Atorvastatin reduces coronary plaque volume in dependence on reductions in low-density lipoprotein: A meta-analysis and meta-regression of randomized controlled trials

2012 ◽  
Vol 157 (1) ◽  
pp. 114-116 ◽  
Author(s):  
Hisato Takagi ◽  
Takuya Umemoto
Keyword(s):  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Plaque ◽  
Controlled Trials ◽  
Low Density ◽  
Plaque Volume ◽  
Randomized Controlled ◽  
Meta Regression ◽  
Coronary Plaque Volume

scholarly journals The Effects of Statin Dose, Lipophilicity, and Combination of Statins plus Ezetimibe on Circulating Oxidized Low-Density Lipoprotein Levels: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Tannaz Jamialahmadi ◽  
Fatemeh Baratzadeh ◽  
Željko Reiner ◽  
Luis E. Simental-Mendía ◽  
Suowen Xu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
High Intensity ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Moderate Intensity ◽  
Controlled Trials ◽  
Low Density ◽  
Randomized Controlled

Background. Elevated plasma low-density lipoprotein cholesterol (LDL-C) is the main risk factor for atherosclerotic cardiovascular disease (ASCVD). Statins are the drugs of choice for decreasing LDL-C and are used for the prevention and management of ASCVD. Guidelines recommend that subjects with high and very high ASCVD risk should be treated with high-intensity statins or a combination of high-intensity statins and ezetimibe. The lipophilicity or hydrophilicity (solubility) of statins is considered to be important for at least some of their LDL-C lowering independent pleiotropic effects. Oxidative modification of LDL (ox-LDL) is considered to be the most important atherogenic modification of LDL and is supposed to play a crucial role in atherogenesis and ASCVD outcomes. Objective. The aim of this systematic review and meta-analysis was to find out what are the effects of statin intensity, lipophilicity, and combination of statins plus ezetimibe on ox-LDL. Methods. PubMed, Scopus, Embase, and Web of Science were searched from inception to February 5, 2021, for randomized controlled trials (RCTs). Two independent and blinded authors evaluated eligibility by screening the titles and abstracts of the studies. Risk of bias in the studies included in this meta-analysis was evaluated according to the Cochrane instructions. Meta-analysis was performed using Comprehensive Meta-Analysis (CMA) V2 software. Evaluation of funnel plot, Begg’s rank correlation, and Egger’s weighted regression tests were used to assess the presence of publication bias. Results. Among the 1427 published studies identified by a systematic databases search, 20 RCTs were finally included in the systematic review and meta-analysis. A total of 1874 patients are included in this meta-analysis. This meta-analysis suggests that high-intensity statin treatment is associated with a significant decrease in circulating concentrations of ox-LDL when compared with low-to-moderate treatment (SMD: -0.675, 95% CI: -0.994, -0.357, p < 0.001 ; I 2 : 55.93%). There was no difference concerning ox-LDL concentration between treatments with hydrophilic and lipophilic statins (SMD: -0.129, 95% CI: -0.330, -0.071, p = 0.206 ; I 2 : 45.3%), but there was a significant reduction in circulating concentrations of ox-LDL associated with statin plus ezetimibe combination therapy when compared with statin monotherapy (SMD: -0.220, 95% CI: -0.369, -0.071, p = 0.004 ; I 2 : 0%). Conclusion. High-dose statin or combination of statins with ezetmibe reduces plasma ox-LDL in comparison low-to-moderate intensity statin therapy alone. Statin lipophilicity is not associated with reduction in ox-LDL plasma concentrations.

Recent lipid-lowering trials in perspective: implications for therapy

2011 ◽  
pp. 111-119
Keyword(s):  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Controlled Trials ◽  
Low Density ◽  
Coronary Syndrome ◽  
Clinical Benefits ◽  
Prevention Trials ◽  
Cvd Prevention

• Despite the clinical benefits of statin therapy in primary and secondary cardiovascular disease (CVD) prevention trials, considerable residual risk persists. • Meta-analysis of major randomized controlled trials (RCTs) suggests that greater low-density lipoprotein (LDL)-lowering is associated with greater reduction in events. • Recent RCTs in stable coronary disease and in acute coronary syndrome have demonstrated greater benefit with more intensive LDL-lowering. • The results of these trials have changed LDL goals of therapy for those at highest risk.

Efficacy and Safety of Berberine Alone or Combined with Statins for the Treatment of Hyperlipidemia: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

2019 ◽  
Vol 47 (04) ◽  
pp. 751-767 ◽  
Author(s):  
Li-Shuang Zhang ◽  
Jun-Hua Zhang ◽  
Rui Feng ◽  
Xin-Yao Jin ◽  
Feng-Wen Yang ◽  
...  
Keyword(s):  
High Density Lipoprotein ◽  
Total Cholesterol ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Simvastatin Group

