Statin 當primary prevention仍存疑(Jupitor substudy做HSCRP的人被認為有問題)
Archives' Studies Call into Question Statins for Primary Prevention
Two papers in the Archives of Internal Medicine cast doubt on the benefits of statins for primary prevention.
In a meta-analysis, researchers combined data from 11 placebo-controlled trials of statin use in some 65,000 high-risk patients without cardiovascular disease at baseline. During nearly 4 years of treatment, LDL levels were lower in statin than in placebo users (mean, 94 vs. 134 mg/dL) — but there was no difference in all-cause mortality. Editorialists say the analysis "makes it clear that in the short-term, for true primary prevention, the benefit, if any, is very small."
In another paper, investigators took a closer look at the JUPITER trial, in which rosuvastatin reportedly lowered cardiovascular risk by 50% among patients without heart disease or hypercholesterolemia but with high C-reactive protein. The investigators say the trial was "flawed" — it was stopped too early, data on cardiovascular mortality were lacking, and more than half the researchers had financial ties to industry. Accordingly, they conclude: "The results of the trial do not support the use of statin treatment for primary prevention."
Archives of Internal Medicine meta-analysis (Free)
Archives of Internal Medicine editorial on statins (Subscription required)
Archives of Internal Medicine article on JUPITER reappraisal (Free abstract)
Physician's First Watch coverage of initial JUPITER findings (Free)
Two papers in the Archives of Internal Medicine cast doubt on the benefits of statins for primary prevention.
In a meta-analysis, researchers combined data from 11 placebo-controlled trials of statin use in some 65,000 high-risk patients without cardiovascular disease at baseline. During nearly 4 years of treatment, LDL levels were lower in statin than in placebo users (mean, 94 vs. 134 mg/dL) — but there was no difference in all-cause mortality. Editorialists say the analysis "makes it clear that in the short-term, for true primary prevention, the benefit, if any, is very small."
In another paper, investigators took a closer look at the JUPITER trial, in which rosuvastatin reportedly lowered cardiovascular risk by 50% among patients without heart disease or hypercholesterolemia but with high C-reactive protein. The investigators say the trial was "flawed" — it was stopped too early, data on cardiovascular mortality were lacking, and more than half the researchers had financial ties to industry. Accordingly, they conclude: "The results of the trial do not support the use of statin treatment for primary prevention."
Archives of Internal Medicine meta-analysis (Free)
Archives of Internal Medicine editorial on statins (Subscription required)
Archives of Internal Medicine article on JUPITER reappraisal (Free abstract)
Physician's First Watch coverage of initial JUPITER findings (Free)
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