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 .
Changes in sequential coronary arteriograms and subsequent coronary events. Surgical Control of the Hyperlipidemias (POSCH) Group.
OBJECTIVE Assessment of the relationship between changes in sequential coronary arteriograms and subsequent clinical coronary events . DESIGN The Program on the Surgical Control of the Hyperlipidemias , a r and omized secondary atherosclerosis intervention trial , obtained coronary arteriograms at baseline , 3 , 5 , and 7 or 10 years of follow-up . Assessment s of changes between pairs of coronary arteriograms were made by two-member panels blinded to the patients ' assigned treatment and to the temporal sequence of the films . The relationship of changes between the baseline and the 3-year follow-up arteriograms and subsequent clinical coronary events was examined . SETTING Three university hospitals and one private primary care facility . PATIENTS A total of 838 patients , with 417 patients r and omized to the control group and 421 to the intervention group . Of all patients , 695 had baseline and 3-year arteriograms . INTERVENTION The control group received American Heart Association Phase II diet instruction and the intervention group received identical dietary instruction plus a partial ileal bypass operation . MAIN OUTCOME MEASURE The use of arteriographic changes as a predictor of subsequent clinical coronary events . RESULTS Changes between the baseline and the 3-year coronary arteriographic overall disease assessment were significantly associated with subsequent overall and atherosclerotic coronary heart disease mortality ( P less than .01 ) . For the combined end point of atherosclerotic coronary heart disease mortality or confirmed nonfatal myocardial infa rct ion , a significant relationship between the overall disease assessment and subsequent clinical events was found in the control group ( P less than .0001 ) and in the surgery group ( P = .04 ) . For this combined end point , however , the control and the surgery groups were different with respect to clinical coronary events after 3 years , stratified by the baseline to 3-year overall disease assessment ( P less than .001 , unadjusted ; P = .06 , adjusted for 3-year clinical covariates ) . CONCLUSIONS Coronary arteriographic changes can be used in atherosclerosis intervention trials as a limited surrogate end point for certain clinical coronary events . This relationship is statistically compelling for overall mortality and atherosclerotic coronary heart disease mortality . For an individual patient , changes in the severity of coronary atherosclerosis seen on sequential coronary arteriograms can serve as prognostic indicators for subsequent overall or atherosclerotic coronary heart disease mortality
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 .