Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials

2005, Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90 056 participants in 14 randomised trials of statins, Lancet, 366, 1267, 10.1016/S0140-6736(05)67394-1 1994, Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S), Lancet, 344, 1383 Shepherd, 1995, Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia, N Engl J Med, 333, 1301, 10.1056/NEJM199511163332001 Sacks, 1996, The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators, N Engl J Med, 335, 1001, 10.1056/NEJM199610033351401 1997, The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts, N Engl J Med, 336, 153, 10.1056/NEJM199701163360301 Downs, 1998, Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS, JAMA, 279, 1615, 10.1001/jama.279.20.1615 1998, Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels, N Engl J Med, 339, 1349, 10.1056/NEJM199811053391902 2000, Results of the low dose (20 mg) pravastatin GISSI Prevenzione trial in 4271 patients with recent myocardial infarction: do stopped trials contribute to overall knowledge?, Ital Heart J, 1, 810 Serruys, 2002, Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention, JAMA, 287, 3215, 10.1001/jama.287.24.3215 2002, MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebo-controlled trial, Lancet, 360, 7, 10.1016/S0140-6736(02)09327-3 Shepherd, 2002, Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial, Lancet, 360, 1623, 10.1016/S0140-6736(02)11600-X 2002, Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care, JAMA, 288, 2998, 10.1001/jama.288.23.2998 Sever, 2003, Lancet, 361, 1149, 10.1016/S0140-6736(03)12948-0 Holdaas, 2003, Effect of fluvastatin on cardiac outcomes in renal transplant recipients: a multicentre, randomised, placebo-controlled trial, Lancet, 361, 2024, 10.1016/S0140-6736(03)13638-0 Colhoun, 2004, Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial, Lancet, 364, 685, 10.1016/S0140-6736(04)16895-5 Stamler, 1993, Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial, Diabetes Care, 16, 434, 10.2337/diacare.16.2.434 Chen, 1991, Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations, BMJ, 303, 276, 10.1136/bmj.303.6797.276 2007, Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55 000 vascular deaths, Lancet, 370, 1829, 10.1016/S0140-6736(07)61778-4 Davidson, 1997, The efficacy and six-week tolerability of simvastatin 80 and 160 mg/day, Am J Cardiol, 79, 38, 10.1016/S0002-9149(96)00742-4 Pedersen, 1996, Benefits and risks of HMG-CoA reductase inhibitors in the prevention of coronary heart disease: a reappraisal, Drug Saf, 14, 11, 10.2165/00002018-199614010-00003 de Lemos, 2004, Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial, JAMA, 292, 1307, 10.1001/jama.292.11.1307 Cannon, 2004, Intensive versus moderate lipid lowering with statins after acute coronary syndromes, N Engl J Med, 350, 1495, 10.1056/NEJMoa040583 Pedersen, 2005, High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial, JAMA, 294, 2437, 10.1001/jama.294.19.2437 LaRosa, 2005, Intensive lipid lowering with atorvastatin in patients with stable coronary disease, N Engl J Med, 352, 1425, 10.1056/NEJMoa050461 2010, Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12 064 survivors of myocardial infarction: a double-blind randomised trial, Lancet Cannon, 2006, Meta-analysis of cardiovascular outcomes trials comparing intensive versus moderate statin therapy, J Am Coll Cardiol, 48, 438, 10.1016/j.jacc.2006.04.070 Wanner, 2005, Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis, N Engl J Med, 353, 238, 10.1056/NEJMoa043545 Fellstrom, 2009, Rosuvastatin and cardiovascular events in patients undergoing hemodialysis, N Engl J Med, 360, 1395, 10.1056/NEJMoa0810177 2008, Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial, Lancet, 372, 1231, 10.1016/S0140-6736(08)61240-4 Kjekshus, 2007, Rosuvastatin in older patients with systolic heart failure, N Engl J Med, 357, 2248, 10.1056/NEJMoa0706201 2006, High-dose atorvastatin after stroke or transient ischemic attack, N Engl J Med, 355, 549, 10.1056/NEJMoa061894 Alsheikh-Ali, 2007, Effect of the magnitude of lipid-lowering on risk of elevated liver enzymes, rhabdomyolysis, and cancer: insights from large randomized statin trials, J Am Coll Cardiol, 50, 409, 10.1016/j.jacc.2007.02.073 Ben-Yehuda, 2008, Low LDL-C levels and cancer: reassuring but still not definitive, J Am Coll Cardiol, 52, 1150, 10.1016/j.jacc.2008.08.001 1995, Protocol for a prospective collaborative overview of all current and planned randomized trials of cholesterol treatment regimens. Cholesterol Treatment Trialists' (CTT) Collaboration, Am J Cardiol, 75, 1130, 10.1016/S0002-9149(99)80744-9 Nakamura, 2006, Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial, Lancet, 368, 1155, 10.1016/S0140-6736(06)69472-5 Ridker, 2008, Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein, N Engl J Med, 359, 2195, 10.1056/NEJMoa0807646 Koren, 2004, Clinical outcomes in managed-care patients with coronary heart disease treated aggressively in lipid-lowering disease management clinics: the alliance study, J Am Coll Cardiol, 44, 1772 Knopp, 2006, Efficacy and safety of atorvastatin in the prevention of cardiovascular end points in subjects with type 2 diabetes: the Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in non-insulin-dependent diabetes mellitus (ASPEN), Diabetes Care, 29, 1478, 10.2337/dc05-2415 Athyros, 2002, Treatment with atorvastatin to the National Cholesterol Education Program goal versus ‘usual’ care in secondary coronary heart disease prevention. The GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) study, Curr Med Res Opin, 18, 220, 10.1185/030079902125000787 Ridker, 2010, HDL cholesterol and residual risk of first cardiovascular events after treatment with potent statin therapy: an analysis from the JUPITER trial, Lancet, 376, 333, 10.1016/S0140-6736(10)60713-1 Iso, 1989, Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the Multiple Risk Factor Intervention Trial, N Engl J Med, 320, 904, 10.1056/NEJM198904063201405 Goldstein, 2007, Low LDL cholesterol, statins, and brain hemorrhage: should we worry?, Neurology, 68, 719, 10.1212/01.wnl.0000258538.06950.a1 Grundy, 2004, Implications of recent trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines, J Am Coll Cardiol, 44, 720, 10.1016/j.jacc.2004.07.001 2008 Armitage, 2007, The safety of statins in clinical practice, Lancet, 370, 1781, 10.1016/S0140-6736(07)60716-8 Davidson, 2007, Safety of aggressive lipid management, J Am Coll Cardiol, 49, 1753, 10.1016/j.jacc.2007.01.067 Ara, 2009, Early high-dose lipid-lowering therapy to avoid cardiac events: a systematic review and economic evaluation, Health Technol Assess, 13, 1, 10.3310/hta13340