1.
Meta-analysis of statin therapy in maintenance dialysis patients.
Sun, L, Zou, L, Chen, M, Liu, B
Renal failure. 2015;(7):1149-56
Abstract
The effects of statin therapy in patients on maintenance dialysis remained uncertain. We conducted a meta-analysis to investigate the effects of statin on major clinical outcomes. We systematically searched Pubmed, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang and Chinese Technological Journal of Database for randomized controlled trials (RCTs). Criteria for inclusion were RCTs on statins therapy versus placebo, >3 months of follow-up. The outcomes were serum level of low density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP) and albumin (ALB), all cardiac events, cardiovascular deaths and all-cause mortality. Twenty-one trials were identified, providing data for 8186 patients on maintenance dialysis. Statin therapy reduced LDL-C (weighted mean difference [WMD] = -0.74 mmol/L; 95%CI [-0.96, -0.52], p < 0.00001), TG (WMD = -0.36 mmol/L; 95%CI [-0.57, -0.14], p = 0.001), and hs-CRP (WMD = -3.98 mg/L; 95%CI [-5.24, -2.72], p < 0.00001), elevated HDL-C (WMD = 0.25 mmol/L; 95%CI [0.10, 0.39], p = 0.0007) and ALB (WMD = 1.70 g/L; 95%CI [0.19, 3.21], p = 0.03) significantly comparing with placebo. Statin therapy also had benefit in reducing all cardiac events (relative risk [RR] = 0.90; 95%CI [0.83, 0.97], p = 0.006), but had no effect on cardiovascular deaths (RR = 0.97; 95%CI [0.88, 1.07], p = 0.54) or all-cause mortality (RR = 0.98; 95%CI [0.93, 1.04], p = 0.49). In conclusion, statins had no impact on all-cause or cardiovascular mortality, while there was an overall significant improvement for dyslipidemia, hs-CRP, hypoalbuminemia and cardiovascular events in dialysis patients.
2.
Statin use and risk of pancreatic cancer: a meta-analysis.
Cui, X, Xie, Y, Chen, M, Li, J, Liao, X, Shen, J, Shi, M, Li, W, Zheng, H, Jiang, B
Cancer causes & control : CCC. 2012;(7):1099-111
Abstract
PURPOSE Statins are commonly prescribed medications that potently reduce cholesterol levels and the risk of cardiovascular events. Preclinical studies suggested statins also possess cancer chemopreventive properties. However, the clinical studies provided contradictory results as to whether statins influence the risk of pancreatic cancer. Herein, we present this meta-analysis to assess the association between statin use and risk of pancreatic cancer. METHODS We conducted a comprehensive search up to August 2011 for the eligible studies. Pooled relative risk (RR) estimates and corresponding 95 % confidence intervals (CIs) were calculated using the inverse-variance-weighted random-effects model. Subgroup analyses were conducted where data were available. Heterogeneity was assessed by the Cochran's Q test and the I(2) statistic. RESULTS We included 16 studies that involving 1,692,863 participants and 7,807 pancreatic cancer cases. Pooled results only indicated a non-significant decrease of pancreatic cancer risk among all statin users (RR 0.89; 95 % CIs, 0.74-1.07). Similar results were obtained in the subgroup analyses of the long-term (more than 4 years) follow-up (RR 0.94, 0.81-1.08) and statin use (RR 0.97, 0.76-1.23), and a null association was found between lipophilic statin use and pancreatic cancer risk (RR 1.03, 0.92-1.16). No evidence of publication bias was observed in the present meta-analysis. However, significant heterogeneity was detected among all studies (p < 0.00001, I(2) = 81 %). CONCLUSIONS In conclusion, our results suggest that there is no association between statin use and pancreatic cancer risk, when statins are taken at daily doses for cardiovascular event prevention.