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Cholesterol reduction yields clinical benefit: impact of statin trials.
Gould, A L; Rossouw, J E; Santanello, N C; Heyse, J F; Furberg, C D.
Afiliación
  • Gould AL; Merck Research Laboratories, West Point, PA 19486, USA. goulda@merck.com
Circulation ; 97(10): 946-52, 1998 Mar 17.
Article en En | MEDLINE | ID: mdl-9529261
BACKGROUND: We determined the effect of incorporating the results of eight recently published trials of Hmg CoA reductase inhibitors ("statins") on the conclusions from our previously published meta-analysis regarding the clinical benefit of cholesterol lowering. METHODS AND RESULTS: We used the same analytic approach as in our previous investigation, separating the specific effects of cholesterol lowering from the effects attributable to the different types of intervention studied. The reductions in coronary heart disease (CHD) and total mortality risk observed for the statins fell near the predictions from our earlier meta-analysis. Including the statin trial findings into the calculations led to a prediction that for every 10 percentage points of cholesterol lowering, CHD mortality risk would be reduced by 15% (P<.001), and total mortality risk would be reduced by 11% (P<.001), as opposed to the values of 13% and 10%, respectively, reported previously. Cholesterol lowering in general and by the statins in particular does not increase non-CHD mortality risk. CONCLUSIONS: Adding the results from the statin trials confirmed our original conclusion that lowering cholesterol is clinically beneficial. The relationships (slope) between cholesterol lowering and reduction in CHD and total mortality risk became stronger, and the standard error of the estimated slopes decreased by about half. Use of statins does not increase non-CHD mortality risk. The effect of the statins on CHD and total mortality risk can be explained by their lipid-lowering ability and appears to be directly proportional to the degree to which they lower lipids.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colesterol / Enfermedad Coronaria / Hidroximetilglutaril-CoA Reductasas Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Circulation Año: 1998 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colesterol / Enfermedad Coronaria / Hidroximetilglutaril-CoA Reductasas Tipo de estudio: Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Circulation Año: 1998 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos