cholesterol lowering intervention

systematic review meta-analysis network meta-analysis

Select acute coronary syndromeacute myocardial infarctionaortic stenosisCABG surgerycardiovascular preventiondiabetes type 2familial hypercholesterolemia heart failurehypertensionperipheral vascular diseasespost myocardial infarctionpost stroke all chronical situationsAll type of patientDiabetic patientsdiabetic patients with or withour hypercholesterolemiauncoded clinical condition ***elderly patientshigh risk patients with or without LDL cholesterol elevationpatient with related diseasePatients with LDL elevation and without CHDpatients with other atherosclerotic localisationpatients with prior MI or with CHDpost stroke (or TIA)primary preventionsecondary preventionwomen       ACAT inhibitionCETP inhibitorcolestipol-niacincombination therapiesdietezetimibefibrateshormonesinhibitor of lipoprotein-associated phospholipaseniacinniacin (on top statin)other cholesterol lowering drugsPolicosanolProbucolresinsstatinsstatins high dosestatins+ezetimibestrategysurgery atorvastatincerivastatinfluvastatinlovastatinpravastatinrosuvastatinsimvastatinezetimibebezafibratefenofibratepolicosanolcholestyramineclofibratecolestipoldietestrogenetofibrategemfibrozilniacinpactimibeprobucolthyroxinetorcetrapib vs placebovs placebo or controlvs active treatmentvs angioplastyvs ezetimibevs statin       cerebral vascular diseaseearly initiationelderlyhypertensive patientskidney diseasesprimary preventionsecondary preventionsquamous NSCLCtype 2 diabetes

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Group by Group by... nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition MA  in first nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in second nothing pathology treatment patient comparator classe classe comparator mechanism clinical condition  in third	Description Synopsis Comparison Treatments Patients Characteristics Method Risk of bias References None Tools Indexation					Results Global trial result Main results All results All result tag NCT results	All cause death (370)non cardiovascular death (195)stroke (fatal and non fatal) (189)Coronary death (188)Coronary event (186)cardiovascular events (165)cardiac death (156)Non fatal MI (150)Cardiovascular death (109)Rhabdomyolysis (79)Coronary death and non fatal MI (68)Death from cancer (65)MACE (62)Fatal stroke (56)new-onset diabetes (52)Revascularization (46)Fatal MI (42)Myopathy (40)Haemmorhagic stroke (35)Adverse events (30)cardiovascular events at 4 months (30)cardiovascular events at 1 month (30)Cancer (13)Non fatal stroke (12)myocardial infarction (fatal and non fatal) (9)Venous thromboembolism (6)CABG (6)recurrent angina (6)Non vascular death (6)atrial fibrillation (5)stroke or TIA (4)TIA (4)LDL (3)HDL (at 1 y) (3)total cholesterol (at 1 y) (3)Deaths or MI (3)PTCA (3)retinopathy (2)vision loss (2)Amputation (2)cardiac event (fatal and non fatal ) (2)End stage renal disease (2)Myocardial ischemia (1) Options Numeric bar chart forest plot medians
Trial	Studied trt	Control trt	patients	tags	ROB	Trial result	All cause death	non cardiovascular death
acute coronary syndrome
atorvastatin
MIRACL, 2001	atorvastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	suggesting
Colivicchi, 2002	atorvastatin	usual care	acute coronary syndrome	early initiation	Exploratory	negative
ESTABLISH, 2004	atorvastatin	usual care	acute coronary syndrome	early initiation	Exploratory	negative
PROVE IT - TIMI 22, 2004	atorvastatin	pravastatin	acute coronary syndrome	early initiation	Low risk of bias	suggesting
ezetimibe
IMPROVE-IT, 2014      NCT	ezetimibe	placebo (on top statins)		early initiation	Low risk of bias	conclusive
fluvastatin
LIPS (sub groups), 2002	fluvastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	negative
FLORIDA, 2002	fluvastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	negative
pravastatin
LAMIL, 1997	pravastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	negative
RECIFE, 1999	pravastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	negative
PAIS, 2001	pravastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	negative
PACT, 2004	pravastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	suggesting
L-CAD, 2000	pravastatin	usual care	acute coronary syndrome	early initiation	Exploratory	suggesting
PTT, 2002	pravastatin	usual care	acute coronary syndrome	early initiation	Exploratory	suggesting