To systematically evaluate the efficacy and safety of berberine for the treatment of hyperlipidemia, six electronic literature databases including SinoMed, CNKI, WanFang Data, PubMed, Embase and The Cochrane Library were searched to collect clinical randomized controlled trials (RCTs) of berberine alone or combined with statins for the treatment of hyperlipidemia from the inception to 8 March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included RCTs. Then, meta-analysis was performed by using RevMan 5.3 software. A total of 11 RCTs involving 1386 patients were finally included. The results of meta-analysis showed that compared with the placebo group, berberine could significantly reduce the total cholesterol and low-density lipoprotein levels and elevate the high density lipoprotein level ([Formula: see text]). Compared with the simvastatin group, berberine was effective only in reducing the level of triglyceride ([Formula: see text], 95% CI: [Formula: see text]0.66, [Formula: see text]0.07, [Formula: see text]). There, however, was no statistical significance between the BBR group and simvastatin group in the low density lipoprotein and high density lipoprotein levels. Compared with the simvastatin group, berberine plus simvastatin was more effective in reducing the level of triglyceride ([Formula: see text], 95% CI: [Formula: see text]0.46, [Formula: see text]0.20, [Formula: see text]) and total cholesterol ([Formula: see text], 95% CI: [Formula: see text]0.60, [Formula: see text]0.12, [Formula: see text]). In terms of adverse reactions, the incidence of adverse reactions including transaminase elevation and muscle aches was lower in the berberine alone or combined with simvastatin group than that in the control group, while the instance of constipation was higher. This study suggests that berberine is effective for hyperlipidemia. The quality and quantity of included studies, however, were dissatisfactory, which might decrease the reliability of the results. Higher quality studies are needed to provide more high quality evidence.

scholarly journals Efficacy of Berberine Alone and in Combination for the Treatment of Hyperlipidemia: A Systematic Review

2017 ◽  
Vol 22 (4) ◽  
pp. 956-968 ◽  
Author(s):  
Laura M. Koppen ◽  
Andrea Whitaker ◽  
Audrey Rosene ◽  
Robert D. Beckett
Keyword(s):  
Systematic Review ◽  
Statin Therapy ◽  
Literature Search ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Controlled Trials ◽  
Low Density ◽  
Randomized Controlled ◽  
Risk Patients ◽  
Concomitant Medications

The objective of this review is to identify, summarize, and evaluate clinical trials of berberine for the treatment of hyperlipidemia and other dyslipidemias. A literature search for randomized, controlled trials of berberine that assessed at least 2 lipid values as endpoints resulted in identification of 12 articles that met criteria. The majority of evaluated articles consistently suggest that berberine has a beneficial effect on low-density lipoprotein (reductions ranging from approximately 20 to 50 mg/dL) and triglycerides (reductions ranging from approximately 25 to 55 mg/dL). Common study limitations included lack of reporting of precision in their endpoints, description of blinding, transparency in flow of patients, and reporting of baseline concomitant medications. Berberine could serve as an alternative for patients who are intolerant to statins, patients resistant to starting statin therapy but who are open to alternative treatments, and for low-risk patients not indicated for statin therapy.

Incorporating healthy dietary changes in addition to an increase in fruit and vegetable intake further improves the status of cardiovascular disease risk factors: A systematic review, meta-regression, and meta-analysis of randomized controlled trials

2019 ◽  
Vol 78 (7) ◽  
pp. 532-545 ◽  
Author(s):  
Darel Wee Kiat Toh ◽  
Evangelyn Sihui Koh ◽  
Jung Eun Kim
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Dietary Changes ◽  
Randomized Controlled ◽  
Meta Regression

Abstract Context Fruit and vegetable (FV) intake has been associated with a reduced risk of cardiovascular disease (CVD). Beyond increasing FV intake, the incorporation of other healthy dietary changes may help to further attenuate CVD risk. Objective A systematic review and meta-analysis was conducted to determine the effect of increasing FV intake to &gt; 3 servings daily as well as incorporating other healthy dietary changes on classical CVD risk factors through a systematic review, meta-regression, and meta-analysis of randomized controlled trials. Data Sources The following databases were searched: PubMed, CINAHL Plus with Full Text, Medline (ProQuest), and Cochrane Library. Data Extraction 82, 24, and 10 articles were selected for the systematic review, meta-regression, and meta-analysis, respectively. Data Analysis Meta-regression analysis showed a dose-dependent response between the number of FV servings consumed in each intervention group and the blood triglyceride change value. Pooled weighted mean differences from the meta-analysis suggested that increasing FV intake to &gt; 3 servings daily contributes to significant decreases in triglyceride (−0.10 mmol/L; 95%CI, −0.18 to −0.01) and diastolic blood pressure (−1.99 mmHg; 95%CI, −2.28 to −1.70) as well as marginal decreases in total cholesterol and low-density lipoprotein cholesterol. While improvements were observed in the triglyceride and high-density lipoprotein cholesterol response following the incorporation of other healthy dietary changes, no additional cardiovascular benefits were observed when FV intake was increased from &gt; 3 to &gt; 5 servings daily. Conclusion Increasing FV intake to &gt; 3 servings daily improves CVD risk factors, most distinctly triglyceride, especially when complemented with other healthy dietary changes.

Sign in / Sign up

Export Citation Format

Share Document