Evidence Limited on Statins for Primary Prevention

Statins found to reduce death, cardiac events, but selective and potentially biased reporting occurred

20 jan 2011-- There is not enough evidence to support the widespread use of statins in individuals with no history of cardiovascular disease (CVD), according to a review published in The Cochrane Library.

Fiona Taylor, of the London School of Hygiene and Tropical Medicine, and colleagues reviewed data from 14 trials involving 34,272 patients to assess the effects of statins among individuals with no history of CVD. Outcomes in patients prescribed statins were compared to outcomes in patients given placebos or usual care.

Using combined data from eight trials involving 28,161 patients that provided data on deaths from all causes, the investigators found that statins reduced the risk of dying from nine to eight deaths for every 1,000 people treated with statins each year. In addition, statins reduced fatal and non-fatal CVD events, stroke and revascularization surgery, and blood cholesterol levels. However, the researchers write that their conclusions are limited by unclear, selective, and possibly biased reporting and that patients' individual risk profiles should be carefully considered before statins are prescribed.

"Although reductions in all-cause mortality, composite end points, and revascularisations were found with no excess of adverse events, there was evidence of selective reporting of outcomes, failure to report adverse events, and inclusion of people with CVD. Only limited evidence showed that primary prevention with statins may be cost effective and improve patient quality of life. Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk," the authors write.

Abstract