Statin therapy in the prevention of recurrent cardiovascular events a sex-based meta-analysis

Jose Gutierrez, Gilbert Ramirez, Tatjana Rundek, Ralph L Sacco

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

Background: The effect of statins on the prevention of cardiovascular events is well demonstrated. Whether this protective effect is equal for women and men remains less well established. Our objective was to evaluate if statin therapy is equally effective in decreasing recurrent cardiovascular events in women and men. Data Sources: Randomized clinical trials were searched in PubMed using as indexing terms (statins OR cholesterol lowering medications) AND (cardiovascular events OR stroke OR myocardial infarction OR cardiovascular death). Study Selection: We included randomized, double-blinded, placebo-controlled trials evaluating statins for secondary prevention of cardiovascular events. Studies with an open-label design and observational studies were excluded. Data Extraction: The earliest citation was used to determine the characteristic of the studied population and the methodology. All subsequent citations corresponding to the trial were evaluated for outcome rates by sex. Data Synthesis: Eleven trials representing 43 193 patients were included in the analysis. Overall, statin therapy was associated with a reduced risk of cardiovascular events in all outcomes for women (relative risk [RR], 0.81 [95% CI, 0.74-0.89]) and men (RR, 0.82 [95% CI, 0.78- 0.85]). However, they did not reduce all-cause mortality in women vs men (RR, 0.92 [95% CI, 0.76-1.13] vs RR, 0.79 [95% CI, 0.720.87]) or stroke (RR, 0.92 [95% CI, 0.76-1.10] vs RR, 0.81 [95% CI, 0.72-0.92]). Conclusions: Statin therapy is an effective intervention in the secondary prevention of cardiovascular events in both sexes, but there is no benefit on stroke and all-cause mortality in women.

Original languageEnglish
Pages (from-to)909-919
Number of pages11
JournalArchives of Internal Medicine
Volume172
Issue number12
DOIs
StatePublished - Jun 25 2012

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Meta-Analysis
Stroke
Secondary Prevention
Therapeutics
Mortality
Information Storage and Retrieval
Population Characteristics
PubMed
Observational Studies
Randomized Controlled Trials
Myocardial Infarction
Cholesterol
Placebos

ASJC Scopus subject areas

  • Internal Medicine

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Statin therapy in the prevention of recurrent cardiovascular events a sex-based meta-analysis. / Gutierrez, Jose; Ramirez, Gilbert; Rundek, Tatjana; Sacco, Ralph L.

In: Archives of Internal Medicine, Vol. 172, No. 12, 25.06.2012, p. 909-919.

Research output: Contribution to journalArticle

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abstract = "Background: The effect of statins on the prevention of cardiovascular events is well demonstrated. Whether this protective effect is equal for women and men remains less well established. Our objective was to evaluate if statin therapy is equally effective in decreasing recurrent cardiovascular events in women and men. Data Sources: Randomized clinical trials were searched in PubMed using as indexing terms (statins OR cholesterol lowering medications) AND (cardiovascular events OR stroke OR myocardial infarction OR cardiovascular death). Study Selection: We included randomized, double-blinded, placebo-controlled trials evaluating statins for secondary prevention of cardiovascular events. Studies with an open-label design and observational studies were excluded. Data Extraction: The earliest citation was used to determine the characteristic of the studied population and the methodology. All subsequent citations corresponding to the trial were evaluated for outcome rates by sex. Data Synthesis: Eleven trials representing 43 193 patients were included in the analysis. Overall, statin therapy was associated with a reduced risk of cardiovascular events in all outcomes for women (relative risk [RR], 0.81 [95{\%} CI, 0.74-0.89]) and men (RR, 0.82 [95{\%} CI, 0.78- 0.85]). However, they did not reduce all-cause mortality in women vs men (RR, 0.92 [95{\%} CI, 0.76-1.13] vs RR, 0.79 [95{\%} CI, 0.720.87]) or stroke (RR, 0.92 [95{\%} CI, 0.76-1.10] vs RR, 0.81 [95{\%} CI, 0.72-0.92]). Conclusions: Statin therapy is an effective intervention in the secondary prevention of cardiovascular events in both sexes, but there is no benefit on stroke and all-cause mortality in women.",
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