Prevention & lipidsMeta-analysis
Alternative LDL Cholesterol–Lowering Strategy vs High-Intensity Statins in Atherosclerotic Cardiovascular Disease
- Systematic review and individual patient data meta-analysis of randomised trials
- 1-stage approach
Authors' conclusion
Results of this systematic review and individual patient data meta-analysis suggest that compared with a high-intensity statin strategy, the alternative LDL cholesterol-lowering strategy demonstrated comparable efficacy regarding 3-year death or cardiovascular events in patients with ASCVD, with an associated reduction in LDL cholesterol levels and risk for new-onset diabetes and intolerance.
Study context
- Population
- Patients with atherosclerotic CVD (atherosclerotic cardiovascular disease (ASCVD))
- Participants
- 8,180 patients · 2 RCTs
- Comparison
- Alternative LDL-C–lowering strategy vs high-intensity statin strategy
- Alternative strategyn = 4,094
- High-intensity statin strategyn = 4,086reference
- Outcome
- Composite of:
- All-cause death
- MI
- Stroke
- Coronary revascularization
- Follow-up
- 3 years
Pooled result
As reported in the abstract
Hazard ratio
0.98
95% CI 0.84–1.15
P = 0.82
Events by group
Further pooled results
LDL-C during treatment
P < 0.001
Safety
New-onset DM
P = 0.047
Initiation of antidiabetic medication for new-onset DM
P = 0.02
Intolerance-related discontinuation or dose reduction
P < 0.001
Original publication
Summarised from the published abstract; every number is checked against it