Regular statin treatment for adults without cardiovascular disease may reduce the risk of major cardiac and cerebrovascular events such as myocardial infarction and stroke but not of coronary heart disease or overall death, according to an article in the November 27 issue of Archives of Internal Medicine.

Current USA treatment guidelines recommend use of statins in patients without cardiovascular disease based on risk profile and low-density lipoprotein cholesterol level. For patients without cardiovascular disease and with normal cholesterol level, statins are recommended only for individuals with diabetes or with two or more other cardiac risk factors that raise their 10-year risk of a myocardial infarction or other cardiac event to at least 10 percent.

Paaladinesh Thavendiranathan, MD, MSc, University of Toronto, and his Canadian colleagues analyzed the results of seven previously published clinical trials that assessed the benefits of statins in a total of 42,848 patients, 90 percent of whom had no history of cardiovascular disease.

In each study, patients were randomized to a statin or another form of care and were followed for at least one year, at least 100 major cardiovascular events occurred during follow-up, and 80 percent or more of participants did not have cardiovascular disease.

In total, 21,409 patients took statins and 21,439 took a placebo. Average follow-up ranged from 3.2 to 5.2 years; age ranged from 55.1 to 75.4 years, and men accounted for 42 percent to 100 percent.

In patients on statin therapy, there were 924 major coronary events compared with 1,219 in control groups, a 29.2-percent reduction in risk. Major cerebrovascular events, including stroke, occurred in 440 patients taking statins and 517 controls, a 14.4-percent lower risk.

Statin treatment was also associated with a 31.7-percent reduction in risk for non-fatal myocardial infarctions and a 33.8-percent reduction in revascularization procedures. There were no statistically significant differences between groups in rates of patients who died from cardiovascular disease or from all causes.