Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins
Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins
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DOI：
10.1016/s0140-6736(05)67394-1
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发表时间：
2005-10-08
期刊：
影响因子：
168.9
通讯作者：
Simes, J
中科院分区：
文献类型：
--
作者：
Baigent, C;Keech, A;Simes, J
先前的随机试验结果表明，降低LDL胆固醇浓度的干预措施可以显著降低冠心病（CHD）和其他主要血管事件的发生率。但每个单独的试验在评估特定结果或特定参与者类别方面的能力有限。方法对14项他汀类药物随机试验9056例患者的数据进行前瞻性荟萃分析。加权估计每降低1.0 mmol/L LDL胆固醇对不同临床结果的影响。在平均5年的时间里，有8186人死亡，14348人有重大血管事件，5103人患上癌症。在这些试验中，1年的平均LDL胆固醇差异范围从0.35 mmol/L到1.77 mmol/L（平均1.09）。低密度脂蛋白胆固醇每mmol/L降低，全因死亡率按比例降低12%(比率比[RR] 0.88, 95% CI 0.84-0.91
Background Results of previous randomised trials have shown that interventions that lower LDL cholesterol concentrations can significantly reduce the incidence of coronary heart disease (CHD) and other major vascular events in a wide range of individuals. But each separate trial has limited power to assess particular outcomes or particular categories of participant.Methods A prospective meta-analysis of data from 90 056 individuals in 14 randomised trials of statins was done. Weighted estimates were obtained of effects on different clinical outcomes per 1.0 mmol/L reduction in LDL cholesterol.Findings During a mean of 5 years, there were 8186 deaths, 14 348 individuals had major vascular events, and 5103 developed cancer. Mean LDL cholesterol differences at 1 year ranged from 0.35 mmol/L to 1.77 mmol/L (mean 1.09) in these trials. There was a 12% proportional reduction in all-cause mortality per mmol/L reduction in LDL cholesterol (rate ratio [RR] 0.88, 95% CI 0.84-0.91; p