Meta-analysis of efficacy and safety of statins for cardiovascular disease

January 01, 0001

Meta-analysis of efficacy and safety of statins for cardiovascular disease

These Canadian authors combined evidence from all RCTs comparing a statin with placebo or usual care among patients with and without prior coronary heart disease (CHD) to determine clinical outcomes. They included RCTs of any statin versus any non-drug control in any populations. They abstracted data in duplicate on reported major clinical events and adverse events.

They found: "We included a total of 76 RCTs involving 170,255 participants. There were a total of 14,878 deaths. Statin therapy reduced all-cause mortality, Relative Risk (RR) 0.90; cardiovascular disease (CVD) mortality (RR 0.80); fatal myocardial infarction (MI) (RR 0.82); non-fatal MI (RR 0.74,); revascularization (RR 0.76); and a composite of fatal and non-fatal strokes (0.86). Adverse events were generally mild, but 17 RCTs reported on increased risk of development of incident diabetes ( (OR 1.09). Studies did not yield important differences across populations. We did not find any differing treatment effects between statins."

The authors concluded: "Statin therapies offer clear benefits across broad populations. As generic formulations become more available efforts to expand access should be a priority."

The most important finding is the reduction in all-cause mortality, modest, but clinically and statistically significant.

For the full abstract, click here.

QJM (2):109-124, February 2011
© 2010 to the Author.
fficacy and safety of statin treatment for cardiovascular disease: a network meta-analysis of 170,255 patients from 76 randomized trials. E.J. Mills, P. WU, G. Chong et al. Correspondence to Dr. Mills:

Category: K. Circulatory. Keywords: statin, cardiovascular disease, all-cause mortality, diabetes, meta-analysis of randomized controlled trials, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 8 February 2011

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