obsidian/🥙 Nutrition Vault/Shitty meta-analysis on statin efficacy.md
2024-09-14 08:39:18 -05:00

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Byrne, Paula, et al. Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment: A Systematic Review and Meta-Analysis. _JAMA Internal Medicine_, Mar. 2022. _Silverchair_, https://doi.org/10.1001/jamainternmed.2022.0134.
**Link:**
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2790055
**Notes:**
>- No distinction between time-based and event-based stopping conditions.
>- Relative risk and absolute risk are answering two different questions.
>- Included many trials with chronic kidney failure and on hemodialysis (high risk with unclear potential benefit of lipid lowering).
>- Unclear distinction between high and moderate risk populations, with high risk populations already having achieved significant lipid reductions.
>- Authors assume linearity in the relationship between LDL and their endpoints (average 3-4 years versus 20 years, when the largest risk reductions seem to be achieved).
>- Mixed primary and secondary prevention trials.
**Conclusions:**
> The results of this meta-analysis suggest that the absolute risk reductions of treatment with statins in terms of all-cause mortality, myocardial infarction, and stroke are modest compared with the relative risk reductions, and the presence of significant heterogeneity reduces the certainty of the evidence. A conclusive association between absolute reductions in LDL-C levels and individual clinical outcomes was not established, and these findings underscore the importance of discussing absolute risk reductions when making informed clinical decisions with individual patients.
**PDF:**
[[📂 Media/PDFs/Evaluating_the_Association_Between_Low-Density_Lipoprotein_Cholesterol_Reduction_and_Relative_and_Absolute_Effects_of_Statin_Treatment_A_Systematic_Review_and_Meta-analysis.pdf]]
| **Endpoints** | **Exposures** | **Populations** | **General** | **People** |
| ------------- | ------------------ | --------------- | ------------- | ---------- |
| #coronary_heart_disease | #statins | #humans | #blood_lipids | |
| #all_cause_mortality | #LDL | #multinational | #disease | |
| #stroke | #serum_cholesterol | | #clownery | |
| | | | #clown_papers | | | | | | |
****