Statin therapy in the prevention of recurrent cardiovascular events: a sex-based meta-analysis.
BACKGROUND
The effect of statins on the prevention of cardiovascular events is well demonstrated. Whether this protective effect is equal for women and men remains less well established. Our objective was to evaluate if statin therapy is equally effective in decreasing recurrent cardiovascular events in women and men.


METHODS
Randomized clinical trials were searched in PubMed using as indexing terms (statins OR cholesterol lowering medications) AND (cardiovascular events OR stroke OR myocardial infarction OR cardiovascular death).


METHODS
We included randomized, double-blinded, placebo-controlled trials evaluating statins for secondary prevention of cardiovascular events. Studies with an open-label design and observational studies were excluded.


METHODS
The earliest citation was used to determine the characteristic of the studied population and the methodology. All subsequent citations corresponding to the trial were evaluated for outcome rates by sex.


RESULTS
Eleven trials representing 43,193 patients were included in the analysis. Overall, statin therapy was associated with a reduced risk of cardiovascular events in all outcomes for women (relative risk [RR], 0.81 [95% CI, 0.74-0.89]) and men (RR, 0.82 [95% CI, 0.78-0.85]). However, they did not reduce all-cause mortality in women vs men (RR, 0.92 [95% CI, 0.76-1.13] vs RR, 0.79 [95% CI, 0.720.87]) or stroke (RR, 0.92 [95% CI, 0.76-1.10] vs RR, 0.81 [95% CI, 0.72-0.92]).


CONCLUSIONS
Statin therapy is an effective intervention in the secondary prevention of cardiovascular events in both sexes, but there is no benefit on stroke and all-cause mortality in women.
Department of Neurology, Neurological Institute, Columbia University, New York, New York 10032, USA. jg3233@columbia.edu
Jose
J
Gutierrez
Gilbert
G
Ramirez
Tatjana
T
Rundek
Ralph L
RL
Sacco
D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy; D008297:Male; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D012737:Sex Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors