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Latest & greatest articles for statin
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lipid or blood pressure levels with appropriate medications). 3 Reducing increased lipid levels is important for the prevention of CVD events. 4 Statins (HMG-CoAreductaseinhibitors) are currently the main class of lipid-lowering drugs and their use reduces the risk of CVD- associated morbidity and mortality. 2 Use of statins: online tool KCE Report 324 Dyslipidaemia is a trouble of function and/or concentration of plasmatic lipids. It includes a number of lipid metabolism troubles that may (...) : Cardiovascular Diseases; Decision Making, Computer-Assisted; Hydroxymethylglutaryl-CoAReductaseInhibitors; Primary prevention NLM Classification: WG 120 Language: English Format: Adobe® PDF™ (A4) Legal depot: D/2019/10.273/71 ISSN: 2466-6459 Copyright: KCE reports are published under a “by/nc/nd” Creative Commons Licence http://kce.fgov.be/content/about-copyrights-for-kce-publications. How to refer to this document? De Meester C, Rondia K, Goorden T, Janssens S, Steyaert P, De Laet, C, Albertijn M, Kohn L
Recommendations for (Discontinuation of) Statin Treatment in Older Adults: Review of Guidelines As a person's age increases and his/her health status declines, new challenges arise that may lead physicians to consider deprescribing statins. We aimed to provide insight into recommendations available in international cardiovascular disease prevention guidelines regarding discontinuation of statin treatment applicable to older adults.We systematically searched PubMed, EMBASE, EMCARE (...) , and the websites of guideline development organizations and online guideline repositories for cardiovascular disease prevention guidelines aimed at the general population. We selected all guidelines with recommendations (instructions and suggestions) on discontinuation of statin treatment applicable to older adults, published between January 2009 and April 2019. In addition, we performed a synthesis of information from all other recommendations for older adults regarding statin treatment. Methodological
Diagnosis of osteoporosis in statin-treated patients is dose-dependent Whether HMG-CoA-reductase inhibition, the main mechanism of statins, plays a role in the pathogenesis of osteoporosis, is not entirely known so far. Consequently, this study was set out to investigate the relationship of different kinds and dosages of statins with osteoporosis, hypothesising that the inhibition of the synthesis of cholesterol could influence sex-hormones and therefore the diagnosis of osteoporosis.Medical (...) claims data of all Austrians from 2006 to 2007 was used to identify all patients treated with statins to compute their daily defined dose averages of six different types of statins. We applied multiple logistic regression to analyse the dose-dependent risks of being diagnosed with osteoporosis for each statin individually.In the general study population, statin treatment was associated with an overrepresentation of diagnosed osteoporosis compared with controls (OR: 3.62, 95% CI 3.55 to 3.69, p<0.01
Use of fenofibrate on cardiovascular outcomes in statin users with metabolic syndrome: propensity matched cohort study. To investigate whether fenofibrate as add-on to statin treatment reduce persistent cardiovascular risk in adults with metabolic syndrome in a real world setting.Propensity matched cohort study.Population based cohort in Korea.29 771 adults with metabolic syndrome (≥40 years) receiving statin treatment. 2156 participants receiving combined treatment (statin plus fenofibrate (...) ) were weighted based on propensity score in a 1:5 ratio with 8549 participants using statin only treatment.Primary outcome was composite cardiovascular events including incident coronary heart disease, ischaemic stroke, and death from cardiovascular causes.The incidence rate per 1000 person years of composite cardiovascular events was 17.7 (95% confidence interval 14.4 to 21.8) in the combined treatment group and 22.0 (20.1 to 24.1) in the statin group. The risk of composite cardiovascular events
Lipophilic Statins and Risk for Hepatocellular Carcinoma and Death in Patients With Chronic Viral Hepatitis: Results From a Nationwide Swedish Population. Whether statin type influences hepatocellular carcinoma (HCC) incidence or mortality in chronic hepatitis B or C virus infection is unknown.To assess the relationship between lipophilic or hydrophilic statin use and HCC incidence and mortality in a nationwide population with viral hepatitis.Prospective propensity score (PS)-matched (...) cohort.Swedish registers, 2005 to 2013.A PS-matched cohort of 16 668 adults (8334 who initiated statin use [6554 lipophilic and 1780 hydrophilic] and 8334 nonusers) among 63 279 eligible adults.Time to incident HCC, ascertained from validated registers. Statin use was defined from filled prescriptions as 30 or more cumulative defined daily doses (cDDDs).Compared with matched nonusers, 10-year HCC risk was significantly lower among lipophilic statin users (8.1% vs. 3.3%; absolute risk difference [RD], -4.8
