Abstract
Most of the previously published meta-analyses include studies exploring the effect of statins, rather than all dyslipidemic drugs, on mortality. We explored the overall effect of all dyslipidemic drugs on coronary artery disease mortality, cardio-vascular disease mortality and all-cause mortality. A meta-analysis of all randomized controlled trials that were published before February 2006 was carried out. Data sources were published articles in bibliographic electronic databases and medical journals. The article selection criteria included all randomized placebo-controlled trials of at least one year duration and those which measured at least one of the following clinical endpoints: coronary artery disease mortality, cardio-vascular mortality or all-cause mortality. Information on sample size, follow up period, drug used, and clinical outcomes was abstracted independently by two authors. Disagreements were resolved by consensus. The meta-analysis (19 trials, 59033 patients) showed a significant relative risk reduction of coronary artery disease mortality of 23% (P<0.00001), cardiovascular disease mortality of 19% (P<0.00001) and all-cause mortality of 14% (P<0.0001), without any significant heterogeneity and inconsistency between the trials. It was concluded from this meta-analyses that dyslipidemic drugs are indeed highly effective medicines and confer benefit to patients, in terms of primary and secondary prevention of coronary artery disease.
Highlights
Cardio-vascular disease (CVD) is the world’s leading killer, accounting for 16.7 million or 29.2% of the total global deaths in 2003
Eligibility Criteria Two authors separately reviewed the abstracts produced by the literature search to identify studies that are randomized placebo-controlled trials evaluating the effectiveness of any dyslipidemic drug and reporting one of the following clinical endpoints: CAD mortality, CVD mortality or all-cause mortality
Treatment reduced the relative risk of CHD mortality by 23%
Summary
Cardio-vascular disease (CVD) is the world’s leading killer, accounting for 16.7 million or 29.2% of the total global deaths in 2003. While deaths from heart attacks have declined more than 50% since the 1960s in many industrialized countries, 80% of the global CVD related deaths occur in low and middleincome nations, which cover most countries in Asia. In India, in the past five decades, the rate of coronary disease among urban populations has risen from 4 to 11%.[1]. Dyslipidemia (elevated total cholesterol and Low-density Lipoprotein (LDL), and depressed High-density Lipoprotein (HDL) levels are independent risk factors. Statins (HMG-CoA reductase), fibrates and resins are known dyslipidemic drugs, which act by increasing or decreasing lipoprotein (Lp) or its components levels. Many trials have been conducted to show their effectiveness in treating Coronary Artery Diseases (CAD).
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