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 .
No effect of statin therapy on silent myocardial ischemia in patients with type 2 diabetes without manifest cardiovascular disease.
OBJECTIVE Coronary artery disease is the most important cause of mortality in patients with type 2 diabetes . We aim ed to determine the prevalence of silent myocardial ischemia ( SMI ) and the effect of statin therapy on SMI in type 2 diabetic patients without manifest cardiovascular disease . RESEARCH DESIGN AND METHODS A r and omized , placebo-controlled , double-blind trial was performed in 250 patients with type 2 diabetes without manifest cardiovascular disease . Patients were given either 0.4 mg cerivastatin or placebo daily . In August 2001 , when cerivastatin was withdrawn from the market , cerivastatin 0.4 mg was replaced by 20 mg simvastatin without deblinding the study . The primary end point was the change in ischemic episodes , duration , and burden as measured by 48-h ambulatory electrocardiography ( AECG ) over 2 years . RESULTS At baseline , 47 of 233 ( 20 % ) evaluable ambulatory electrocardiograms showed evidence of ischemia . After 2 years , there was a trend toward more ischemia in both treatment groups , without significant differences between the changes in ischemic parameters ( episodes P = 0.498 ; duration P = 0.697 ; burden P = 0.798 ) in the two treatment groups . Cardiovascular events occurred in 12 patients in the placebo group and in two patients in the statin group ( P = 0.006 ) . There was no relationship between these cardiovascular events and the presence of SMI at baseline . CONCLUSIONS SMI occurred in 20 % of type 2 diabetes patients without manifest cardiovascular disease . There was no effect from 2 years of statin therapy on SMI . In contrast , we observed a significantly lower cardiovascular event rate on statin therapy . AECG may not be a proper tool for risk stratification in patients with type 2 diabetes
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 .