simvastatin
A to Z, 2004	simvastatin	placebo	acute coronary syndrome	early initiation		negative
acute myocardial infarction
atorvastatin
PROVE-IT, 2004	atorvastatin high dose	pravastatin	diabetic	early initiation	Low risk of bias	suggesting
aortic stenosis
atorvastatin
SALTIRE, 2005	atorvastatin	placebo	aortic stenosis		Low risk of bias	negative
rosuvastatin
ASTRONOMER, 2010	rosuvastatin	placebo	aortic stenosis		Low risk of bias	-
simvastatin
SEAS, 2008    NCT	ezetimibe+simvastatin	placebo	aortic stenosis		Low risk of bias	negative
CABG surgery
atorvastatin
Chello et al., 2006	preoperative atorvastatin	placebo			Low risk of bias	negative
Patti et al., 2006	preoperative atorvastatin	placebo			Low risk of bias	suggesting
simvastatin
Christenson, 1999	preoperative simvastatin	no treatment				negative
cardiovascular prevention
atorvastatin
ASCOT (diabetics sub group), 2003	atorvastatin	placebo	diabetic patients	primary prevention	Exploratory	negative
CARDS, 2004      NCT	atorvastatin	placebo	diabetic	type 2 diabetes	Low risk of bias	conclusive
Deutsche Diabetes Dialyse Studie (4D), 2005	atorvastatin	placebo			Low risk of bias	suggesting
ASPEN, 2006	atorvastatin	placebo	diabetic	type 2 diabetes	Low risk of bias	negative
ASPEN, 2006	atorvastatin	placebo	diabetic patients		Low risk of bias	negative
ASCOT, 2003	atorvastatin	placebo	at risk hypertensive	hypertensive patients	Low risk of bias	conclusive
MIRACL, 2001	atorvastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	suggesting
macin, 2005	atorvastatin	placebo	acute coronary syndrome	squamous NSCLC	Low risk of bias	-
SALTIRE, 2005	atorvastatin	placebo	aortic stenosis		Low risk of bias	negative
Mohler III, 2003	atorvastatin	placebo	Peripheral Arterial Disease		Exploratory	-
SPARCL, 2006      NCT	atorvastatin	placebo	post stroke	cerebral vascular disease	Low risk of bias	suggesting
Strey, 2005	atorvastatin	placebo	heart failure			-
Mohler, 2003	atorvastatin	placebo	secondary prevention		Low risk of bias	-
ASPEN (primary prevention sub group), 2006	atorvastatin	placebo	diabetic	type 2 diabetes	Low risk of bias	negative
ASCOT (women subgroup) , 2003	Atorvastatin	placebo	women		Exploratory	negative
Colivicchi, 2002	atorvastatin	usual care	acute coronary syndrome	early initiation	Exploratory	negative
ESTABLISH, 2004	atorvastatin	usual care	acute coronary syndrome	early initiation	Exploratory	negative
GREACE, 2002	atorvastatin	usual care	secondary prevention		Risk of bias	suggesting
AVERT, 1999	atorvastatin high dose	angioplasty	secondary prevention		Risk of bias	negative
TNT (diabetic sub group), 2006	atorvastatin high dose	atorvastatin	diabetic patients	secondary prevention	Low risk of bias	suggesting
TNT, 2005            NCT	atorvastatin high dose	atorvastatin	secondary prevention		Low risk of bias	conclusive
Vascular basis, 2005	atorvastatin high dose	lovastatin	secondary prevention		Exploratory	negative
PROVE IT - TIMI 22, 2004	atorvastatin	pravastatin	acute coronary syndrome	early initiation	Low risk of bias	suggesting
REVERSAL, 2004	atorvastatin high dose	pravastatin	secondary prevention		Exploratory	negative
PROVE-IT, 2004	atorvastatin high dose	pravastatin	diabetic	early initiation	Low risk of bias	suggesting
SAGE, 2007	atorvastatin high dose	pravastatin	secondary prevention		Exploratory	suggesting
IDEAL, 2005        NCT	atorvastatin high dose	simvastatin	secondary prevention		Risk of bias	suggesting
bezafibrate
SENDCAP, 1998	bezafibrate	placebo		type 2 diabetes	Exploratory	suggesting
LEADER, 2002	bezafibrate	placebo			Low risk of bias	negative
LEADER trial, 2000	bezafibrate	placebo	Peripheral Arterial Disease		Low risk of bias	-
BECAIT, 1996	bezafibrate	placebo	secondary prevention		Exploratory	suggesting
BIP, 2000	bezafibrate	placebo	secondary prevention		Low risk of bias	negative
cerivastatin
Laufs, 2004	cerivastatin	placebo	heart failure		Low risk of bias	-
cholestyramine
STARS (cholestyramine), 1992	cholestyramine	control			Low risk of bias	negative
LRC, 1984	cholestyramine	placebo			Low risk of bias	negative
NHLBI (Brensike), 1984    NCT	cholestyramine	placebo	diabetic		Exploratory	negative
clofibrate
WHO clofibrate, 1978	clofibrate	placebo			Low risk of bias	suggesting
Cullen, 1974	clofibrate	placebo			Low risk of bias	-
Harrold, 1969	clofibrate	placebo		type 2 diabetes	Low risk of bias	-
