Postponement of Death by Statin Use: a Systematic Review and Meta-analysis of Randomized Clinical Trials
| Autor: | Per Damkier, Jesper Hallas, Kasper Søltoft Larsen, Anton Pottegård, Malene Elisa Lopez Kristensen, Asbjørn Hróbjartsson, Kenneth Grønkjær Madsen, Morten Rix Hansen, René dePont Christensen, Palle Mark Christensen |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Relative risk reduction Pediatrics medicine.medical_specialty Review Article Kaplan-Meier Estimate ATORVASTATIN 01 natural sciences law.invention EVENTS 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Secondary Prevention Internal Medicine Humans Medicine CORONARY-HEART-DISEASE LIFE EXPECTANCY 030212 general & internal medicine 0101 mathematics ROSUVASTATIN Aged Randomized Controlled Trials as Topic CARDIAC OUTCOMES business.industry Mortality rate Postponement 010102 general mathematics Hazard ratio Middle Aged PREVENTION Survival Analysis Primary Prevention DENSITY-LIPOPROTEIN CHOLESTEROL CARDIOVASCULAR-DISEASE PRAVASTATIN Relative risk Meta-analysis Number needed to treat Female Hydroxymethylglutaryl-CoA Reductase Inhibitors business |
| Zdroj: | J Gen Intern Med Hansen, M R, Hrobjartsson, A, Pottegard, A, Damkier, P, Larsen, K S, Madsen, K G, Christensen, R D, Kristensen, M E L, Christensen, P M & Hallas, J 2019, ' Postponement of Death by Statin Use : a Systematic Review and Meta-analysis of Randomized Clinical Trials ', Journal of General Internal Medicine, vol. 34, no. 8, pp. 1607-1614 . https://doi.org/10.1007/s11606-019-05024-4 Hansen, M R, Hróbjartsson, A, Pottegård, A, Damkier, P, Larsen, K S, Madsen, K G, dePont Christensen, R, Kristensen, M E L, Christensen, P M & Hallas, J 2019, ' Postponement of Death by Statin Use : a Systematic Review and Meta-analysis of Randomized Clinical Trials ', Journal of General Internal Medicine, vol. 34, no. 8, pp. 1607-1614 . https://doi.org/10.1007/s11606-019-05024-4 |
| ISSN: | 1525-1497 0884-8734 4201-6037 |
| DOI: | 10.1007/s11606-019-05024-4 |
| Popis: | BACKGROUND: The average postponement of the outcome (gain in time to event) has been proposed as a measure to convey the effect of preventive medications. Among its advantages over number needed to treat and relative risk reduction is a better intuitive understanding among lay persons. OBJECTIVES: To develop a novel approach for modeling outcome postponement achieved within a trial’s duration, based on published trial data and to present a formalized meta-analysis of modeled outcome postponement for all-cause mortality in statin trials. METHODS: The outcome postponement was modeled on the basis of the hazard ratio or relative risk, the mortality rate in the placebo group and the trial’s duration. Outcome postponement was subjected to a meta-analysis. We also estimated the average outcome postponement as the area between Kaplan–Meier curves. Statin trials were identified through a systematic review. RESULTS: The median modeled outcome postponement was 10.0 days (interquartile range, 2.9–19.5 days). Meta-analysis of 16 trials provided a summary estimate of outcome postponement for all-cause mortality of 12.6 days, with a 95% postponement interval (PI) of 7.1–18.0. For primary, secondary, and mixed prevention trials, respectively, outcome postponements were 10.2 days (PI, 4.0–16.3), 17.4 days (PI, 6.0–28.8), and 8.5 days (PI, 1.9–15.0). CONCLUSIONS: The modeled outcome postponement is amenable to meta-analysis and may be a useful approach for presenting the benefits of preventive interventions. Statin treatment results in a small increase of average survival within the duration of a trial. SYSTEMATIC REVIEW REGISTRATION: The systematic review was registered in PROSPERO [CRD42016037507]. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-019-05024-4) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink