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Efficacy and safety evaluation of intensive statin therapy in older patients with coronary heart disease: a systematic review and meta-analysis.
- Source :
- European Journal of Clinical Pharmacology; Dec2013, Vol. 69 Issue 12, p2001-2009, 9p, 1 Diagram, 11 Charts
- Publication Year :
- 2013
-
Abstract
- Purpose: To reveal and evaluate the efficacy and safety of intensive statin therapy in older patients (age ≥ 65 years) with coronary heart disease (CHD). Methods: Electronic databases were searched for randomized controlled trials (RCTs) that involved intensive statin therapy use in older patients with CHD. Data was extracted and used to calculate risk ratios (RR) by software Revman 5.1. Results: Five RCTs and 11,132 patients were included in. Compared with non-intensive statin therapy, intensive statin therapy had significant effect on reducing low density lipoprotein cholesterol (LDL-C) levels (55.4 %) and total cholesterol (TC) and triglyceride (Tg). Although the results showed that intensive statin therapy had no superior effect on reduction of mortality (both all-cause mortality [RR = 0.97, p = 0.65] and cardiac death [RR = 0.95, p = 0.57]) and cardiac arrest (RR = 1.09, p = 0.81), it possessed significant effects on prevention of nonfatal myocardial infarction (MI) (RR = 0.78, p = 0.008), stroke (RR = 0.72, p = 0.02) and coronary revascularization (RR = 0.69, p = 0.007). In terms of side effects, intensive statin therapy was associated with small absolute increase in incidence of drug discontinuation, due to adverse events (3.9 %) and liver enzymes abnormalities (1.7 %). And the occurrence rates of myopathy, rhabdomyolysis and creatine kinase (CK) elevation were very low. Conclusions: This results show that intensive statin therapy has excellent effects on reduction of serum lipid level including LDL-C, TC, Tg, and also on prevention of nonfatal MI, stroke and coronary revascularization with small absolute increased risk of side effects. Our analysis supports the use of intensive statin therapy in patients ≥ 65 years old with CHD. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHI-squared test
CONFIDENCE intervals
CORONARY disease
MEDICAL information storage & retrieval systems
MEDLINE
META-analysis
ONLINE information services
PATIENT safety
SYSTEMATIC reviews
STATINS (Cardiovascular agents)
DATA analysis
RELATIVE medical risk
DATA analysis software
DESCRIPTIVE statistics
OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 00316970
- Volume :
- 69
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- European Journal of Clinical Pharmacology
- Publication Type :
- Academic Journal
- Accession number :
- 92014258
- Full Text :
- https://doi.org/10.1007/s00228-013-1570-0