Positive outcome trials driven by reduction in nonfatal myocardial infarction: A systematic review and relevant guideline recommendations
Authors' conclusion
In contemporary pharmacological RCTs with positive composite outcome driven by nonfatal MI reduction, intensive lipid-lowering trials are more frequently received strong guideline recommendations.
Study context
- Population
- Pharmacological randomized controlled trials (RCTs) published 2000–2024 with positive outcomes driven by nonfatal myocardial infarction (MI) reduction, cited in current guidelinesRCTs, of 21,005 records
- Participants
- 6 rcts
- Comparison
- Guideline recommendation classes for positive RCTs driven by nonfatal MI reduction, by therapy class
- Intensive lipid-loweringn = 2
- Anti-thromboticn = 3
- Anti-inflammatoryn = 1
- Outcome
- Guideline recommendation class by therapy type of trials with positive outcomes driven by nonfatal MI reduction
Methodological detailsleave-one-out analysis, meta-analysis of intensive lipid-lowering RCTs
- Leave-one-out analysis
- Meta-analysis of intensive lipid-lowering RCTs
Pooled result
As reported in the abstract
Class IIb
| Outcome | Intensive lipid-lowering | Anti-thrombotic | Anti-inflammatory | |
|---|---|---|---|---|
| Class I | 45% | Not reported in the abstract | Not reported in the abstract | Anti-thrombotic, Anti-inflammatory: not reported in the abstract |
| Class IIa | 33.3% | Not reported in the abstract | Not reported in the abstract | Anti-thrombotic, Anti-inflammatory: not reported in the abstract |
Further pooled results
Primary composite outcome after removing nonfatal MI events (meta-analysis of IMPROVE-IT, FOURIER, ODYSSEY OUTCOMES, on top of maximally tolerated statins)
| Comparison | RR (95% CI) | |
|---|---|---|
| Intensive lipid-loweringNo statistical difference | 0.94 (0.88–1.01) | |
| 0.512Relative risk (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Positive outcome trials driven by reduction in nonfatal myocardial infarction: A systematic review and relevant guideline recommendations. Am Heart J. Published 18 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it