[Clinical benefits of cholesterol lowering treatments. Meta-analysis of randomized therapeutic trials]

Cucherat et al., 2000 | Presse Med | Meta Analysis

Citation

Cucherat M, Lièvre M, Gueyffier F. [Clinical benefits of cholesterol lowering treatments. Meta-analysis of randomized therapeutic trials]. Presse Med. 2000-May-13;29(17):965-76

Abstract

PRIMARY PREVENTION: A meta-analysis of the 7 available randomized cholesterol lowering trials (2 on statins, 2 on fibrates, 2 on resins and 1 on diet) demonstrates a significant 24% relative reduction in the frequency of fatal and non-fatal coronary events, leading to a significant 14% relative reduction in coronary disease related mortality. For total mortality, the statin trials were not comparable with other treatments where there was a trend to overmortality. With the 2 statin trials, there was a nonsignificant 13% reduction in total mortality. SECONDARY PREVENTION: A meta-analysis of the 13 available randomized trials (3 with clofribrate, 1 with gemfibrozil, 2 with nicotinic acid, and 4 with diet) showed a significant 21% reduction in the frequency of fatal and non-fatal coronary events, coronary mortality and total mortality. For total mortality, only the result of the 2 statin trials was significant (-20%). BENEFICIAL EFFECT OF STATINS, ABSOLUTE VALUES: Measured as the number of patients to treat for 5 years in order to avoid 1 event (NNT), there is a clinically pertinent benefit of secondary prevention (NNT = 15 for events, NNT = 30 for coronary mortality). The absolute value is weaker when patients with minimally elevated cholesterol levels are included. For primary prevention, the absolute value is low with NNT = 44 for events and NNT = 300 for coronary mortality. In addition, as these results were obtained in trials including populations with a much higher risk than the general French population, the absolute beneficial effect may not be pertinent in France except in high-risk patients who present, in addition to a high cholesterol level, other cardiovascular risk factors.

Key Findings

In addition, as these results were obtained in trials including populations with a much higher risk than the general French population, the absolute beneficial effect may not be pertinent in France except in high-risk patients who present, in addition to a high cholesterol level, other cardiovascular risk factors.

Outcomes Measured

• Requires manual extraction

Population

MeSH Terms

• Anticholesteremic Agents
• France
• Humans
• Hypercholesterolemia
• Myocardial Infarction
• Randomized Controlled Trials as Topic
• Survival Rate
• Treatment Outcome

Evidence Classification

• Level: Meta Analysis
• Publication Types: Comparative Study, English Abstract, Journal Article, Meta-Analysis
• Vertical: niacin

Provenance

• PMID: 10855251
• DOI: (not available)
• PMCID: Not in PMC
• Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09