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Benefits of statins appear varied and modest in meta-analysis

JAMA Internal Medicine
Reuters Health - 17/03/2022 - The link between statin-induced lowering of LDL cholesterol and protection from heart attack and stroke may not be as strong as previously thought, according to a systematic review and meta-analysis.

"The message has long been that lowering your cholesterol will reduce your risk of heart disease, and that statins help to achieve this. However, our research indicates that, in reality, the benefits of taking statins are varied and can be quite modest," Dr. Paula Byrne of the HRB Center for Primary Care Research, RCSI University of Medicine and Health Sciences, in Dublin, Ireland, said in a news release.

The meta-analysis included 21 large randomized primary- and secondary-prevention trials that tested statin therapy against placebo or usual care for reducing total mortality and cardiovascular outcomes.

While there was "significant heterogeneity" between trials, statin use was associated with an absolute risk reduction for all-cause mortality of 0.8 percentage points (95% CI, 0.4 to 1.2).

The absolute risk reduction for heart attack was 1.3 percentage points (95% CI, 0.9 to 1.7), and for stroke it was 0.4 percentage points (95% CI, 0.2 to 0.6).

The corresponding relative risk reductions with statin therapy were 9%, 29% and 14%.

"A meta-regression was inconclusive regarding the association between the magnitude of statin-induced LDL-C reduction and all-cause mortality, myocardial infarction, or stroke," the researchers note in JAMA Internal Medicine.

"The study results suggest that the absolute benefits of statins are modest, may not be strongly mediated through the degree of LDL-C reduction, and should be communicated to patients as part of informed clinical decision-making as well as to inform clinical guidelines and policy," Dr. Bryne and colleagues write.

"In addition, our findings have implications for future clinical guideline development and for policy makers and payers considering the opportunity cost of statin therapy," they add.

The study had no specific funding and the authors have no relevant disclosures.

SOURCE: https://bit.ly/3qbw0nQ JAMA Internal Medicine, online March 14, 2022.

By Reuters Staff

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