Statin therapy for prevention and treatment of acute and chronic cardiovascular disease: Update on recent trials and metaanalyses

Current Opinion in Lipidology

Volumn 16, Issue 6, 2005, Pages 601-605

  Briel, Matthias ^a   Nordmann, Alain J ^a   Bucher, Heiner C ^a  

^a UNIVERSITY HOSPITAL BASEL   (Switzerland)

Author keywords

Coronary artery disease; Metaanalysis; Randomized controlled trial; Statin therapy

Indexed keywords

ANTILIPEMIC AGENT; ATORVASTATIN; CREATINE KINASE; FLUINDOSTATIN; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LOW DENSITY LIPOPROTEIN CHOLESTEROL; MEVINOLIN; PLACEBO; PRAVASTATIN; ROSUVASTATIN; SIMVASTATIN;

ABNORMALLY HIGH SUBSTRATE CONCENTRATION IN BLOOD; ACUTE CORONARY SYNDROME; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CHOLESTEROL BLOOD LEVEL; CLINICAL TRIAL; CORONARY ARTERY DISEASE; CORONARY RISK; CREATINE KINASE BLOOD LEVEL; DEATH; DIABETES MELLITUS; DRUG EFFICACY; HEART INFARCTION; HUMAN; KIDNEY FAILURE; META ANALYSIS; MORBIDITY; MORTALITY; MUSCLE DISEASE; MYOPATHY; NON INSULIN DEPENDENT DIABETES MELLITUS; PRIMARY PREVENTION; PRIORITY JOURNAL; RANDOMIZATION; REVIEW; RHABDOMYOLYSIS; RISK REDUCTION; SECONDARY PREVENTION; STROKE; SYSTEMATIC REVIEW;

ACUTE DISEASE; CARDIOVASCULAR DISEASES; CHRONIC DISEASE; HUMANS; HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS; META-ANALYSIS AS TOPIC; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 29444440835     PISSN: 09579672     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (28)

1. 4S-Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344:1383-389.
2. Studer M, Briel M, Leimenstoll B, et al. Effect of different antilipidemic agents and diets on mortality: a systematic review. Arch Intern Med 2005; 165:725-730. This metaanalysis summarizes a large body of evidence about different lipid-lowering interventions.
3. Briel M, Studer M, Glass TR, Bucher HC. Effects of statins on stroke prevention in patients with and without coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med 2004; 117:596-606. The results of this study suggest for the first time that statins reduce the incidence of stroke not only in patients with clinically established CAD but also in patients without the condition.
4. Amarenco P, Bogousslavsky J, Callahan AS, et al. Design and baseline characteristics of the stroke prevention by aggressive reduction in cholesterol levels (SPARCL) study. Cerebrovasc Dis 2003; 16:389-395.
5. Fellstrom B, Zannad F, Schmieder R, et al. Effect of rosuvastatin on outcomes in chronic haemodialysis patients: design and rationale of the AURORA study. Curr Control Trials Cardiovasc Med 2005; 6:9.
6. Prisant LM. Clinical trials and lipid guidelines for type II diabetes. J Clin Pharmacol 2004; 44:423-430.
7. MacMahon M, Kirkpatrick C, Cummings CE, et al. A pilot study with simvastatin and folic acid/vitamin B12 in preparation for the Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH). Nutr Metab Cardiovasc Dis 2000; 10:195-203.
8. Pedersen TR, Faergeman O, Kastelein JJ, et al. Design and baseline characteristics of the Incremental Decrease in Endpoints through Aggressive Lipid Lowering study. Am J Cardiol 2004; 94:720-724.
9. Collins R, Armitage J, Parish S, et al. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet 2003; 361:2005-2016.
10. ALLHAT-Investigators. Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: the Anti-hypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA 2002; 288:2998-3007.
11. Sever PS, Dahlof B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet 2003; 361:1149-1158.
12. Sever PS, Poulter NR, Dahlof B, et al. Reduction in cardiovascular events with atorvastatin in 2,532 patients with type 2 diabetes: Anglo-Scandinavian Cardiac Outcomes Trial-lipid-lowering arm (ASCOT-LLA). Diabetes Care 2005; 28:1151-1157. Large trial with a substantial number of patients with diabetes that allowed comparison of the effects of statins in patients with and without diabetes.
13. Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet 2004; 364:685-696. The trial included almost 3000 patients with type 2 diabetes and no cardiovascular disease. It suggested a clinical benefit even for patients with LDL cholesterol levels less than 2.6 mmol/l (100 mg/dl).
14. Wanner C, Krane V, Marz W, et al. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med 2005; 353:238-248. This is the first trial in patients with diabetes and end-stage renal disease that was adequately powered to show the effects of atorvastatin on clinical outcomes.
15. De Lemos JA, Blazing MA, Wiviott SD, et al. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA 2004; 292:1307-1316. Well designed, large clinical trial that investigated early treatment with simvastatin in patients with ACS. An increased myopathy rate with simvastatin 80 mg/day raised safety concerns about high-dose simvastatin.
16. LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352:1425-1435. Very large trial that compared a high dose with a moderate dose of atorvastatin in patients with stable CAD and low levels of LDL cholesterol. The results of this trial will impact current guidelines.
17. Protocol for a prospective collaborative overview of all current and planned randomized trials of cholesterol treatment regimens. Cholesterol Treatment Trialists' (CTT) Collaboration. Am J Cardiol 1995; 75:1130-1134.
18. Sposito AC, Chapman MJ. Statin therapy in acute coronary syndromes: mechanistic insight into clinical benefit. Arterioscler Thromb Vasc Biol 2002; 22:1524-1534.
19. Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 2001; 285:1711-1718.
20. Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 2004; 350:1495-1504.
21. Ridker PM, Cannon CP, Morrow D, et al. C-reactive protein levels and outcomes after statin therapy. N Engl J Med 2005; 352:20-28. This substudy of PROVE IT showed convincingly that lowering of CRP with statins is associated with a clinical benefit independently of the LDL cholesterol level.
22. Nissen SE, Tuzcu EM, Schoenhagen P, et al. Statin therapy, LDL cholesterol, C-reactive protein, and coronary artery disease. N Engl J Med 2005; 352:29-38. Well designed ultrasound study that showed a correlation of CRP levels with the progression of atherosclerosis independently of lipid levels.
23. Davidson MH, Stein EA, Hunninghake DB, et al. Lipid-altering efficacy and safety of simvastatin 80 mg/day: worldwide long-term experience in patients with hypercholesterolemia. Nutr Metab Cardiovasc Dis 2000; 10:253-262.
24. Thompson PD, Clarkson P, Karas RH. Statin-associated myopathy. JAMA 2003; 289:1681-1690.
25. Pitt B. Low-density lipoprotein cholesterol in patients with stable coronary heart disease: is it time to shift our goals? N Engl J Med 2005; 352:1483-1484.
26. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285:2486-2497.
27. de Backer G, Ambrosioni E, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2003; 24:1601-1610.
28. Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Arterioscler Thromb Vasc Biol 2004; 24:e149-e161. This is the most recent update of official guidelines for lipid-lowering in adults.