Primary prevention of cardiovascular mortality and events with statin treatments: A network meta-analysis involving more than 65,000 patients
Mills EJ et al. – Statins have a clear role in primary prevention of cardiovascular disease (CVD) mortality and major events. Methods- Study to evaluate effectiveness of 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (statins) in primary prevention of cardiovascular events
- Comprehensive searches of 10 electronic databases from inception to May 2008
- Contact of study investigators for maintainence of a comprehensive bibliography of statin studies
- Review of randomized trials of ≥12-mo duration in predominantly primary prevention populations
- Independent data extraction in duplicate by 2 reviewers
- Random-effects meta-analysis and meta-regression, calculation of optimal information size, and mixed-treatment comparison analysis
Results- Of 20 randomized clinical trials, 19 trials pooled (63,899 pts) for all-cause mortality
- Pooled data showed relative risk (RR) of 0.93
- Cardiovascular deaths assessed in 18 trials (59,469 pts)
- Major cardiovascular events assessed in 17 trials (53,371 pts) with RR of 0.85; 17 trials (52,976 pts) assessed myocardial infarctions
- Incidence of cancer not elevated in 10 trials (45,469 pts) nor was rhabdomyolysis
- Analysis included a sufficient sample to reliably answer primary outcome of CVD mortality
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