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Submitted: 17 May 2007
HERDIN Record #: PCHRDPC060336

Statins for the primary prevention of mortality and cardiovascular events: A meta-analysis.

 Locnen, Sue Ann,
 Cheng, Federick,
 Sy, Ma Florema

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OBJECTIVE: To determine whether the use of statins in patients with normal or abnormal cholesterol levels, with or without other cardiovascular risk factors and those without symptomatic or asymptomatic coronary heart disease would significantly decrease the risk of mortality and cardiovascular events
METHODS: The study design is a meta-analysis (hazard ratio/risk ratio and confidence interval). The trials were collected from Medline search of randomized controlled studies from 1995-2005 (keywords: statins + primary prevention + coronary events + mortality), Medical Up-to-Date 2004 Edition and Cochrane Registry. Five trials were included in the study: WOSCOPS, AFCAPS/ TexCAPS, ALLHAT-LLT, ASCOT-LLA, and CARDS. The trials were all randomized controlled, three of which were double blind, while two were open-blinded. Four were placebo-controlled while one was compared with the usual care. Data extraction was done by two independent unblinded observers
RESULTS: All cause mortality showed a combined risk ratio (RR) 0.88 (p=0.06), 95 percent CI 0.76-1.01. Mortality from all cardiovascular causes showed a combined RR 0.87 (p=0.14), 95 percent CI 0.72 -1.05. Mortality from coronary heart disease showed a combined RR 0.77 (p=0.01), 95 percent CI 0.63-0.95. Incidence of acute coronary event showed a combined RR 0.71 (p=0.0002), 95 percent CI 0.59.085. Incidence of no-fatal MI and/or death from coronary heart disease showed a combined RR 0.75 (p=0.0009), 95 percent CI 0.64-089
CONCLUSION: Statins did not significantly decrease all cause mortality and mortality from all cardiovascular causes but they significantly decrease mortality from coronary heart disease, incidence of non-fatal MI and/or mortality from coronary heart disease and incidence of acute coronary events in patients with normal or abnormal cholesterol levels, with or without cardiovascular risk factors and those without symptomatic or asymptomatic coronary heart disease. (Author)

Publication Type
Proceedings
Title
Philippine Heart Association 36th Annual Conventio
Date
Page(s)
0
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Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)