follow-up in survivors 4.8 y) and 5 trials comparing more with less intensive statin therapy (n = 39 612, mean age 62 y, 81% men, median follow-up in survivors 5.1 y). Data were analyzed using an intention-to-treat approach and in subgroups based on baseline 5-year MVE risk (< 5%, ≥ 5% to < 10%, ≥ 10% to < 20%, ≥ 20% to < 30%, and ≥ 30%).
Individual patient meta-analysis showed that using statins to lower LDL-C levels by 1 mmol/L (39 mg/dL) reduced MVEs regardless of baseline risk level (Table).
Lowering low-density lipoprotein cholesterol levels using statins reduces major vascular events compared with control regardless of baseline risk level.
Individual patient meta-analysis of statin therapy vs control or more vs less intensive statin therapy*
*LDL-C = low-density lipoprotein cholesterol; MVE = major vascular event; other abbreviations defined in Glossary. RRR and CI calculated from data in article based on 22 trials of statins vs control (n = 134 537) and 5 of more vs less intensive statin therapy (n = 39 612).
†Major coronary event (nonfatal myocardial infarction or coronary death), coronary revascularization, or stroke.
‡P = 0.04 for trend.
Jain M, Rosenberg M. Meta-analysis: Lowering LDL-C levels using statins reduces major vascular events regardless of baseline risk. Ann Intern Med. ;157:JC4–2. doi: 10.7326/0003-4819-157-8-201210160-02002
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Published: Ann Intern Med. 2012;157(8):JC4-2.
Cardiology, Coronary Risk Factors, Dyslipidemia.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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