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Effects of statin therapy on arterial stiffness: A systematic review and meta-analysis of randomized controlled trial
Sikarin Upala1, Kamonkiat Wirunsawanya2, Veeravich Jaruvongvanich3
1Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Statin therapy significantly reduces aortic arterial stiffness, a key predictor of cardiovascular events. This meta-analysis confirms statins
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biomedical Engineering
Background:
- Arterial stiffness is a recognized independent predictor of cardiovascular events.
- The impact of statins, a class of cholesterol-lowering agents, on arterial stiffness remains inconsistent across studies.
- Systematic review and meta-analysis are crucial for synthesizing existing evidence on statin therapy's effects on arterial properties.
Purpose of the Study:
- To systematically review and meta-analyze all randomized controlled trials (RCTs) assessing the impact of statin therapy on arterial stiffness.
- To provide a consolidated understanding of how statin treatment influences arterial properties.
Main Methods:
- Comprehensive literature search of MEDLINE, EMBASE, and Cochrane databases up to April 2016.
- Inclusion of RCTs comparing changes in arterial stiffness (measured by aortic pulse wave velocity, PWV) between statin and control groups.
- Utilized a random-effects model to calculate pooled standardized mean difference (SMD) with 95% confidence intervals (CI).
Main Results:
- Six studies were included in the meta-analysis.
- Statin therapy encompassed various agents including simvastatin, rosuvastatin, lovastatin, fluvastatin, and atorvastatin.
- Statin therapy was associated with a significant reduction in aortic pulse wave velocity (aPWV) compared to active control or placebo groups (SMD=2.31, 95% CI: 1.15-3.45).
Conclusions:
- The meta-analysis provides evidence that statin therapy exerts a beneficial effect on aortic arterial stiffness.
- Further research is warranted to explore the effects of statin therapy on arterial stiffness at different anatomical sites and under various physiological conditions.
Background:
Arterial stiffness has been observed to be an independent predictor for cardiovascular events. Effects of cholesterol lowering agents (statins) on arterial stiffness are inconsistent. We conducted a systematic review with a meta-analysis of all RCTs investigating the impact of statin therapy on arterial properties.
Methods:
We comprehensively searched the databases of MEDLINE, EMBASE, and Cochrane from their dates of inception through April 2016. The inclusion criteria were published RCTs comparing change in arterial stiffness between statin administration and active control or placebo groups. Arterial stiffness is determined by aortic pulse wave velocity (PWV). We used a random-effects model and calculated pooled standardized mean difference (SMD) with 95% confidence intervals (CI) comparing change in PWV between the statin and control groups.
Results:
Six studies were included in the meta-analysis. Statin therapy includes simvastatin, rosuvastatin, lovastatin, fluvastatin, and atorvastatin. Compared with the active control or placebo group, the statin therapy group had lower aPWV (SMD=2.31, 95% CI: 1.15-3.45, Pheterogeneity=0.07, I2=93%).
Conclusion:
Our meta-analysis demonstrates that statin therapy has a beneficial effect on aortic arterial stiffness. Further studies should be conducted to assess the effects of this therapy on arterial stiffness at various sites and conditions.
