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 .
Cerivastatin, a New Potent Synthetic HMG Co-A Reductase Inhibitor: Effect of 0.2 mg Daily in Subjects With Primary Hypercholesterolemia
Background : Reduction of serum cholesterol , most notably low-density lipoprotein choles terol is associated with reductions in cardiovascular morbidity and mortality . Statins have been shown to effectively reduce low-density lipoprotein cholesterol via inhibition of the hydroxymethyl-coenzyme A ( HMG-CoA ) reductase . Cerivastatin is the most potent HMG- CoA reductase inhibitor currently under study in the United States . Methods and Results : A parallel group , r and omized , placebo-controlled , double-blind , mul ticenter study was conducted to compare the efficacy and safety of three different dosing reg imens of 0.2 mg/day of cerivastatin , a new HMG-CoA reductase inhibitor , in patients with hypercholesterolemia . After a 10-week diet-placebo lead-in period , 319 patients with low- density lipoprotein cholesterol > 160 mg/dL were r and omized to 4 weeks of treatment with one of the following regimens : cerivastatin 0.1 mg twice daily , cerivastatin 0.2 mg once daily with the evening meal , cerivastatin 0.2 mg once daily at bedtime or placebo . All three active treatment groups produced statistically significant ( P < .05 ) changes compared to baseline and placebo in total cholesterol ( 0.1 mg twice daily -18.9 % ; 0.2 mg once daily with the evening meal : -21.9 % ; 0.2 mg once daily at bedtime : -22.1 % ; placebo : 0.0 % ) , low-density lipoprotein cholesterol ( 0.1 mg twice daily : -25.7 % ; 0.2 mg once daily with the evening meal : -29.4 % ; 0.2 mg once daily at bedtime : -30.4 % ; placebo : 1.4 % ) and high-density lipoprotein cholesterol ( 0.1 mg twice daily : 5.3 % ; 0.2 mg once daily with the evening meal : 2.3 % ; 0.2 mg once daily at bedtime : 3.2 % ; placebo : -1.2 % ) . Triglycerides , compared to baseline and placebo , were also reduced by all active treatments ( 0.1 mg twice daily : -11.6 % [ P = .05 ] ; 0.2 mg once daily with the evening meal : -11.6 % [ P = .05 ] ; and 0.2 mg at bed time : -10.9 % [ P = .07 ] ) . The percentage change in total cholesterol and low-density lipopro tein cholesterol after 4 weeks of therapy for the once-daily cerivastatin groups was statisti cally significantly greater ( P < .05 ) than the cerivastatin twice daily regimen . A treatment response was seen by 1 week of therapy and was maximal by 3 weeks . The drug was well tolerated in all three dosing regimens and result ed in no significant increase in biochemical or clinical side effects compared to placebo . Conclusion : Cerivastatin is a novel , highly potent , well-tolerated HMG-CoA reductase inhibitor that produces low-density lipoprotein cholesterol reductions of approximately 30 % when administered at 0.2 mg once a day in the evenings
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 .