Statins versus placebo for people with chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable respiratory disease. COPD exacerbations are associated with worse quality of life, increased hospitalisations, and increased mortality. Currently available pharmacological interventions have variable impact on exacerbation frequency. The anti-inflammatory effects of statins may lead to decreased pulmonary and systemic inflammation (...) , resulting in fewer exacerbations of COPD. Several observational studies have shown potential benefits of statins for patients with COPD.This review aims to evaluate available evidence on benefits and harms associated with statin therapy compared with placebo as adjunct therapy for patients with COPD. Primary objectives include the following.• To determine whether statins reduce mortality rates in COPD.• To determine whether statins reduce exacerbation frequency, improve quality of life, or improve lung
2019CochraneControlled trial quality: predicted high
Statin therapy increases lipoprotein(a) levels Lipoprotein(a) [Lp(a)] is elevated in 20-30% of people. This study aimed to assess the effect of statins on Lp(a) levels.This subject-level meta-analysis includes 5256 patients (1371 on placebo and 3885 on statin) from six randomized trials, three statin-vs.-placebo trials, and three statin-vs.-statin trials, with pre- and on-treatment (4-104 weeks) Lp(a) levels. Statins included atorvastatin 10 mg/day and 80 mg/day, pravastatin 40 mg/day (...) , rosuvastatin 40 mg/day, and pitavastatin 2 mg/day. Lipoprotein(a) levels were measured with the same validated assay. The primary analysis of Lp(a) is based on the log-transformed data. In the statin-vs.-placebo pooled analysis, the ratio of geometric means [95% confidence interval (CI)] for statin to placebo is 1.11 (1.07-1.14) (P < 0.0001), with ratio >1 indicating a higher increase in Lp(a) from baseline in statin vs. placebo. The mean percent change from baseline ranged from 8.5% to 19.6% in the statin
Statins do not increase risk of polyneuropathy: A case-control study and literature review To investigate whether there is an association between cholesterol-lowering medication use, specifically statins, and chronic polyneuropathy.A literature study was carried out to assess the current state of evidence on the association between chronic polyneuropathy and cholesterol-lowering medication use. We also conducted a prospective case-control study to compare exposure to cholesterol-lowering (...) . There was insufficient evidence that statin use is a risk factor for polyneuropathy. Our prospective case-control study included 333 patients with cryptogenic axonal polyneuropathy and 283 controls. Patients with polyneuropathy were less likely to have been exposed to statins than controls (OR 0.56, 95% confidence interval 0.34-0.95, p = 0.03). The odds of polyneuropathy decreased as exposure duration to statins increased. Cholesterol-lowering medication consisted almost exclusively of statins; therefore we only
Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Statin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We undertook a meta-analysis of data from all large statin trials to compare the effects of statin therapy at different ages.In this meta-analysis, randomised trials (...) of statin therapy were eligible if they aimed to recruit at least 1000 participants with a scheduled treatment duration of at least 2 years. We analysed individual participant data from 22 trials (n=134 537) and detailed summary data from one trial (n=12 705) of statin therapy versus control, plus individual participant data from five trials of more intensive versus less intensive statin therapy (n=39 612). We subdivided participants into six age groups (55 years or younger, 56-60 years, 61-65 years, 66
People take prescribed statins more reliably after discussing their advantages and disadvantages People take prescribed statins more reliably after discussing their advantages and disadvantages Discover Portal Discover Portal People take prescribed statins more reliably after discussing their advantages and disadvantages Published on 11 September 2018 doi: Patients want to know more about how statins work, the reasons for prescribing them and their possible side effects. Statins lower (...) cholesterol and reduce the risk of recurrent stroke or heart attack. They also help prevent cardiovascular disease developing in people at high risk. At a population, level statins reduce the overall incidence of cardiovascular disease for people at moderate risk, but the benefits for an individual are less clear-cut. This review found that people are happy to take statins if they believe they will prolong good quality of life. Barriers include mistrust and scepticism about over-prescribing. Worry about
A statin drug during admission for heart surgery did not prevent an irregular heart beat A statin drug during admission for heart surgery did not prevent an irregular heart beat Discover Portal Discover Portal A statin drug during admission for heart surgery did not prevent an irregular heart beat Published on 14 July 2016 doi: The statin, rosuvastatin, taken by adults before and after heart surgery, did not prevent atrial fibrillation or heart muscle injury compared to placebo. Acute kidney (...) to reduce atrial fibrillation, nor heart muscle damage. It did, as expected, reduce “bad” cholesterol and C-reactive protein, a marker of inflammation, compared to the inactive placebo. Statins do have proven longer term benefits in reducing further damage to the coronary arteries and deaths from heart disease. Share your views on the research. Why was this study needed? Atrial fibrillation can occur in about 20% of people undergoing heart surgery and if not corrected is associated with poorer recovery
