Effect of Statins on the Blood Lipid Profile in Patients with Different Cardiovascular Diseases: A Systematic Review with Meta-analysis of Randomized Clinical Trials.

Statins are the main lipid-lowering drugs and are used in the prevention of cardiovascular diseases (CVDs). Since the results have been, to some extent, inconsistent in the clinical trials concerning different types of CVDs, a systematic review and meta-analysis was performed to prove the effect of statins on decreasing elevated levels of total cholesterol, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in patients with CVDs. Literature search was performed on major electronic databases (MEDLINE/ PubMed, Scopus, and ISI Web of Science) from inception up to July 2021 to find randomized controlled trials (RCTs) evaluating the effect of different statins on different types of CVDs. The effect size was determined using weighted mean difference (WMD) and corresponding 95% confidence interval (CI). Statin therapy significantly decreased levels of total cholesterol (WMD = -33.37 mg/dl, 95% CI: -45.98 to -20.76, P<0.001), LDL-C (WMD = -29.42 mg/dl, 95% CI: -36.81 to -22.03, P<0.001), and TG (WMD = -15.19 mg/dl, 95% CI = -26.41 to -3.97, P<0.001), and increased levels of HDL-C (WMD = 1.55 mg/dl, 95% CI: 0.20, to 2.90, P=0.02) in patients with different CVDs. Statin therapy was found effective in lowering levels of total cholesterol, LDL-C, and TG, and increasing levels of HDL-C in patients with different CVDs.

Aslani S ，Razi B ，Imani D ，Mohammadi K ，Jamialahmadi T ，Reiner Ž ，Sahebkar A ... -  《-》

A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials investigating the effects of statin therapy on plasma lipid concentrations in HIV-infected patients.

Statin therapy may lower plasma lipid concentrations, but the evidence in HIV-infected patients is still unclear. Therefore, we aimed to investigate the impact of statin therapy on plasma lipid concentrations through a systematic review of the literature and meta-analysis of available randomized controlled trials (RCTs). The literature search included PUBMED, SCOPUS, Web of Science and Google Scholar up to October 30, 2015. The meta-analysis was performed using either a fixed-effects or random-effect model according to I(2) statistic. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Two investigators independently reviewed the title or abstract, further reviewed the full-texts and extracted information on study characteristics and study outcomes. Meta-analysis of 12 RCTs with 697 participants suggested significant reductions in plasma concentrations of low density lipoprotein (LDL) cholesterol (WMD: -0.72mmol/L [-27.8mg/dL], 95%CI: -1.04, -0.39, p<0.001; I(2)=85.7%), total cholesterol (WMD: -1.03mmol/L [-39.8mg/dL], 95%CI: -1.42, -0.64, p<0.001; I(2)=94.7%) and non-high density lipoprotein cholesterol (non-HDL-C) (WMD: -0.81mmol/L [-31.3mg/dl], 95%CI: -1.32, -0.30, p=0.002; I(2)=76.5%), and elevations in HDL-C (WMD: 0.072mmol/L [2.8mg/dL], 95%CI: 0.053, 0.092, p<0.001; I(2)=0%) following treatment with statins (mostly of moderate-intensity). No significant alteration in plasma triglycerides (TG) concentrations was found (WMD: -0.16mmol/L [-14.2mg/dL], 95%CI: -0.61, 0.29, p=0.475; I(2)=90.2%). All these effects were robust in sensitivity analysis, suggesting that the computed effect is not driven by any single study. In subgroup analysis, no significant difference was found among different statins in terms of changing plasma concentrations of LDL-C, HDL-C and TG. However, atorvastatin was found to be more efficacious in reducing plasma total cholesterol concentrations (p<0.001). In conclusion, the meta-analysis suggested significant reductions in plasma concentrations of LDL-C, total cholesterol and non-HDL-C, and elevations in HDL-C, but no significant alteration in plasma TG following treatment with statins.

Banach M ，Dinca M ，Ursoniu S ，Serban MC ，Howard G ，Mikhailidis DP ，Nicholls S ，Lip GYH ，Glasser S ，Martin SS ，Muntner P ，Rysz J ，Toth PP ，Sahebkar A ，Lipid Blood Pressure Meta-analysis Collaboration Group ... -  《-》

Statin Therapy and Lipid Indices in Chronic Kidney Disease: A Systematic Review and Meta-analysis of Randomized Control Trials.

