Pleiotropic effects of statins: benefit beyond cholesterol reduction? A meta-regression analysis

Jennifer G Robinson; Brian Smith; Nidhi Maheshwari; Helmut Schrott

doi:10.1016/j.jacc.2005.05.085

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Pleiotropic effects of statins: benefit beyond cholesterol reduction? A meta-regression analysis

Journal article

Open access

Peer reviewed

Pleiotropic effects of statins: benefit beyond cholesterol reduction? A meta-regression analysis

Jennifer G Robinson, Brian Smith, Nidhi Maheshwari and Helmut Schrott

Journal of the American College of Cardiology, Vol.46(10), pp.1855-1862

11/15/2005

DOI: 10.1016/j.jacc.2005.05.085

PMID: 16286171

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Abstract

This study sought to determine whether statins reduce coronary heart disease (CHD) risk more than other interventions that also primarily lower low-density lipoprotein cholesterol (LDL-C). Statins have anti-inflammatory, immunomodulatory, antithrombotic, vascular, and other non-LDL-C-lowering effects. It is unclear whether these pleiotropic effects contribute to cardiovascular risk reduction beyond that expected from LDL-C reduction alone. Trials published in English language journals were retrieved by searching Medline (1966 to October 2004), bibliographies, and the author's reference files. Randomized, placebo-controlled trials of interventions to primarily lower LDL-C of three or more years' duration in which clinical disease or death were primary outcomes were used. Information on sample size, treatment type and duration, participant characteristics at baseline, reduction in lipids, and outcome was independently abstracted by two authors (J.R. and N.M.) using a standardized protocol. Data from 5 diet, 3 bile acid sequestrant, 1 surgery, and 10 statin trials, with 81,859 participants, were included in the CHD meta-regression analysis. The regression lines for non-statin and statin trials were similar and consistent with a one-to-one relationship between LDL-C lowering and CHD and stroke reduction over five years of treatment. The pleiotropic effects of statins do not seem to contribute an additional cardiovascular risk reduction benefit beyond that expected from the degree of LDL-C lowering observed in other trials that primarily lowered LDL-C.

Coronary Disease - blood

Regression Analysis

Humans

Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use

Coronary Disease - drug therapy

Cholesterol, LDL - blood

Clinical Trials as Topic

Details

Title: Subtitle: Pleiotropic effects of statins: benefit beyond cholesterol reduction? A meta-regression analysis
Creators: Jennifer G Robinson - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA. jennifer-g-robinson@uiowa.edu
Brian Smith
Nidhi Maheshwari
Helmut Schrott
Resource Type: Journal article
Publication Details: Journal of the American College of Cardiology, Vol.46(10), pp.1855-1862
DOI: 10.1016/j.jacc.2005.05.085
PMID: 16286171
NLM abbreviation: J Am Coll Cardiol
ISSN: 0735-1097
eISSN: 1558-3597
Publisher: United States
Language: English
Date published: 11/15/2005
Academic Unit: Epidemiology; Biostatistics; Holden Comprehensive Cancer Center; Internal Medicine
Record Identifier: 9983995033302771

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