Twenty-seven RCTs were included (174,149 participants, range 1,255 to 20,536).
Reduction of LDL cholesterol with a statin reduced the risk of major vascular events by 21% for each 1mmol/L reduction (RR 0.79, 95% CI 0.77 to 0.81) irrespective of age, gender and baseline LDL cholesterol. By baseline risk the reduction was at least as big in the two lowest risk categories. Rate ratios were (lowest to highest risk): 0.62 (99% CI 0.47 to 0.81), 0.69 (99% CI 0.60 to 0.79), 0.79 (99% CI 0.74 to 0.85), 0.81 (99% CI 0.77 to 0.86) and 0.79 (99% CI 0.74 to 0.84); Χ²=4.3, p=0.04.
For stroke, the reduction in risk in participants with five-year risk of major vascular events lower than 10% was similar to that seen in higher risk categories. In participants with no history of vascular disease, statins reduced the risks of vascular (RR 0.85, 95% CI 0.77 to 0.95) and all-cause mortality (RR 0.91, 95% CI 0.85 to 0.97), with proportional reductions being similar by baseline risk. There was no evidence that reduction of LDL cholesterol with a statin increased cancer incidence, cancer mortality or other non-vascular mortality.
The estimated absolute reduction in major vascular events in participants with a five-year risk lower than 10% was around 11 per 1,000 over five years for each 1.0mmol/L reduction in LDL cholesterol (4.1% statin or more intensive statin regimen versus 5.2% control or less intensive regimen).
Further results were reported.