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Statins and n-3 fatty acids are the best lipid-lowering interventions for reducing mortality
ARTICLE IN PRESS Evidence-based Cardiovascular Medicine (2005) 9, 237–238
Evidence-based
CARDIOVASCULAR MEDICINE www.elsevier.com/locate/ebcm
OTHER PAPERS
Statins and n-3 fatty acids are the best lipidlowering interventions for reducing mortality$ Background Many studies have investigated the prevention and treatment of hyperlipidemia, but trials often use clinical endpoints or focus on lipid lowering rather than mortality outcomes.
Objective Studer and colleagues assessed the efficacy and safety of different lipid-lowering interventions based on mortality data. The main outcomes were mortality from all, cardiac, and non-cardiovascular causes.
and niacin had no significant effect on overall mortality compared to controls (see Table 1). Fibrates potentially reduced cardiac mortality but this was offset by an increased risk of death from non-cardiovascular causes.
Table 1 Mortality reductions from lipid-lowering therapies Overall mortality Cardiac mortality risk ratio (95% CI) risk ratio (95% CI) N-3 fatty acids Statins Fibrates
Method This systematic review included 97 randomised trials with 276,116 participants. The authors searched Medline, Embase, Pascal, the Cochrane Controlled Trials Register, and previous reviews for trials published between 1965 and June 2003 that compared mortality outcomes from a lipid-lowering intervention versus placebo or usual diet. There were no language restrictions.
Main results Compared to controls, statins and n-3 fatty acids reduced overall mortality. Resins, fibrates, diet, DOI of associated commentary: 10.1016/j.ebcm.2005.06.025 Abstracted from Studer M, Briel M, Leimenstoll B, et al. Effect of different antilipidemic agents and diets on mortality: a systematic review. Arch Intern Med 2005; 165(7): 725–30. $
doi:10.1016/j.ebcm.2005.06.024
Resins Niacin Diet
0.77 (0.63 to 0.94) 0.87 (0.81 to 0.94) 1.00 (0.91 to 1.11) 0.84 (0.66 to 1.08) 0.96 (0.86 to 1.08) 0.97 (0.91 to 1.04)
0.68 (0.52 to 0.90) 0.78 (0.72 to 0.84) 0.93 (0.81 to 1.08) 0.70 (0.50 to 0.99) 0.95 (0.82 to 1.10) 0.91 (0.82 to 1.02)
Authors’ conclusions The authors concluded that statins and n-3 fatty acids are the best lipid-lowering interventions for reducing overall and cardiac mortality.
ARTICLE IN PRESS 238
Other papers
Overall quality The authors did not report any study sponsorship. Individual authors were sponsored by Foundations. Enquiries to [email protected]
topic importance
Results abstracted by Debbie Singh.
method quality practical use Poor
Fair
Good
Excellent
Evidence-based
CARDIOVASCULAR MEDICINE www.elsevier.com/locate/ebcm
OTHER PAPERS
Statins and n-3 fatty acids are the best lipidlowering interventions for reducing mortality$ Background Many studies have investigated the prevention and treatment of hyperlipidemia, but trials often use clinical endpoints or focus on lipid lowering rather than mortality outcomes.
Objective Studer and colleagues assessed the efficacy and safety of different lipid-lowering interventions based on mortality data. The main outcomes were mortality from all, cardiac, and non-cardiovascular causes.
and niacin had no significant effect on overall mortality compared to controls (see Table 1). Fibrates potentially reduced cardiac mortality but this was offset by an increased risk of death from non-cardiovascular causes.
Table 1 Mortality reductions from lipid-lowering therapies Overall mortality Cardiac mortality risk ratio (95% CI) risk ratio (95% CI) N-3 fatty acids Statins Fibrates
Method This systematic review included 97 randomised trials with 276,116 participants. The authors searched Medline, Embase, Pascal, the Cochrane Controlled Trials Register, and previous reviews for trials published between 1965 and June 2003 that compared mortality outcomes from a lipid-lowering intervention versus placebo or usual diet. There were no language restrictions.
Main results Compared to controls, statins and n-3 fatty acids reduced overall mortality. Resins, fibrates, diet, DOI of associated commentary: 10.1016/j.ebcm.2005.06.025 Abstracted from Studer M, Briel M, Leimenstoll B, et al. Effect of different antilipidemic agents and diets on mortality: a systematic review. Arch Intern Med 2005; 165(7): 725–30. $
doi:10.1016/j.ebcm.2005.06.024
Resins Niacin Diet
0.77 (0.63 to 0.94) 0.87 (0.81 to 0.94) 1.00 (0.91 to 1.11) 0.84 (0.66 to 1.08) 0.96 (0.86 to 1.08) 0.97 (0.91 to 1.04)
0.68 (0.52 to 0.90) 0.78 (0.72 to 0.84) 0.93 (0.81 to 1.08) 0.70 (0.50 to 0.99) 0.95 (0.82 to 1.10) 0.91 (0.82 to 1.02)
Authors’ conclusions The authors concluded that statins and n-3 fatty acids are the best lipid-lowering interventions for reducing overall and cardiac mortality.
ARTICLE IN PRESS 238
Other papers
Overall quality The authors did not report any study sponsorship. Individual authors were sponsored by Foundations. Enquiries to [email protected]
topic importance
Results abstracted by Debbie Singh.
method quality practical use Poor
Fair
Good
Excellent