Meta-Analysis Confirms Benefits of Statins in Women

February 1st, 2012

Meta-Analysis Confirms Benefits of Statins in Women

Larry Husten, PHD

Although clinical trials have consistently found a beneficial effects for statins, some critics have questioned the strength of the evidence in women, who are often under-represented in clinical trials. A large new meta-analysis published in the Journal of the American College of Cardiology provides the best evidence yet that the relative reductions in events observed in men also occur in women, but doesn’t provide evidence about the absolute risk benefit in women.

William Kostis and colleagues analyzed data from 18 randomized trials of primary and secondary prevention, including 141,235 patients (40,275 women). The reduction in cardiovascular risk was similar for both sexes:

Women: OR: 0.81, CI 0.75 – 0.89, p < 0.0001
Men: OR: 0.77, CI: 0.71 – 0.83, p < 0.0001

All-cause mortality was also significantly reduced by statins in both sexes:

Women: OR: 0.90, CI: 0.82 – 0.99, p = 0.0344
Men: OR: 0.84, CI: 0.77 – 0.92, p = 0.0003

For women the effect on all-cause mortality did not achieve statistical significance in the secondary prevention trials, while for men the difference in mortality did not achieve significance in the primary prevention trials. However, investigators did not find a significant interaction by sex in these analyses.

The authors conclude that “statin therapy should be used in appropriate patients without regard to sex. It seems that, with respect to statin therapy, what is good for the gander is good for the goose.”

In an accompanying editorial comment, Lori Mosca praises the meta-analysis but notes that it only treats “sex-specific relative risk benefit and not absolute benefit,” and that both are needed “to make informed clinical choices with regard to the use of statins for primary prevention.” She also notes that the meta-analysis did not provide any evidence about the relative safety of statins in women.

CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

February 1st, 2012