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@article{Collins:2016:10.1016/S0140-6736(16)31357-5,
author = {Collins, R and Reith, C and Emberson, J and Armitage, J and Baigent, C and Blackwell, L and Blumenthal, R and Danesh, J and Smith, GD and DeMets, D and Evans, S and Law, M and MacMahon, S and Martin, S and Neal, B and Poulter, N and Preiss, D and Ridker, P and Roberts, I and Rodgers, A and Sandercock, P and Schulz, K and Sever, P and Simes, J and Smeeth, L and Wald, N and Yusuf, S and Peto, R},
doi = {10.1016/S0140-6736(16)31357-5},
journal = {Lancet},
pages = {2532--2561},
title = {Interpretation of the evidence for the efficacy and safety of statin therapy},
url = {http://dx.doi.org/10.1016/S0140-6736(16)31357-5},
volume = {388},
year = {2016}
}

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TY  - JOUR
AB  - This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment. Large-scale evidence from randomised trials shows that statin therapy reduces the risk of major vascular events (ie, coronary deaths or myocardial infarctions, strokes, and coronary revascularisation procedures) by about one-quarter for each mmol/L reduction in LDL cholesterol during each year (after the first) that it continues to be taken. The absolute benefits of statin therapy depend on an individual's absolute risk of occlusive vascular events and the absolute reduction in LDL cholesterol that is achieved. For example, lowering LDL cholesterol by 2 mmol/L (77 mg/dL) with an effective low-cost statin regimen (eg, atorvastatin 40 mg daily, costing about £2 per month) for 5 years in 10000 patients would typically prevent major vascular events from occurring in about 1000 patients (ie, 10% absolute benefit) with pre-existing occlusive vascular disease (secondary prevention) and in 500 patients (ie, 5% absolute benefit) who are at increased risk but have not yet had a vascular event (primary prevention). Statin therapy has been shown to reduce vascular disease risk during each year it continues to be taken, so larger absolute benefits would accrue with more prolonged therapy, and these benefits persist long term. The only serious adverse events that have been shown to be caused by long-term statin therapy-ie, adverse effects of the statin-are myopathy (defined as muscle pain or weakness combined with large increases in blood concentrations of creatine ki
AU  - Collins,R
AU  - Reith,C
AU  - Emberson,J
AU  - Armitage,J
AU  - Baigent,C
AU  - Blackwell,L
AU  - Blumenthal,R
AU  - Danesh,J
AU  - Smith,GD
AU  - DeMets,D
AU  - Evans,S
AU  - Law,M
AU  - MacMahon,S
AU  - Martin,S
AU  - Neal,B
AU  - Poulter,N
AU  - Preiss,D
AU  - Ridker,P
AU  - Roberts,I
AU  - Rodgers,A
AU  - Sandercock,P
AU  - Schulz,K
AU  - Sever,P
AU  - Simes,J
AU  - Smeeth,L
AU  - Wald,N
AU  - Yusuf,S
AU  - Peto,R
DO  - 10.1016/S0140-6736(16)31357-5
EP  - 2561
PY  - 2016///
SN  - 1474-547X
SP  - 2532
TI  - Interpretation of the evidence for the efficacy and safety of statin therapy
T2  - Lancet
UR  - http://dx.doi.org/10.1016/S0140-6736(16)31357-5
UR  - http://hdl.handle.net/10044/1/43661
VL  - 388
ER  -

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