Evidence map›Paper›PMID 15089818›Full record

SynthesisBritish journal of clinical pharmacology2004

Meta-analysis of large randomized controlled trials to evaluate the impact of statins on cardiovascular outcomes.

Bernard M Y Cheung, Ian J Lauder, Chu-Pak Lau, Cyrus R Kumana

Open access · bronzeAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 12 pooled it
25.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

85 citing papers in PubMed, 12 syntheses or guidelines pooled it, 305 citations in OpenAlex.

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  4. The Relationship between Empathy and Attachment in Children and Adolescents: Three-Level Meta-Analyses.International journal of environmental research and public health · 2022
    Pooled it
  5. Statins in Healthy Adults: A Meta-Analysis.Medicina (Kaunas, Lithuania) · 2021
    Pooled it
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  7. Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2013 · on this map
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  9. Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2011 · on this map
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  11. Does pravastatin promote cancer in elderly patients? A meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2007
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25 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 2 countries.

Bernard M Y CheungDepartment of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong. mycheung@hkucc.khu.hk
Ian J Lauder
Chu-Pak Lau
Cyrus R Kumana
University of Hong Kong · HK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsSince 2002, there have been five major outcome trials of statins reporting findings from more than 47,000 subjects. As individual trial results differed, we performed a meta-analysis to ascertain the effectiveness and safety of statins overall and in subgroups. The aim of the study was to estimate the effect of statins on major coronary events and strokes, all-cause mortality and noncardiovascular mortality, and in different subgroups.

methodsPubMed was searched for trials published in English. Randomized placebo-controlled statin trials with an average follow up of at least 3 years and at least 100 major coronary events were included. For each trial, the statin used, number and type of subjects, proportion of women, mean age and follow up, baseline and change in lipid profile, cardiovascular and non-cardiovascular outcomes were recorded.

resultsTen trials involving 79,494 subjects were included in the meta-analysis. Due to heterogeneity, ALLHAT-LLT was excluded from some analyses. Statin therapy reduced major coronary events by 27% (95%CI 23, 30%), stroke by 18% (95%CI 10, 25%) and all-cause mortality by 15% (95%CI 8, 21%). There was a 4% (95%CI -10, 3%) nonsignificant reduction in noncardiovascular mortality. The reduction in major coronary events is independent of gender and presence of hypertension or diabetes. The risk reduction was greater in smokers (P < 0.05). Coronary events were reduced by 23% (95%CI 18, 29%) in pravastatin trials and 29% (95%CI 25, 33%) in five trials using other statins. Pravastatin reduced strokes by 12% (95%CI 1, 21%) whilst other statins reduced strokes by 24% (95%CI 16, 32%) (P = 0.04).

conclusionsStatins reduce coronary events, strokes and all-cause mortality without increasing noncoronary mortality. The benefits accrue in men and women, hypertensives and normotensives, diabetics and nondiabetics, and particularly in smokers. Pravastatin appears to have less impact on strokes.

Indexed as

Coronary DiseaseHumansHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatinRandomized Controlled Trials as TopicSex FactorsSmokingStrokeHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatin

Identifiers

PMID15089818
PMCPMC1884492
OpenAlexW2032568924

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.