Highlights
- •Used a Bayesian network meta-analysis to study CHD with using different statins.
- •Studied the efficacy and safety for treatment CHD with using different statins.
- •Only considered prospective cohort study, which has reliable data, less recall bias, better explain causal relationships.
- •Outcome included not only clinical indicators, but also ultimate outcomes, which better explained which statin is the best choice.
Abstract
Background and aims
Our study aims to evaluate the efficacy and safety of long-term treatment of statins
for coronary heart disease (CHD).
Methods
Efficacy outcomes included changes in blood lipids, risk of CHD mortality and all-cause
mortality. Safety outcomes were evaluated by the risk of adverse events (AE). Bayesian
network meta-analysis was used to compare the direct and indirect effects between
different statins.
Results
The systematic review showed that levels of blood lipids decreased during statin treatment.
High dose of atorvastatin was the most obvious treatment for the reduction of blood
lipids. Network meta-analysis showed that statins were significantly more effective
than the control in reducing the risk of CHD mortality (Odds Ratio (OR) 0.69, 95%
CI 0.61–0.77) and all-cause mortality (OR 0.84, 95% CI 0.80–0.87). In terms of reducing
the risk of CHD morality, fluvastatin (77.3%), atorvastatin (72.3%) and lovastatin
(68.4%) had higher cumulative probability than other statins, which were more effective
treatments for the reduction of CHD morality. In terms of reducing all-cause mortality,
atorvastatin (78.6%), fluvastatin (77.1%) and pitavastatin (74.1%) had higher cumulative
probability than other statins, which were more effective treatment for reducing the
all-cause mortality. Compared with placebo, statins increased the incidence risk of
muscle disease (OR 1.05, 95% CI 1.00–1.10) and kidney disease (OR 1.11, 95% CI 1.05–1.72).
Conclusions
Statins significantly reduced levels of blood lipids, with a high dose of atorvastatin
being the most effective in blood-lipid level modification. Statins reduced the risk
of CHD mortality and all-cause mortality, with atorvastatin and fluvastatin being
the most effective in reducing the risk of CHD mortality and all-cause mortality.
Statins increased the risk of muscle disease and kidney damage.
Keywords
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Article info
Publication history
Published online: October 13, 2016
Accepted:
October 13,
2016
Received in revised form:
October 6,
2016
Received:
July 10,
2016
Identification
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