Statins are of no benefit in acute respiratory distress syndrome Statins are of no benefit in acute respiratory distress syndrome Discover Portal Discover Portal Statins are of no benefit in acute respiratory distress syndrome Published on 13 March 2018 doi: Giving statins to patients with acute respiratory distress syndrome made no difference to the number of days they spent on a ventilator. It also had no effect on mortality or the length of time spent in intensive care or in hospital (...) compared with placebo. In acute respiratory distress syndrome, the lungs become severely inflamed, fill with fluid (pulmonary oedema) and can no longer function. The person needs mechanical ventilation and is at high risk of multiple organ failure and mortality. This serious condition has high impact on both patients and NHS resources. Early studies had suggested statins may help to reverse the inflammatory process and could be a potential treatment to explore. This large, multicentre trial, funded
A, Taylor HL, Blackburn H, et al. Coronary Heart Disease among Minnesota Business and Professional Men Followed Fifteen Years. Circulation 28:381-95 (Sept 1963) 9. Tobert JA. Lovastatin and beyond: the history of the HMG-CoAreductaseinhibitors. Nat Rev Drug Discov. 2003;2(7):517-26. 10. Peter Landers. How one scientist intrigued by molds found first statin. Wall Street Journal. January 9, 2006. 11. Endo A, Kuroda M, Tsujita Y. ML-236A, ML-236B, and ML-236C, new inhibitors of cholesterogenesis produced (...) in August 1987. Although the main mechanism of statins to inhibit HMG-CoAreductase was understood, it was not until the work of Drs. Brown and Goldstein in the 1970’s that allowed us to fully comprehend how this class of medication lowers cholesterol. Working with tissue samples from people afflicted with familial hypercholesterolemia, Brown and Goldstein elucidated the cell-surface LDL receptor and demonstrated that inhibition of HMG-CoAreductase stimulates the upregulation of hepatic LDL receptors
HISTORICAL AND CURRENT STATIN USE IN BELGIUM 3.1 Introduction Statins (also known as HMG-CoAreductaseinhibitors) are a class of lipid- lowering medications. Statins proved to reduce the relative risk for cardiovascular disease (CVD), CVD events and mortality similarly in all individuals, but the absolute risk reduction is much greater in those who are at high risk of CVD events. Statins are used both in the primary and secondary prevention of CVD. Clinical practice guidelines generally recommend (...) the full responsibility of the KCE. Publication date: 15 January 2019 Domain: Health Technology Assessment (HTA) MeSH: Hydroxymethylglutaryl-CoAReductaseInhibitors; Cardiovascular Diseases; Primary prevention; Costs and Cost Analysis. NLM Classification: WG 120 Language: English Format: Adobe® PDF™ (A4) Legal depot: D/2019/10.273/07 ISSN: 2466-6459 Copyright: KCE reports are published under a “by/nc/nd” Creative Commons Licence http://kce.fgov.be/content/about-copyrights-for-kce-publications. How
of these events is a priority. Overall, in patients for whom statin treatment is recommended by current guidelines, the benefits greatly outweigh the risks. The development and use of the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductaseinhibitor (statin) class of drugs, which, according to the prescribing information, reduce low-density lipoprotein cholesterol (LDL-C) on average by 55% to 60% at the maximal doses of the most potent statins, has had a major impact in reducing the incidence (...) metabolites, which is equivalent to taking a larger dose, and thereby increases the risk of myopathy/rhabdomyolysis. The most important pharmacokinetic difference among the statins is that only lovastatin, simvastatin, and atorvastatin are cytochrome P450 3A4 (CYP3A4) substrates and consequently are vulnerable to drug interactions with CYP3A4 inhibitors, some of which are commonly used. Because of the high first-pass metabolism of lovastatin and simvastatin, the effects of CYP3A4 inhibitors
Finding the Balance Between Benefits and Harms When Using Statins for Primary Prevention of Cardiovascular Disease: A Modeling Study. Many guidelines use expected risk for cardiovascular disease (CVD) during the next 10 years as a basis for recommendations on use of statins for primary prevention of CVD. However, how harms were considered and weighed against benefits is often unclear.To identify the expected risk above which statins provide net benefit.Quantitative benefit-harm balance modeling (...) study.Network meta-analysis of primary prevention trials, a preference survey, and selected observational studies.Persons aged 40 to 75 years with no history of CVD.10 years.Clinicians and guideline developers.Low- or moderate-dose statin versus no statin.The 10-year risk for CVD at which statins provide at least a 60% probability of net benefit, with baseline risk, frequencies of and preferences for statin benefits and harms, and competing risk for non-CVD death taken into account.Younger men had net