+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Statins and total (not LDL) cholesterol concentration and outcome of myocardial infarction: results from a meta-analysis and an observational study



Statins and total (not LDL) cholesterol concentration and outcome of myocardial infarction: results from a meta-analysis and an observational study



European Journal of Clinical Pharmacology 65(11): 1071-1080



The purpose of this study was to evaluate how total cholesterol (TC) concentration in subjects treated with statins predicts myocardial infarction (MI) risk in the absence of low density lipoprotein cholesterol (LDL-C) measurement in clinical trials and in the setting of usual care. A systematic review of published English language randomised clinical trials comparing statins with placebo that reported TC changes in subjects with or without prior MI between 1993 and 2008 was carried out using Medline, the Cochrane Library, Web of Science and the ISI Web of Knowledge. In addition, a cohort study of MI patients who had at least two TC measurements in Tayside, Scotland, between 1989 and 2002 was performed. The main outcome was TC concentration changes and risk of subsequent MI. In the meta-analyses of secondary and primary prevention trials statins decreased TC by 1.54 mmol/L and 1.37 mmol/L versus placebo. Statin-associated TC reduction translated into a risk reduction of 18% per mmol (RR 0.82; 95%CI 0.72-0.93) for secondary prevention and 24% per mmol (RR 0.76; 95%CI 0.62-0.93) for primary prevention. In the cohort study, statin use reduced TC by 0.98 mmol/L compared with non statin-use. Statin use was associated with a 28% reduction (adjusted HR 0.72; 95%CI 0.51-0.98) for recurrent MI. Total cholesterol measurements can be used with confidence in the absence of LDL measurements to make decisions about statin drug introduction or titration. Randomised trials of statin therapy had good external validity and cholesterol changes and outcomes in trials were comparable to those observed in the setting of usual care.

(PDF emailed within 0-6 h: $19.90)

Accession: 055911907

Download citation: RISBibTeXText

PMID: 19730842

DOI: 10.1007/s00228-009-0720-x


Related references

Exploratory analysis on the use of statins with or without n-3 PUFA and major events in patients discharged for acute myocardial infarction: an observational retrospective study. Plos One 8(5): E62772-E62772, 2013

Safety of prasugrel in real-world patients with ST-segment elevation myocardial infarction: 1-year results from a prospective observational study (Bleeding and Myocardial Infarction Study). Archives of Cardiovascular Diseases 109(1): 31-38, 2015

Cholesterol levels and the association of statins with in-hospital mortality of myocardial infarction patients insights from a Chilean registry of myocardial infarction. Clinical Cardiology 36(6): 305-311, 2014

Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: results of a meta-analysis. Journal of Nutrition 127(10): 1973-1980, 1997

Pre-stroke use of statins on stroke outcome: a meta-analysis of observational studies. Acta Neurologica Belgica 111(4): 261-267, 2012

Individual patient-data meta-analysis comparing clinical outcome in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention with or without prior thrombectomy. ATTEMPT study: a pooled Analysis of Trials on ThrombEctomy in acute Myocardial infarction based on individual PatienT data. Vascular Health and Risk Management 5(1): 243-247, 2009

Management and in-hospital outcome for patients with acute myocardial infarction in contemporary practice Japan Acute Myocardial Infarction Study Prospective multicenter observational cohort study in Japan. Journal of the American College of Cardiology 41(6 Supplement A): 533A, March 19, 2003

Effect of statins pretreatment on periprocedural myocardial infarction in patients undergoing percutaneous coronary intervention: a meta-analysis. Annals of Medicine 42(3): 171-177, 2010

Myocardial infarction risk and antipsychotics use revisited: a meta-analysis of 10 observational studies. Journal of Psychopharmacology: 269881117714047-269881117714047, 2017

High density lipoprotein cholesterol, total cholesterol screening, and myocardial infarction. The Framingham Study. Arteriosclerosis 8(3): 207-211, 1988

Independent prognostic importance of a restrictive left ventricular filling pattern after myocardial infarction: an individual patient meta-analysis: Meta-Analysis Research Group in Echocardiography acute myocardial infarction. Circulation 117(20): 2591-2598, 2008

Effect of perioperative statins on death, myocardial infarction, atrial fibrillation, and length of stay: a systematic review and meta-analysis. Archives of Surgery 147(2): 181-189, 2012

Association between blood vitamin D and myocardial infarction: A meta-analysis including observational studies. Clinica Chimica Acta; International Journal of Clinical Chemistry 471: 270-275, 2017

Is non-HDL-cholesterol a better predictor of long-term outcome in patients after acute myocardial infarction compared to LDL-cholesterol? : a retrospective study. Bmc Cardiovascular Disorders 17(1): 10-10, 2017

Impact of low levels of vascular endothelial growth factor after myocardial infarction on 6-month clinical outcome. Results from the Nagoya Acute Myocardial Infarction Study. Circulation Journal 76(6): 1509-1516, 2012