Meta-analysis of the cardiovascular benefits of intensive lipid lowering with statins

Chan DKY, O’Rourke F, Shen Q, Mak JCS, Hung WT. Meta‐analysis of the cardiovascular benefits of intensive lipid lowering with statins. Acta Neurol Scand: 2011: 124: 188–195. © 2010 John Wiley & Sons A/S. Objective – To evaluate the efficacy of intensive lipid lowering with higher‐dose statins. Methods – Meta‐analysis of seven randomized controlled trials comprising 50,972 participants. Results – Mean follow‐up was 3.1 years with mean age 63 years. Final LDL‐C levels in intensive lipid‐lowering group were 1.42–2.07 mmol/l compared to 2.1–3.5 mmol/l in the less intensive or control group. The intensive arm had significantly lower risks for stroke OR 0.80 (95% CI 0.71–0.89); major coronary events OR 0.74 (95% CI 0.65–0.83); cardiovascular disease (CVD) or coronary heart disease (CHD) deaths OR 0.84 (95% CI 0.74–0.95). Significantly higher liver enzyme abnormalities occurred in intensive group* (OR 3.96; 95% CI 2.08–7.53), but it was not associated with drug discontinuations (OR 1.20; 95% CI 0.88–1.64). Conclusion – In those at high risk of cardiovascular events, intensive lipid lowering with statins to LDL‐C level