Authors' reply

摘要

The Cholesterol Treatment Trialists' (CTT) collaborative meta-analysis of individual data on more than 170000 randomised participants (of whom 70000 had no history of vascular disease) in 27 trials showed reliably that statins reduce the risk of "major vascular events" (ie, coronary deaths, heart attacks, strokes, and coronary revascularisations) by about a fifth per mmol/L reduction in LDL cholesterol, with proportional reductions in low-risk participants (eg, those with a 5-year risk of major vascular events <10%) at least as large as those in higher risk participants.Statin treatment mainly reduced atherosclerotic events (eg, heart attacks and ischaemic strokes), with little or no effect on non-atherosclerotic vascular events or on non-vascular events. For this reason, atherosclerotic events provide a sensitive assessment of the benefits of statin therapy in different circumstances (eg, lower vs higher risk participants). Coronary revascularisation procedures are typically done for the treatment of ischaemic symptoms, so their reduction indicates a delay in such outcomes.