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Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials
This meta-analysis demonstrated the effect of intensive versus standard statins on the risk of stroke in patients with coronary artery syndromes (CAS). PubMed, Embase, the Cochrane library, and clinicaltrials.gov were searched, and the retrieved studies were undertaken for randomized controlled tria...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Journal of Cardiovascular Pharmacology
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190051/ https://www.ncbi.nlm.nih.gov/pubmed/31876797 http://dx.doi.org/10.1097/FJC.0000000000000784 |
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author | Xie, Chengjuan Zhu, Mingyu Hu, Ying Wang, Kai |
author_facet | Xie, Chengjuan Zhu, Mingyu Hu, Ying Wang, Kai |
author_sort | Xie, Chengjuan |
collection | PubMed |
description | This meta-analysis demonstrated the effect of intensive versus standard statins on the risk of stroke in patients with coronary artery syndromes (CAS). PubMed, Embase, the Cochrane library, and clinicaltrials.gov were searched, and the retrieved studies were undertaken for randomized controlled trials (RCTs) throughout September 2018. Studies that were designed as RCTs and recruited at least 1000 CAS patients followed up greater than 1 year were eligible for this study. The summary relative risk with the 95% confidence interval was used as an effect estimate and calculated using the random-effects model. Five RCTs comprising a total of 39,612 coronary syndrome patients with reported 1236 stroke events were included in this meta-analysis. The summary result indicated a 14% reduction in the risk of stroke in CAS patients receiving intensive statin therapy as compared to standard statin therapy. The significant differences mainly occurred in mean age ≥60 years (P = 0.007), percentage of males ≥80% (P = 0.011), percentage diabetes mellitus ≥ 15% (P = 0.018), percentage hypertension ≥50% (P = 0.030), percentage of current smokers <30% (P = 0.011), percentage of prior myocardial infarction ≥50% (P = 0.011), percentage of peripheral arterial disease ≥10% (P = 0.030), patients with stable CAS (P = 0.011), patients using atorvastatin (P = 0.015), follow-up duration ≥3 years (P = 0.011), and study with moderate quality (P = 0.013). Intensive statin therapy should be considered for CAS patients at high risk of stroke events. Further large-scale RCT should be conducted to verify the results of stratified analysis in this study. |
format | Online Article Text |
id | pubmed-7190051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Journal of Cardiovascular Pharmacology |
record_format | MEDLINE/PubMed |
spelling | pubmed-71900512020-05-04 Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials Xie, Chengjuan Zhu, Mingyu Hu, Ying Wang, Kai J Cardiovasc Pharmacol Original Article This meta-analysis demonstrated the effect of intensive versus standard statins on the risk of stroke in patients with coronary artery syndromes (CAS). PubMed, Embase, the Cochrane library, and clinicaltrials.gov were searched, and the retrieved studies were undertaken for randomized controlled trials (RCTs) throughout September 2018. Studies that were designed as RCTs and recruited at least 1000 CAS patients followed up greater than 1 year were eligible for this study. The summary relative risk with the 95% confidence interval was used as an effect estimate and calculated using the random-effects model. Five RCTs comprising a total of 39,612 coronary syndrome patients with reported 1236 stroke events were included in this meta-analysis. The summary result indicated a 14% reduction in the risk of stroke in CAS patients receiving intensive statin therapy as compared to standard statin therapy. The significant differences mainly occurred in mean age ≥60 years (P = 0.007), percentage of males ≥80% (P = 0.011), percentage diabetes mellitus ≥ 15% (P = 0.018), percentage hypertension ≥50% (P = 0.030), percentage of current smokers <30% (P = 0.011), percentage of prior myocardial infarction ≥50% (P = 0.011), percentage of peripheral arterial disease ≥10% (P = 0.030), patients with stable CAS (P = 0.011), patients using atorvastatin (P = 0.015), follow-up duration ≥3 years (P = 0.011), and study with moderate quality (P = 0.013). Intensive statin therapy should be considered for CAS patients at high risk of stroke events. Further large-scale RCT should be conducted to verify the results of stratified analysis in this study. Journal of Cardiovascular Pharmacology 2020-03-27 /pmc/articles/PMC7190051/ /pubmed/31876797 http://dx.doi.org/10.1097/FJC.0000000000000784 Text en Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Article Xie, Chengjuan Zhu, Mingyu Hu, Ying Wang, Kai Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials |
title | Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials |
title_full | Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials |
title_fullStr | Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials |
title_full_unstemmed | Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials |
title_short | Effect of Intensive and Standard Lipid-Lowering Therapy on the Progression of Stroke in Patients With Coronary Artery Syndromes: A Meta-Analysis of Randomized Controlled Trials |
title_sort | effect of intensive and standard lipid-lowering therapy on the progression of stroke in patients with coronary artery syndromes: a meta-analysis of randomized controlled trials |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190051/ https://www.ncbi.nlm.nih.gov/pubmed/31876797 http://dx.doi.org/10.1097/FJC.0000000000000784 |
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