American journal of cardiovascular drugs : drugs, devices, and other interventions · 2020
Overall Mortality and LDL Cholesterol Reduction in Secondary Prevention Trials of Cardiovascular Disease.
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Pedro-Botet Juan, López-Miranda Jose, Badimón Lina, Civeira Fernando, Guijarro Carlos, Millán Jesús, Mostaza Jose M, Pintó Xavier, Valdivielso Pedro, Masana Luis, Expert group from the Spanish Arteriosclerosis Society
Аннотация
Pooled data from randomized clinical trials on lipid-lowering therapy have provided valuable information and clinical insights. Although cardiovascular disease is a common cause of death, mortality data have rarely been prominent in key lipid trials. The 4S, LIPID and HPS trials were the first to demonstrate a reduction in overall mortality. Lower- versus higher-intensity statin trials and non-statin lipid-lowering trials with ezetimibe and proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors proved that additional lipid lowering significantly reduces the occurrence of cardiovascular events. However, only the ODYSSEY OUTCOMES trial showed a reduction in all-cause mortality. The aim of the present narrative review was to contrast these results with those of other key lipid trials: those assessing statins compared with placebo, those evaluating intensive- versus moderate-intensity lipid-lowering therapy and, finally, those investigating non-statin lipid-lowering therapies.