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 .
Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease. Atorvastatin versus Revascularization Treatment Investigators.
BACKGROUND Percutaneous coronary revascularization is widely used in improving symptoms and exercise performance in patients with ischemic heart disease and stable angina pectoris . In this study , we compared percutaneous coronary revascularization with lipid-lowering treatment for reducing the incidence of ischemic events . METHODS We studied 341 patients with stable coronary artery disease , relatively normal left ventricular function , asymptomatic or mild-to-moderate angina , and a serum level of low-density lipoprotein ( LDL ) cholesterol of at least 115 mg per deciliter ( 3.0 mmol per liter ) who were referred for percutaneous revascularization .  We r and omly assigned the patients either to receive medical treatment with atorvastatin , at 80 mg per day ( 164 patients ) , or to undergo the recommended percutaneous revascularization procedure ( angioplasty ) followed by usual care , which could include lipid-lowering treatment ( 177 patients ) . The follow-up period was 18 months . RESULTS Twenty-two ( 13 percent ) of the patients who received aggressive lipid-lowering treatment with atorvastatin ( result ing in a 46 percent reduction in the mean serum LDL cholesterol level , to 77 mg per deciliter [ 2.0 mmol per liter ] ) had ischemic events , as compared with 37 ( 21 percent ) of the patients who underwent angioplasty ( who had an 18 percent reduction in the mean serum LDL cholesterol level , to 119 mg per deciliter [ 3.0 mmol per liter ] ) . The incidence of ischemic events was thus 36 percent lower in the atorvastatin group over an 18-month period ( P=0.048 , which was not statistically significant after adjustment for interim analyses ) . This reduction in events was due to a smaller number of angioplasty procedures , coronary-artery bypass operations , and hospitalizations for worsening angina . As compared with the patients who were treated with angioplasty and usual care , the patients who received atorvastatin had a significantly longer time to the first ischemic event ( P=0.03 ) . CONCLUSIONS In low-risk patients with stable coronary artery disease , aggressive lipid-lowering therapy is at least as effective as angioplasty and usual care in reducing the incidence of ischemic events
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 .