Statins and primary prevention of cardiovascular diseases: is there any point?

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Abstract

Increased blood cholesterol level is one of the most studied risk factors for cardiovascular diseases. While benefits of statins in secondary prevention are shown, their role in primary prevention is not clear. To assess the potential benefits of statin use in primary prevention of cardiovascular diseases, we searched databases for published data in English language for secondary analyses of clinical trials of statin use in primary prevention of cardiovascular diseases. The data on clinical outcomes were extracted to calculate the ratio of beneficial effect to no effect (benefit/no effect ratio - BNER). One Cochrane systematic review and 5 meta-analyses were found, including 27 clinical trials. The authors of four out of six reviews declared potential conflict of interests with pharmaceutical companies manufacturing statins. We could not extract data on individual outcomes because they were not reported. For deaths of all causes, the BNER was 3:3 as assessed in 6 analyses. Only three reviews examined the effects of statins on coronary events and all reported positive effect of statins. Four out of six reviews reported data on coronary heart disease mortality and all found no positive effect of statins. Cardiovascular events and mortality were evaluated in two and three reviews, respectively, which showed positive effect of statins. Thus, there is no convincing evidence for statin use in primary prevention. The new studies, if carried out, should be of longer duration and follow-up, should use individual outcomes. Prevention with statins in patients with no history of cardiovascular disease should be performed with great caution, if considered at all.

About the authors

D D Safina

Kazan (Volga Region) Federal University, Kazan, Russia

Email: diliarik@rambler.ru

L E Ziganshina

Kazan (Volga Region) Federal University, Kazan, Russia

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© 2013 Safina D.D., Ziganshina L.E.

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