Effects of statins on stroke prevention in patients with and without coronary heart disease: a meta-analysis of randomized controlled trials.

Abstract

PURPOSE:

To assess if lipid-lowering interventions (statins, fibrates, resins, n-3 fatty acids, diet) prevent nonfatal and fatal strokes in patients with and without coronary heart disease.

METHODS:

We systematically searched the literature up to August 2002 to retrieve all randomized controlled trials of lipid-lowering interventions that reported nonfatal and fatal stroke and mortality data. The search yielded 65 trials with 200,607 patients for a meta-analysis to determine whether treatment effects differed between types of lipid-lowering interventions and between patient samples with and without coronary heart disease.

RESULTS:

The risk ratio for nonfatal and fatal stroke for statins as compared with control interventions was 0.82 (95% confidence interval [CI]: 0.76 to 0.90). The corresponding risk ratios for statins as compared with control were 0.75 (95% CI: 0.65 to 0.87) for patients with coronary heart disease and 0.77 (95% CI: 0.62 to 0.95) for those without coronary heart disease. The confidence intervals of risk ratios for nonfatal and fatal stroke associated with fibrates, resins, n-3 fatty acids, and diet all included 1, as did the confidence intervals for these interventions in patients with and without coronary heart disease. Weighted meta-regression analysis suggested a stronger association of stroke reduction with statin treatment than with the extent of cholesterol reduction.

CONCLUSION:

This meta-analysis suggests that statins reduce the incidence of stroke in patients with and without coronary heart disease.

• Authors: Matthias Briel, Marco Studer, Tracy R Glass, Heiner C Bucher
• Journal: The American journal of medicine (Am J Med) Vol. 117 Issue 8 Pg. 596-606 (Oct 15 2004) ISSN: 0002-9343 [Print] United States
• PMID: 15465509 (Publication Type: Journal Article, Meta-Analysis, Review)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Hypolipidemic Agents

Topics

• Aged
• Confidence Intervals
• Coronary Disease (complications)
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Hypolipidemic Agents (therapeutic use)
• Male
• Middle Aged
• Randomized Controlled Trials as Topic
• Stroke (complications, mortality, prevention & control)