Statins × cardiovascular events

Observational studyAmerican heart journal2021

Statins and atherosclerotic cardiovascular outcomes in patients on incident dialysis and with atherosclerotic heart disease.

Jay S Shavadia et al.PubMed ↗Full text ↗Publisher ↗

  • Statin uselooks good hereNo clear link with fatal/nonfatal myocardial infarction or stroke, fewer deaths, no clear link with composite risk of all-cause mortality, nonfatal myocardial infarction, or stroke thereafter.Correlation only, not a test of it.

What moved togetherboth groups pooled, not the treatment’s effect

Correlation · may be no link

No clear link with fatal/nonfatal myocardial infarction or stroke

+0%−3% to +2%

statin use vs statin nonuse

Smaller than almost all for cardiovascular events

As reported

HR 1.00, 95% CI 0.97–1.02

Correlation · may be no link

No clear link with fatal/nonfatal myocardial infarction or stroke

+5%−5% to +17%

statin use vs statin nonuse, in age< 50 years

Bigger than 1 in 10 for cardiovascular events

As reported

HR 1.05, 95% CI 0.95–1.17

Correlation · may be no link

No clear link with fatal/nonfatal myocardial infarction or stroke

−1%−3% to +2%

statin use vs statin nonuse, in waitlisted for kidney transplant

Smaller than almost all for cardiovascular events

As reported

HR 0.99, 95% CI 0.97–1.02

+3 more in the walkthrough ↓

Who was studied, and how

197,716people with cardiovascular disease, in this paper

Already taking statin use, or nottheir own situation, not assigned

on statin use
statin nonuse

No clear link with fatal/nonfatal myocardial infarction or stroke+0%

Statin use went with fewer deaths−4%

No clear link with composite risk of all-cause mortality, nonfatal myocardial infarction, or stroke thereafter−2%

correlation, not a test

the abstract, start to end

or stroke overall (hazard ratio [HR] 1.00, 95% CI 0.97-1.02), or in subgroups (age< 50 years [HR = 1.05, 95% CI 0.95-1.17]; waitlisted for kidney transplant [HR 0.99, 95% CI 0.97-1.02]).

with lower all-cause mortality (HR 0.96, 95% CI 0.94-0.98; E value = 1.21) and, similarly, a modest lower composite risk of all-cause mortality, nonfatal myocardial infarction, or stroke over the first 2 years (HR 0.90, 95% CI 0.88-0.91) but

← favours treatmentfavours comparator →
could be chance
Fatal/nonfatal myocardial infarction or strokestatin use vs statin nonuse
HR 1.000.97–1.02
Fatal/nonfatal myocardial infarction or strokestatin use vs statin nonuse, in age< 50 years
HR 1.050.95–1.17
Fatal/nonfatal myocardial infarction or strokestatin use vs statin nonuse, in waitlisted for kidney transplant
HR 0.990.97–1.02
All-cause mortalitystatin use vs statin nonuse
HR 0.960.94–0.98
Composite risk of all-cause mortality, nonfatal myocardial infarction, or stroke thereafterstatin use vs statin nonuse
HR 0.980.96–1.01
Composite risk of all-cause mortality, nonfatal myocardial infarction, or stroke over the first 2 yearsstatin use vs statin nonuse
HR 0.900.88–0.91
StatinsCardiovascular eventsAll-cause mortality
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Full record →Abstract, authors, funding and every citing paper · PMID 33096103