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. 2021 Aug;77(8):1133-1145.
doi: 10.1007/s00228-021-03113-0. Epub 2021 Feb 18.

The comparative impact among different intensive statins and combination therapies with niacin/ezetimibe on carotid intima-media thickness: a systematic review, traditional meta-analysis, and network meta-analysis of randomized controlled trials

Hongwei Li  1   2 , Xiaolin Xu  3 , Liming Lu  4 , Runlu Sun  1   2 , Qi Guo  1   2 , Qian Chen  1   2 , Junjie Wang  1   2 , Zhijian He  1   2 , Yuling Zhang  5   6
Affiliations

The comparative impact among different intensive statins and combination therapies with niacin/ezetimibe on carotid intima-media thickness: a systematic review, traditional meta-analysis, and network meta-analysis of randomized controlled trials

Hongwei Li et al. Eur J Clin Pharmacol. 2021 Aug.

Abstract

Purpose: To compare the impact of different statins therapies on the reduction of carotid intima-media thickness (CIMT) may reflect their cardiovascular benefits which is useful in clinical decision.

Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched, and 3539 articles published from 1992 to 2020 were retrieved. CIMT in randomized controlled trials for statins therapies were included for traditional and network meta-analyses analyzed by Stata 16. The quality of included studies was assessed by the Cochrane Collaboration's tool.

Results: Thirty-three randomized controlled trials (n=8762) were eligible for network meta-analysis, of which 18 randomized controlled trials (n=5252) were included for comparison between statins and no statins and 11 randomized controlled trials (n=1338) were included for comparison between high-intensity statins or combination with niacin/ezetimibe and moderate/low-intensity statins in 2 traditional meta-analyses. In the traditional meta-analyses, the statins groups significantly reduce CIMT compared to no statins (standard mean difference=-0.207, 95% confidence interval: -0.291 to -0.123, p<0.001), while high-intensity statins or combination with niacin/ezetimibe performed significant CIMT reduction compared to moderate/low-intensity statins (standard mean difference=-0.287, 95% confidence interval: -0.460 to -0.114, p=0.001). In the network meta-analysis, a relative rank for the ability to reduce CIMT was given as follows: combination therapy with niacin (mean rank: 1.7), high-intensity statins, combination therapy with ezetimibe, and moderate/low-intensity statins.

Conclusion: Statins combined with niacin performed a greater CIMT reduction compared to high-intensity statins alone and combination therapies with ezetimibe. The advantage of niacin-combined statins therapies to improve cardiovascular endpoint needs further validation through randomized controlled trials.

Clinical trial registration: PROSPERO, CRD42020175972.

Keywords: Carotid intima-media thickness; Ezetimibe; Network meta-analysis; Niacin; Statins.

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References

    1. Mach FBC, Catapano AL, Koskinas KC, Casula M, Badimon L, Chapman MJ, De Backer GG, Delgado V, Ference BA, Graham IM, Halliday A, Landmesser U, Mihaylova B, Pedersen TR, Riccardi G, Richter DJ, Sabatine MS, Taskinen MR, Tokgozoglu L, Wiklund O, ESC Scientific Document Group (2020) 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 41(1):111–188. https://doi.org/10.1093/eurheartj/ehz45510 1093/eurheartj/ehz455/5556353 10.1093/eurheartj/ehz455#supplementary-data - DOI - PubMed
    1. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC Jr, Sperling L, Virani SS, Yeboah J (2019) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 73(24):e285–e350. https://doi.org/10.1016/j.jacc.2018.11.003 - DOI - PubMed
    1. Zhao SP, Yu BL, Peng DQ, Huo Y (2014) The effect of moderate-dose versus double-dose statins on patients with acute coronary syndrome in China: results of the CHILLAS trial. Atherosclerosis 233(2):707–712. https://doi.org/10.1016/j.atherosclerosis.2013.12.003 - DOI - PubMed
    1. Dai W, Huang XS, Zhao SP (2016) No evidence to support high-intensity statin in Chinese patients with coronary heart disease. Int J Cardiol 204:57–58. https://doi.org/10.1016/j.ijcard.2015.11.164 - DOI - PubMed
    1. Ji MS, Jeong MH, Ahn YK, Kim SH, Kim YJ, Chae SC, Hong TJ, Seong IW, Chae JK, Kim CJ, Cho MC, Rha SW, Bae JH, Seung KB, Park SJ, other Korea Acute Myocardial Infarction Registry I (2016) Clinical outcome of statin plus ezetimibe versus high-intensity statin therapy in patients with acute myocardial infarction propensity-score matching analysis. Int J Cardiol 225:50–59. https://doi.org/10.1016/j.ijcard.2016.09.082 - DOI - PubMed

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