TY - JOUR
T1 - Postponement of cardiovascular outcomes by statin use
T2 - A systematic review and meta-analysis of randomized clinical trials
AU - Hansen, Morten Rix
AU - Hróbjartsson, Asbjørn
AU - Pottegård, Anton
AU - Damkier, Per
AU - Madsen, Kenneth Grønkjaer
AU - Pareek, Manan
AU - Olesen, Morten
AU - Hallas, Jesper
N1 - © 2020 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).
PY - 2021/2
Y1 - 2021/2
N2 - OBJECTIVE: To estimate the average outcome postponement (gain in days to an event) for cardiovascular outcomes in a meta-analysis of randomized, controlled statin trials, including any myocardial infarction, any stroke and cardiovascular death.DESIGN: Systematic review of large randomized, placebo-controlled trials of statin use, including a random-effects meta-analysis of all included trials.DATA SOURCES: We searched MEDLINE (15 July 2019) and ClinicalTrials.gov (16 October 2019).ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomized, placebo-controlled trials of statin use that included at least 1000 participants. We identified 15 cardiovascular outcomes that were reported in more than 2 trials.RESULTS: We included 19 trials. The summary outcome postponements for the 15 cardiovascular outcomes varied between -1 and 38 days. For four major outcomes, the summary outcome postponement in days was as follows: cardiovascular mortality, 9.27 days (95% CI: 3.6 to 14.91; I2 = 72%; 9 trials) non-vascular and non-cardiovascular mortality, 1.5 days (95% CI: -2.2 to 5.3; I2 = 0%; 6 trials) any myocardial infarction 18.0 days (95% CI; 12.1 to 24.1; I2 = 92%; 15 trials); and any stroke, 6.1 days (95% CI; 2.86 to 9.39; I2 = 66%; 14 trials).CONCLUSION: Statin treatment provided a small, average postponement of cardiovascular outcomes during trial duration.
AB - OBJECTIVE: To estimate the average outcome postponement (gain in days to an event) for cardiovascular outcomes in a meta-analysis of randomized, controlled statin trials, including any myocardial infarction, any stroke and cardiovascular death.DESIGN: Systematic review of large randomized, placebo-controlled trials of statin use, including a random-effects meta-analysis of all included trials.DATA SOURCES: We searched MEDLINE (15 July 2019) and ClinicalTrials.gov (16 October 2019).ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomized, placebo-controlled trials of statin use that included at least 1000 participants. We identified 15 cardiovascular outcomes that were reported in more than 2 trials.RESULTS: We included 19 trials. The summary outcome postponements for the 15 cardiovascular outcomes varied between -1 and 38 days. For four major outcomes, the summary outcome postponement in days was as follows: cardiovascular mortality, 9.27 days (95% CI: 3.6 to 14.91; I2 = 72%; 9 trials) non-vascular and non-cardiovascular mortality, 1.5 days (95% CI: -2.2 to 5.3; I2 = 0%; 6 trials) any myocardial infarction 18.0 days (95% CI; 12.1 to 24.1; I2 = 92%; 15 trials); and any stroke, 6.1 days (95% CI; 2.86 to 9.39; I2 = 66%; 14 trials).CONCLUSION: Statin treatment provided a small, average postponement of cardiovascular outcomes during trial duration.
KW - Cardiovascular Diseases/diagnosis
KW - Cause of Death
KW - Dyslipidemias/diagnosis
KW - Humans
KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects
KW - Primary Prevention
KW - Randomized Controlled Trials as Topic
KW - Risk Assessment
KW - Risk Factors
KW - Secondary Prevention
KW - Time Factors
KW - Treatment Outcome
KW - effect measures
KW - meta-analysis
KW - outcome postponement
KW - cardiovascular endpoints
KW - statins
KW - cholesterol
UR - http://www.scopus.com/inward/record.url?scp=85092167014&partnerID=8YFLogxK
U2 - 10.1111/bcpt.13485
DO - 10.1111/bcpt.13485
M3 - Journal article
C2 - 32896109
SN - 1742-7835
VL - 128
SP - 286
EP - 296
JO - Basic and Clinical Pharmacology and Toxicology
JF - Basic and Clinical Pharmacology and Toxicology
IS - 2
ER -