Meta-analysis of cardiovascular outcomes trials comparing intensive versus moderate statin therapy

摘要: OBJECTIVES The purpose of this study was to conduct a meta-analysis that compares the reduction cardiovascular outcomes with high-dose statin therapy versus standard dosing. BACKGROUND Debate exists regarding merit more intensive lipid lowering as compared standard-dose therapy. METHODS We searched PubMed and article references for randomized controlled trials enrolling than 1,000 patients either stable coronary heart disease or acute syndromes. Four were identified: TNT (Treating New Targets) IDEAL (Incremental Decrease in End Points Through Aggressive Lipid-Lowering) involved disease, PROVE IT-TIMI-22 (Pravastatin Atorvastatin Evaluation Infection Therapy-Thrombolysis Myocardial Infarction-22) A-to-Z (Aggrastat-to-Zocor) carried out relative odds on basis fixed-effects model using Mantel-Haenszel method major death events. RESULTS A total 27,548 enrolled 4 large trials. combined analysis yielded significant 16% myocardial infarction (p < 0.00001), well any event 0.00001). No difference observed non-cardiovascular mortality, but trend toward decreased mortality (odds 12%, p = 0.054) observed. CONCLUSIONS Intensive provides benefit over preventing predominantly non-fatal