Abstract 5141 The Use of Statins in the Primary Prevention of Cardiovascular Disease: A Combined Analysis of Nine Randomized Controlled Trials
Background The benefits of statin treatment on reducing mortality in patients with cardiovascular disease (CVD) are clearly demonstrated in recent years. However, to expand the use of statins to primary prevention purposes is more debated. Until now, no strong benefit on reducing all-cause mortality has been shown in meta-analyses.
Objective: This study was designed to determine whether statins reduce all-cause mortality and cardiovascular events in patients without CVD.
Methods: We included nine randomized placebo-controlled clinical trials involving 52,586 patients without cardiovascular disease. The included trials focussed primarily on primary prevention with statins. Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random effects model.
Results: The mean age was 58.5 (range 55.3 to 75), and mean follow-up was 4.9 years (range 3.2 to 5.3), 32.1% were female (n=16880), and 30.6% diabetic (n=16078). This analysis is the first to show a significant reduction of all-cause mortality (OR 0.90; 95%CI, 0.83– 0.99) and coronary heart disease mortality (OR 0.85; 95%CI, 0.73– 0.98). Furthermore, statin therapy reduced major coronary events (OR 0.68; 95% CI, 0.57– 0.82), major cerebrovascular events (OR 0.87; 0.77– 0.97), non-fatal myocardial infarction (OR 0.73; 95% CI, 0.60 – 0.89), and revascularizations (OR 0.70; 95% CI, 0.60 – 0.81). No evidence of an increased risk of cancer due to statins was observed. Results are presented in figure 1⇓.
Conclusion: Statins significantly reduced all-cause mortality and cardiovascular events in patients free of CVD. Our analysis suggests expanding the use of statins for primary prevention purposes.