For a study, researchers sought to determine the relationship between absolute reductions in low-density lipoprotein cholesterol (LDL-C) levels and all-cause mortality, myocardial infarction, and stroke with statin medication to improve doctors’ and patients’ shared decision-making and inform clinical guidelines and policy. In total, 21 trials were examined. In those randomised to statin treatment, there were reductions in the absolute risk of all-cause mortality of 0.8% (95% CI, 0.4% -1.2%), 1.3% (95% CI, 0.9% -1.7%) for myocardial infarction, and 0.4% (95% CI, 0.2% -0.6%) for stroke, with associated relative risk reductions of 9% (95% CI, 5% -14%), 29% (95% CI, 22%-34%), and 14% (95% CI, 5%-22%) respectively. A meta-analysis of the potential mediating relationship between the degree of statin-induced LDL-C reduction and outcomes came up empty. This meta-analysis revealed that the absolute risk reductions of statin therapy in all-cause mortality, myocardial infarction, and stroke were moderate compared to the relative risk reductions. The evidence’s certainty was lowered due to high heterogeneity. There was no conclusive link between absolute LDL-C reductions and individual clinical outcomes. These data highlight the necessity of considering absolute risk reductions with individual patients when making educated therapeutic decisions.
Source:jamanetwork.com/journals/jamainternalmedicine/article-abstract/2790055
