Risk-benefit analysis of use of statins for primary prevention of cardiovascular disease in subjects without diabetes

摘要

Diabetes, prediabetes and metabolic syndrome are associated with a two- to threefold increased risk for cardiovascular disease and all-cause mortality. In a meta-analysis of the Cholesterol Treatment Trialists Collaboration involving 169,138 individuals from 26 randomized studies which recruited at least 1,000 patients with at least 2 years treatment duration, the authors concluded that for every 1 mmol/L reduction in low-density lipoprotein cholesterol (LDL-C), there was a 22% reduction in all vascular events and 10% in all-cause mortality, mainly as a result of coronary heart disease and other cardiac causes. These clinical benefits remained consistent in all subgroup analyses stratified by age, sex, obesity, presence and types of diabetes, concomitant cardiovascular risk factors, and history of prior cardiovascular or renal events