THE EFFECT OF DYSLIPIDEMIA DRUGS ON CAD MORTALITY - Metaanalysis.pptx

8/12/2019 THE EFFECT OF DYSLIPIDEMIA DRUGS ON CAD MORTALITY - Metaanalysis.pptx

1/12


2/12

Introduction

Dyslipidemia is caused by increase in low-densityLipoprotein (LDL) and depressed high-density Lipoprotein(HDL) level in body.

Statins, fibrates and resins are known dyslipidemic drugs,which act by increasing or decreasing lipoprotein or itscomponents levels. Many trials have been conducted to showtheir effectiveness in Coronary Artery Disease(CAD).


3/12

Eligibility Criteria

Trial was non-randomizedPlacebo controlledStudies in which eligibility criteria included a

particular lifestyle disease e.g. Hypertension

ordiabetes were excluded.The clinical endpoints-CAD mortality, CVDmortality. The follow up period should have beenequal to one year.Patients-59033


4/12

Study Identification

This search resulted in the identification of 20eligible studies.

Due to increase in heterogeneity (funnel plot), onestudy was excluded from the final results.

Thus, the results summarize meta-analysis of 19studies.


5/12

Statistical Analysis

Meta-analysis was performed using the Mantel-Haenszel method, Der-Simonian and the Lairdmethod for random effect model.

Graphs of the outcomes for included trials wereexamined visually and by using the Chi-square test toidentify heterogeneity in the outcome variablesacross different studies.

The results are displayed as summary odds ratio(OR), relative risk (RR) and 95% confidence interval(CI) of OR and RR for CAD mortality, CVDmortality. I 2 value is also calculated .


6/12

An I 2 value represents the percentage of the totalvariation across trials, which is due to heterogeneityrather than chance, and is considered thus I 2 value75% is high. All analyses is doneusing Cochrane Collaboration.

Because the results of meta-analysis did not varydepending on whether the fixed or random effect

model was used, random effect results are presented.


7/12

Results

Results show the effect of treatment withdyslipidemic drugs on CAD mortality, CVDmortality.The point estimate and 95% CI of OR and RR are

reported. For all studies, combined patients whoreceived treatment had a statistically significantadvantage for CAD mortality and CVD mortality.Treatment reduced the relative risk of CHD mortality

by 23% (summary relative risk is 0.77, 0.71 to 0.82),compared with placebo .


8/12

For CVD mortality , reduction was by 19% (summaryrelative risk is 0.81, 0.76 to 0.86) and 14% (summaryrelative risk is 0.86, 0.81 to 0.92) respectively.


9/12


10/12

Discussion

The population in these trials includes men, women,elderly people, hypercholesterolemic and patientswith normal cholesterol levels.

Generalization of these findings to other populationssuch as Asians is difficult, as trials selected for theanalysis do not adequately represent this population.Generally, the population that participated was ofEuropean or American descent.


11/12

The strength of this meta-analysis is that it is basedon more than 50,000 randomized patients. However,the short comings of this analysis are:

1) it was not based on individual data but availabledata from the literature2) some of the articles could not be included as they

were unavailable

3) absolute risk was not calculated.


12/12

THE EFFECT OF DYSLIPIDEMIA DRUGS ON CAD MORTALITY - Metaanalysis.pptx

Documents

Transcript of THE EFFECT OF DYSLIPIDEMIA DRUGS ON CAD MORTALITY - Metaanalysis.pptx