5th June 2006
There's an interesting paper in the June 2006 journal Heart:
Effect of statins on the mortality of patients with ischaemic heart disease: population based cohort study with nested case–control analysis
by J. Hippisley-Cox and C. Coupland (both from University of Nottingham)
Heart 92(6):752-758
These two studied 13,029 patients who were already diagnosed as having "ischaemic heart disease". A quote from their results sums things up:
"In the case–control analysis, patients taking statins had a 39% lower risk of death than did patients not taking statins (adjusted OR 0.61, 95% CI 0.52 to 0.72) after use of other medication, co-morbidity, smoking, body mass index, and deprivation were taken into account. The benefits found in this study compared favourably with those found in the randomised controlled trials, although the current study population is at higher overall risk. The benefits extend to women, patients with diabetes, and the elderly and can be seen within two years of treatment. Longer duration of usage was associated with lower OR for risk of death with a 19% reduction in risk of death with each additional year of treatment (adjusted OR 0.81, 95% CI 0.77 to 0.86 per year). Mortality was similarly reduced among patients prescribed atorvastatin (adjusted OR 0.62, 95% CI 0.48 to 0.79) and simvastatin (adjusted OR 0.62, 95% CI 0.50 to 0.76)."
and thier conclusions:
Conclusions: The benefits of statins found in randomised controlled trials extend to unselected community based patients. The benefits can be seen within the first two years of treatment and continue to accrue over time. Since patients in the community are likely to be at higher risk than those in trials, the potential benefits from statins are likely to be greater than expected."
Just more food for thought, and I'd emphasize that these were people with known heart disease, not a random general population trial.
P.S. "OR" means the "odds ratio" which is a way of comparing whether the probability of a certain event is the same for two groups (ie. on OR=1 means the probability is the same for both groups).
Effect of statins on the mortality of patients with ischaemic heart disease: population based cohort study with nested case–control analysis
by J. Hippisley-Cox and C. Coupland (both from University of Nottingham)
Heart 92(6):752-758
These two studied 13,029 patients who were already diagnosed as having "ischaemic heart disease". A quote from their results sums things up:
"In the case–control analysis, patients taking statins had a 39% lower risk of death than did patients not taking statins (adjusted OR 0.61, 95% CI 0.52 to 0.72) after use of other medication, co-morbidity, smoking, body mass index, and deprivation were taken into account. The benefits found in this study compared favourably with those found in the randomised controlled trials, although the current study population is at higher overall risk. The benefits extend to women, patients with diabetes, and the elderly and can be seen within two years of treatment. Longer duration of usage was associated with lower OR for risk of death with a 19% reduction in risk of death with each additional year of treatment (adjusted OR 0.81, 95% CI 0.77 to 0.86 per year). Mortality was similarly reduced among patients prescribed atorvastatin (adjusted OR 0.62, 95% CI 0.48 to 0.79) and simvastatin (adjusted OR 0.62, 95% CI 0.50 to 0.76)."
and thier conclusions:
Conclusions: The benefits of statins found in randomised controlled trials extend to unselected community based patients. The benefits can be seen within the first two years of treatment and continue to accrue over time. Since patients in the community are likely to be at higher risk than those in trials, the potential benefits from statins are likely to be greater than expected."
Just more food for thought, and I'd emphasize that these were people with known heart disease, not a random general population trial.
P.S. "OR" means the "odds ratio" which is a way of comparing whether the probability of a certain event is the same for two groups (ie. on OR=1 means the probability is the same for both groups).