Several studies have demonstrated the improvement in serum lipoproteins by statins in patients with Chronic Kidney Diseases (CKDs), including End-Stage Renal Disease (ESRD). However, the results of these studies are inconclusive. We aimed to systematically investigate the effect of statins on lipid profiles of patients with CKD by performing a meta-analysis of Randomized Controlled Trials (RCTs). Major electronic databases (Scopus, MEDLINE/PubMed, and ISI Web of Science) were searched from inception to August, 2023, to find randomized controlled trials (RCTs) evaluating the effect of different statins on serum lipoproteins in CKD patients. Weighted Mean Difference (WMD) with 95% Confidence Intervals (CI) was used to estimate the effect size. Trial Sequential Analysis (TSA) was performed to confirm the robustness of the evidence. A total of 18 publications were identified. It was found that statins reduced serum levels of Low-Density Lipoprotein (LDL)-C (WMD = -27.81 mg/dl, 95% CI = -34.47 to -21.15, P < 0.001) and total cholesterol (WMD = -25.44 mg/dl, 95% CI = -34.71 to -16.18, P < 0.001) in patients with CKD compared to the control group. Nonetheless, the effect of statins on High-Density Lipoprotein (HDL)-C (WMD = 0.57 mg/dl, 95% CI = -0.71 to 1.85, P = 0.38) and Triglyceride (TG) (WMD = -9.08 mg/dl, 95% CI = -22.22 to 2.06, P = 0.11) was not statistically significant. The results of TSA confirmed the robustness of the evidence and were consistent with the pooled effect size. The findings of subgroup analysis and time response analysis were also significant. It was found that statin therapy reduced the levels of LDL-C and total cholesterol in patients with CKD.

Karami J ，Razi B ，Imani D ，Aslani S ，Pakjoo M ，Fasihi M ，Mohammadi K ，Sahebkar A ... -  《-》

Effect of resistance training on lipid profile in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials.

Physical exercise decreases cardiovascular risk and can alter the lipid profile in postmenopausal women. Although it is believed that resistance training can potentially decrease serum lipid levels in postmenopausal females, the evidence remains inconclusive. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to clarify the impact of resistance training on the lipid profile in postmenopausal women. Web of Science, Scopus, PubMed/Medline and Embase were searched. RCTs that evaluated the effect of resistance training on total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels were included in this review. Effect size was estimated using the random effects model. Subgroup analyses based on age, duration of intervention, pre-enrolment serum lipid levels and body mass index were performed. Data pooled from 19 RCTs revealed that resistance training can reduce TC [weighted mean difference (WMD) -11.47 mg/dl; p = 0.002], LDL-C (WMD -8.48 mg/dl; p = 0.01) and TG (WMD -6.61 mg/dl; p = 0.043) levels. TC levels decreased particularly in subjects aged < 60 years (WMD -10.77 mg/dl; p = 0.003), in RCTs lasting < 16 weeks (WMD -15.70 mg/dl; p = 0.048), and in subjects with hypercholesterolaemia (WMD -12.36 mg/dl; p = 0.001) or obesity (WMD -19.35 mg/dl; p = 0.006) before RCT enrolment. There was a significant decrease in LDL-C (WMD -14.38 mg/dl; p = 0.002) levels in patients with LDL-C ≥ 130 mg/dl before trial enrolment. Resistance training reduced HDL-C (WMD -2.97 mg/dl; p = 0.01) levels particularly in subjects with obesity. TG (WMD -10.71 mg/dl; p = 0.01) levels decreased particularly when the intervention lasted < 16 weeks. Resistance training can decrease TC, LDL-C and TG levels in postmenopausal females. The impact of resistance training on HDL-C levels was small, and was only observed in individuals with obesity. The effect of resistance training on the lipid profile was more notable in short-term interventions and in postmenopausal women with dyslipidaemia or obesity before trial enrolment.

He M ，Hu S ，Wang J ，Wang J ，Găman MA ，Hariri Z ，Tian Y ... -  《-》

Targeting low HDL-cholesterol to decrease residual cardiovascular risk in the managed care setting.

Cziraky MJ ，Watson KE ，Talbert RL 《JOURNAL OF MANAGED CARE PHARMACY》