Statin use is associated with improved survival and considerable reduction in risk of major cardiovascular events in patients with cardiovascular risk factors but without established cardiovascular disease, according to a study in the online June 30 BMJ.
J.J. Brugts, MD, of the Erasmus MC Thoraxcenter in Rotterdam, the Netherlands, and colleagues, sought to identify the effect of statins in people without established cardiovascular disease, but with risk factors, and if these factors differed between men and women, younger and older patients, and in people with diabetes mellitus. The Cochrane controlled trials register, Embase, and Medline were used in the study, a meta-analysis of randomized trials including 70,388 people (34% women; 23% with diabetes mellitus).
The clinical effects of statins compared with placebo or control group were observed by two independent investigators. Mean follow-up time was 4.1 years. All-cause mortality was the primary endpoint. Death from coronary heart disease, nonfatal myocardial infarction, and fatal and nonfatal stroke were secondary endpoints.
“Treatment with statins significantly reduced the risk of all-cause mortality (odds ratio [OR], 0.88), major coronary events (OR, 0.70), and major cerebrovascular events (0.81),” Dr. Brugts’s group reported. During follow-up, 5.7% of subjects died in the control group, compared with 5.1% of those in the statin group. “Statin therapy was therefore associated with a 12% risk reduction in all-cause mortality compared with the control [group] (OR, 0.88),” Dr. Brugts and coauthors stated.
The annual rate for all-cause mortality with placebo was 1.4%. A 30% risk reduction was noted for major coronary events when comparing participants in the statin group (4.1%) with those in the control group (5.4%). The annual rate for major coronary events with placebo was 1.1%. A total of 2.3% of subjects in the control group experienced a major cerebrovascular event, compared with 1.9% in the statin group (19% risk reduction).
The annual rate for major cerebrovascular events with placebo was 0.6%, for coronary heart disease mortality with placebo it was 0.3%, for nonfatal myocardial infarction it was 0.6%, for revascularization it was 0.6%, and for incidence of cancer it was 1.2%.
“Statin therapy was associated with a significant risk reduction in all-cause mortality of 12%, in major coronary events of 30%, and in major cerebrovascular events of 19%,” Dr. Brugts and coauthors concluded. “Moreover, statin use was not associated with an increased risk of cancer.”