title: Efficacy and safety of long-term treatment with statins for coronary heart disease: A Bayesian network meta-analysis.
abstract: Our study aims to evaluate the efficacy and safety of long-term treatment of statins for coronary heart disease (CHD).
  
  
  
  Efficacy outcomes included changes in blood lipids, risk of CHD mortality and all-cause mortality. Safety outcomes were evaluated by the risk of adverse events (AE). Bayesian network meta-analysis was used to compare the direct and indirect effects between different statins.
  
  
  
  The systematic review showed that levels of blood lipids decreased during statin treatment. High dose of atorvastatin was the most obvious treatment for the reduction of blood lipids. Network meta-analysis showed that statins were significantly more effective than the control in reducing the risk of CHD mortality (Odds Ratio (OR) 0.69, 95% CI 0.61-0.77) and all-cause mortality (OR 0.84, 95% CI 0.80-0.87). In terms of reducing the risk of CHD morality, fluvastatin (77.3%), atorvastatin (72.3%) and lovastatin (68.4%) had higher cumulative probability than other statins, which were more effective treatments for the reduction of CHD morality. In terms of reducing all-cause mortality, atorvastatin (78.6%), fluvastatin (77.1%) and pitavastatin (74.1%) had higher cumulative probability than other statins, which were more effective treatment for reducing the all-cause mortality. Compared with placebo, statins increased the incidence risk of muscle disease (OR 1.05, 95% CI 1.00-1.10) and kidney disease (OR 1.11, 95% CI 1.05-1.72).
  
  
  
  Statins significantly reduced levels of blood lipids, with a high dose of atorvastatin being the most effective in blood-lipid level modification. Statins reduced the risk of CHD mortality and all-cause mortality, with atorvastatin and fluvastatin being the most effective in reducing the risk of CHD mortality and all-cause mortality. Statins increased the risk of muscle disease and kidney damage.
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China.
authors.forename: Yongbin
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Center of Evidence-based Medicine of Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, Gansu, PR China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China.
authors.forename: Yaxue
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Chang
authors.affiliation: Yale University and US. Fulbright Program, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chan
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China.
authors.forename: Yana
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou University, Lanzhou, Gansu 730000, PR China. Electronic address: chengn@lzu.edu.cn.
authors.forename: Ning
authors.initials: N
authors.lastname: Cheng
mesh_terms: D000924:Anticholesteremic Agents / Q000494:pharmacology; D000069059:Atorvastatin / Q000494:pharmacology; D001499:Bayes Theorem; D003327:Coronary Disease / Q000188:drug therapy* / Q000473:pathology; D005229:Fatty Acids, Monounsaturated / Q000494:pharmacology; D000077340:Fluvastatin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology*; D007211:Indoles / Q000494:pharmacology; D007674:Kidney Diseases / Q000188:drug therapy; D008055:Lipids / Q000097:blood; D008148:Lovastatin / Q000031:analogs & derivatives / Q000494:pharmacology; D009132:Muscles / Q000187:drug effects; D061214:Patient Safety; D017035:Pravastatin / Q000494:pharmacology; D011804:Quinolines / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic; D019821:Simvastatin / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D008055:Lipids; D011804:Quinolines; C012258:mevastatin; D000077340:Fluvastatin; D008148:Lovastatin; D000069059:Atorvastatin; D019821:Simvastatin; D017035:Pravastatin; C108475:pitavastatin
keywords: Blood-lipid; CHD; Efficacy; Mortality; Safety; Statin