Research in context
Lowering of LDL cholesterol with a statin reduces the risk of myocardial infarction, coronary death, ischaemic stroke, and coronary revascularisation by about one fifth per 1 mmol/L LDL cholesterol reduction in a wide range of people.1x1Cholesterol Treatment Trialists' (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. Lancet. 2010;
Summary | Full Text | Full Text PDF | PubMed | Scopus (1134)See all References1 However, tabular meta-analyses of people at low risk of these events, studied predominantly in primary prevention trials, have concluded that statin therapy might not result in worthwhile net benefit in this group.3x3Ray, KK, Seshasai, SR, Erqou, S et al. Statins and all-cause mortality in high-risk primary prevention: a meta-analysis of 11 randomized controlled trials involving 65,229 participants. Arch Intern Med. 2010; 170: 1024–1031
CrossRef | PubMed | Scopus (219)See all References, 4x4Taylor, F, Ward, K, Moore, TH et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2011; 1 (CD004816.)
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Individual participant data in the Cholesterol Treatment Trialists' Collaboration of 27 trials involving 175 000 participants showed that statin therapy reduces the risk of major vascular events (non-fatal myocardial infarction, coronary death, coronary revascularisation, or stroke) in people with 5-year risk of such an event lower than 10% (and, separately, in those at 5-year risk <5%), and in these people each 1·0 mmol/L reduction in LDL cholesterol produces 11 fewer major vascular events per 1000 treated over 5 years, a benefit that greatly exceeds any known hazards of statin therapy.