Meta-analysis of the cardiovascular benefits of intensive lipid lowering with statins.
OBJECTIVE
To evaluate the efficacy of intensive lipid lowering with higher-dose statins.


METHODS
Meta-analysis of seven randomized controlled trials comprising 50,972 participants.


RESULTS
Mean follow-up was 3.1 years with mean age 63 years. Final LDL-C levels in intensive lipid-lowering group were 1.42-2.07 mmol/l compared to 2.1-3.5 mmol/l in the less intensive or control group. The intensive arm had significantly lower risks for stroke OR 0.80 (95% CI 0.71-0.89); major coronary events OR 0.74 (95% CI 0.65-0.83); cardiovascular disease (CVD) or coronary heart disease (CHD) deaths OR 0.84 (95% CI 0.74-0.95). Significantly higher liver enzyme abnormalities occurred in intensive group* (OR 3.96; 95% CI 2.08-7.53), but it was not associated with drug discontinuations (OR 1.20; 95% CI 0.88-1.64).


CONCLUSIONS
In those at high risk of cardiovascular events, intensive lipid lowering with statins to LDL-C level <2.1 mmol/l significantly reduces risk of stroke, major coronary events and CVD or CHD deaths compared to LDL-C level ≥ 2.1 mmol/l. [*Correction added on 11 January 2011 after first online publication on 27 October 2010. The phrase, "Significantly higher liver enzyme abnormalities occurred in less intensive group", was amended to "Significantly higher liver enzyme abnormalities occurred in intensive group".].
Chan
D K Y
DK
Department of Aged Care, Stroke and Rehabilitation, Bankstown-Lidcombe Hospital, Sydney, Australia. Daniel.Chan@sswahs.nsw.gov.au
O'Rourke
F
F
Shen
Q
Q
Mak
J C S
JC
Hung
W T
WT
D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000401:mortality* / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000037:antagonists & inhibitors* / Q000097:blood; D002986:Clinical Trials as Topic; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D015994:Incidence; D008875:Middle Aged; D016896:Treatment Outcome
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors