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

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

doi:10.1111/bcpt.13485

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

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

Department of Cardiology

3 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Basic and Clinical Pharmacology and Toxicology
Volume	128
Issue number	2
Pages (from-to)	286-296
Number of pages	11
ISSN	1742-7835
DOIs	https://doi.org/10.1111/bcpt.13485
Publication status	Published - Feb 2021

Keywords

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

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10.1111/bcpt.13485

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Postponement of cardiovascular outcomes by statin use: A systematic review and meta-analysis of randomized clinical trials. / Hansen, Morten Rix; Hróbjartsson, Asbjørn; Pottegård, Anton et al.
In: Basic and Clinical Pharmacology and Toxicology, Vol. 128, No. 2, 02.2021, p. 286-296.

Research output: Contribution to journal › Journal article › Research › peer-review

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

abstract = "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.",

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year = "2021",

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doi = "10.1111/bcpt.13485",

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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

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.

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KW - Cause of Death

KW - Dyslipidemias/diagnosis

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KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects

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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 - https://www.scopus.com/pages/publications/85092167014

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 -

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

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