Clinical and public health assessment of benefits and risks of statins in primary prevention of coronary events: Resolved and unresolved issues

Yola Moride, Robert A. Hegele, Anatoly Langer, Ruth McPherson, David B. Miller, Stéphane Rinfret

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations

Abstract

Peer-reviewed, evidence-based recommendations for statin use in primary prevention of cardiovascular events are limited. A narrative review of published randomized controlled trials and meta-analyses was conducted to critically appraise the benefits and risks of statins in primary prevention. Statins effectively reduce plasma concentrations of low-density lipoprotein cholesterol, and reduce the risk of cardiovascular events and death. The greatest benefits are observed in high-risk subjects, such as patients with diabetes or hypertension. Serious cardiovascular events should not be included among serious adverse events because they are efficacy outcomes and are dependent on the baseline risk of patients. Rates of specific serious adverse events, such as cancer and rhabdomyolysis, seem to be similar between the statin and control arms of the clinical trials examined. Thus, the benefits of statins in primary prevention outweigh the risks, particularly among high-risk patients. However, the benefit-risk ratio would likely be optimized through interventions designed to increase persistence and adherence in a real-life setting.

Original languageEnglish (US)
Pages (from-to)293-300
Number of pages8
JournalCanadian Journal of Cardiology
Volume24
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Keywords

  • Clinical trials
  • Coronary artery disease
  • Drugs
  • Health outcomes
  • Hypercholesterolemia
  • Prevention

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