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Postponement of cardiovascular outcomes by statin use: A systematic review and meta-analysis of randomized clinical trials

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  • Morten Rix Hansen
  • Asbjørn Hróbjartsson
  • Anton Pottegård
  • Per Damkier
  • Kenneth Grønkjaer Madsen
  • Manan Pareek
  • Morten Olesen
  • Jesper Hallas
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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 (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.

Original languageEnglish
JournalBasic & clinical pharmacology & toxicology
Issue number2
Pages (from-to)286-296
Number of pages11
Publication statusPublished - Feb 2021

    Research areas

  • Cardiovascular Diseases/diagnosis, Cause of Death, Dyslipidemias/diagnosis, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects, Primary Prevention, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Secondary Prevention, Time Factors, Treatment Outcome, effect measures, meta-analysis, outcome postponement, cardiovascular endpoints, statins, cholesterol

ID: 67447606