A systematic review and meta-analysis suggests that the absolute benefits of statins are modest and may not be strongly mediated through the degree of low-density lipoprotein cholesterol (LDL-C) reduction. The analysis included 21 randomized clinical trials that examined the effectiveness of statins in reducing total mortality and cardiovascular outcomes with a planned duration of 2 or more years and that reported absolute changes in LDL-C levels. With significant heterogeneity, the meta-analyses showed reductions in the absolute risk of 0.8%, 1.3% and 0.4%, respectively, for all-cause mortality, myocardial infarction, and stroke in those randomized to treatment with statins compared with control, with associated relative risk reductions of 9%, 29%, and 14% respectively. A meta-regression exploring the potential mediating association of the magnitude of statin-induced LDL-C reduction with the outcomes was inconclusive. These findings underscore the importance of discussing absolute risk reductions when making informed clinical decisions with individual patients as well as to make clinical guidelines and policy. Source: https://jamanetwork.com/
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