Pravastatin and cancer: an unproven association.

摘要

Statins produce large cardiovascular benefits, particularly in the secondary prevention of cardiovascular disease. In a meta-analysis of 14 randomized trials, participants with a history of heart disease who were taking statins for 5 years had 48 fewer vascular events per 1000 than those in the control group. Importantly, cardiovascular events occurred about 3 times more frequently than cases of cancer in these trials. In this issue, Bonovas and Sitaras report a possible association between the use of pravastatin (a hydrophilic statin) and cancer among elderly patients in their meta-analysis of 12 randomized controlled trials. Their study is generally well performed and follows the QUOROM guidelines for meta-analyses; however, readers may have several questions about the clinical significance of these findings. Although one may choose to simply dismiss subgroup analyses as merely being hypothesis generating, a Bayesian paradigm, which explicitly states prior beliefs and incorporates new findings according to the rules of probability, may provide additional insights for interpreting this new evidence.