Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects .
There was no evidence of any serious harm caused by statin prescription .
Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life .
Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event .
AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins
BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy .
Statins are the first-choice agents .
Previous review s of the effects of statins have highlighted their benefits in people with CVD .
The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required .
OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .
Long-term treatment with pitavastatin (NK-104), a new HMG-CoA reductase inhibitor, of patients with heterozygous familial hypercholesterolemia.
The clinical efficacy and safety of pitavastatin ( NK-104 ) , a novel HMG-CoA reductase inhibitor , during long-term treatment , were examined in 25 patients ( male/female=11/14 , mean age=53+/-13 ( mean+/-SD ) years ) with heterozygous familial hypercholesterolemia ( FH ) . After a period on placebo of > 4 weeks , 2 mg/day of pitavastatin was administered for 8 weeks , and the dose was increased to 4 mg/day for up to 104 weeks . Total cholesterol ( TC ) decreased by 31 % from the initial value of 340+/-57 to 237+/-40 mg/dl ( P<0.0001 ) at week 8 . During treatment with the higher dose , TC decreased even further to 212+/-35 mg/dl at week 12 ; it decreased by 37 % from the initial value ( P<0.0001 ) . Similarly , the baseline low-density lipoprotein (LDL)-cholesterol ( LDL-C ) decreased by 41 % at week 8 , and by 49 % at week 12 , from 267+/-61 mg/dl at baseline . These findings indicate a dose-dependent effect of the drug on TC and LDL-C concentrations . To examine whether the levels of circulating matrix metalloproteinases ( MMPs ) and their endogenous inhibitors ( tissue inhibitors of metalloproteinases : TIMPs ) are altered during lipid-lowering therapy , we also measured their plasma levels . The mean levels of MMP-2 and -3 were significantly increased . No significant alteration was found in MMP-9 , TIMP-1 and -2 levels . As for the safety of pitavastatin , adverse reactions were observed in one case ( 4 % ) of subjective and objective symptoms . The effects of pitavastatin on TC and LDL-C were stable during long treatment of patients with heterozygous FH
Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects .
There was no evidence of any serious harm caused by statin prescription .
Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life .
Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event .
AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins
BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy .
Statins are the first-choice agents .
Previous review s of the effects of statins have highlighted their benefits in people with CVD .
The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required .
OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .