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 .
Pravastatin therapy in hyperlipidemia: effects on thrombus formation and the systemic hemostatic profile.
OBJECTIVES The study sought to determine the effects of lipid-lowering with pravastatin on the systemic fibrinolytic profile and on thrombus formation under dynamic flow conditions . BACKGROUND Lowering cholesterol ( C ) decreases clinical events in coronary artery disease ( CAD ) patients , but an analysis of the effects of lipid-lowering on the entire hemostatic and thrombotic profile has not been conducted . METHODS We prospect ively studied 93 stable patients with untreated low-density lipoprotein cholesterol ( LDL-C ) > 145 mg/dl . The CAD patients received pravastatin , and non-CAD patients were r and omized to pravastatin versus placebo ( double-blind ) . Thrombus formation upon an injured vascular surface was assessed in a sub study of 40 patients with a previously vali date d ex vivo perfusion chamber system . Systemic hemostatic markers and thrombus formation were evaluated at baseline , three and six months . RESULTS Placebo produced no changes in either the lipid profile , any of the hemostatic markers , or the ex vivo thrombus formation . Both pravastatin groups ( CAD and non-CAD ) showed decreased LDL-C by 30 % within 6 weeks ( 188 to 126 mg/dl , p < 0.001 vs. baseline ) , and decreased plasminogen activator inhibitor-1 at 3- and 6-month follow-up compared to baseline ( 15 % to 18 % decrease at 3 months and 21 % to 23 % at 6 months ) . For the tissue plasminogen activator antigen , CAD and non-CAD groups showed significant decreases at 6 months compared to baseline ( 10 % and 13 % , respectively ) . No significant changes were observed with treatment in d-dimer , fibrinopeptide A , prothrombin fragment F1.2 , factor VIIa , von Willebr and factor , or C-reactive protein . Fibrinogen levels were significantly increased at 6 months compared to baseline , though still below the upper normal limit . In the perfusion chamber sub study , there was a decrease in thrombus area in non-CAD patients treated with pravastatin at both 3 and 6 months compared to baseline ( by 21 % and 34 % , respectively ) . The CAD patients showed decreases in thrombus formation by 13 % at 3 months , and by 16 % at 6 months . The change in LDL-C- correlated modestly with the change in thrombus formation ( r = 0.49 ; p < 0.01 ) . CONCLUSIONS Pravastatin therapy significantly decreased thrombus formation and improved the fibrinolytic profile in patients with and without CAD . These early effects may , in part , explain the benefit rendered in primary and secondary prevention of CAD
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 .