Hanefeld, 1991	clofibrate	placebo		type 2 diabetes	Low risk of bias	negative
Begg, 1971	clofibrate	placebo	secondary prevention		Exploratory	negative
Acheson, 1972	clofibrate	placebo	secondary prevention	cerebral vascular disease	Exploratory	-
VA Neurology Section, 1974	clofibrate	placebo			Low risk of bias	-
CDP Clofibrate, 1975	clofibrate	placebo			Low risk of bias	suggesting
Scottish, 1971	clofibrate	placebo			Low risk of bias	negative
Newcastle, 1971	clofibrate	placebo			Low risk of bias	suggesting
SCOR, 1990	colestipol+clofibrate	placebo	diabetic		Low risk of bias	negative
colestipol
UCS (Dorr), 1978	colestipol	placebo			Low risk of bias	negative
Ryan, 1974	colestipol	placebo			Low risk of bias	-
Gundersen, 1976	colestipol	placebo			Low risk of bias	-
Ruoff, 1978	colestipol	placebo			Low risk of bias	negative
Gross, 1973	colestipol	placebo			Low risk of bias	-
diet
Veterans Ad. (Dayton), 1969	diet	usual diet			Low risk of bias	suggesting
MRFIT, 1982	diet	usual diet			Risk of bias	-
Hjermann, 1981	diet	usual diet			Risk of bias	-
Finnish Mental Hospital (Miettinen), 1985	diet	usual diet	primary prevention		Exploratory	-
WHO Collaborative, 1986	diet	usual diet			Low risk of bias	negative
Goteborg, 1986	diet	usual diet			Risk of bias	-
Rose, 1965	diet	usual diet			Exploratory	negative
Singh, 1992	diet	usual diet			Risk of bias	-
STARS (St Thomas, diet), 1992	diet	usual diet			Exploratory	negative
Los Angeles VA (Dayton), 1969	diet	usual diet			Low risk of bias	-
Ornish, 1990	diet	usual diet			Exploratory	negative
Kallio, 1979	diet	usual diet			Exploratory	-
MRC Soya, 1968	diet	usual diet			Risk of bias	negative
Woodhill, 1966	diet	usual diet			Low risk of bias	negative
Oslo Diet Heart Study (Leren), 1966	diet	usual diet			Risk of bias	suggesting
MRC low fat, 1965	diet	usual diet			Risk of bias	negative
WHI low fat, 2005    NCT	diet	usual diet			Exploratory	negative
Göteborg (Wilhelmsen), 1986	diet	usual diet			Low risk of bias	negative
Black, 1994	diet	usual diet			Risk of bias	negative
Minnesota coronary survey (Frantz), 1975	diet	usual diet			Exploratory	negative
Tuttle, 2008	low fat diet	mediterranean-style diet			Risk of bias	-
estrogen
Marmorstein, 1962	estrogen	placebo			Low risk of bias	-
Stamler, 1963	estrogen	placebo			Low risk of bias	-
CDP estrogen 5, 1975	estrogen	placebo			Low risk of bias	-
CDP estrogen 2.5, 1975	estrogen	placebo			Low risk of bias	-
VA Neurology Section (estrogen), 1966	estrogen	placebo			Low risk of bias	-
VA drugs (Estrogen or thyroxine), 1968	estrogen or thyroxine	placebo			Low risk of bias	suggesting
etofibrate
Emmerich, 2009	etofibrate	placebo	diabetic	type 2 diabetes	Exploratory	-
ezetimibe
SHARP, 2010      NCT	ezetimibe+simvastatin	placebo			Low risk of bias	suggesting
IMPROVE-IT, 2014      NCT	ezetimibe	placebo (on top statins)		early initiation	Low risk of bias	conclusive
Enhance, 2008	ezetimibe	placebo (on top statins)			Low risk of bias	-
SANDS, 2008      NCT	aggressive treatment	standard teatment	diabetic	type 2 diabetes	Exploratory	negative
ARBITER-HALTS 6, 2010	ezetimibe	niacin			Exploratory	-
fenofibrate
FIELD, 2005	fenofibrate	placebo	diabetic patients		Low risk of bias	suggesting
DAIS, 2001	fenofibrate	placebo	diabetic	type 2 diabetes	Exploratory	negative
FIELD, 2005	fenofibrate	placebo	diabetic	type 2 diabetes	Low risk of bias	suggesting
ACCORD lipid, 2010    NCT	fenofibrate	placebo (on top simvastatine)	diabetic patients		Low risk of bias	negative
fluvastatin
LIPS (diabetic sub group), 2002	fluvastatin	placebo	diabetic patients	secondary prevention	Exploratory	suggesting
ALERT (diabetic sub group), 2003	fluvastatin	placebo	diabetic patients		Low risk of bias	-
FLARE (elderly subgroup), 1999	fluvastatin	placebo	elderly	elderly	Low risk of bias	negative
LIPS (elderly subgroup), 2002	fluvastatin	placebo	elderly	elderly	Low risk of bias	suggesting
LIPS (sub groups), 2002	fluvastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	negative
FLORIDA, 2002	fluvastatin	placebo	acute coronary syndrome	early initiation	Low risk of bias	negative
LCAS, 1997	fluvastatin	placebo	secondary prevention		Exploratory	negative
Riegger et al., 1999	fluvastatin	placebo	secondary prevention		Low risk of bias	negative
FLARE, 1999	fluvastatin	placebo	secondary prevention		Exploratory	negative
BCAPS, 2001	fluvastatin	placebo	primary prevention	cerebral vascular disease	Low risk of bias