Re: Impact of statin related media coverage on use of statins: interrupted time series analysis with UK primary care data
The authors estimated that one cardiovascular "event per year" could happen by 344 people discontinuing statins over a 10 year period. The authors show bias by calling this their most "pessimistic" estimate with the undertone that more patients continuing statins would be beneficial.
The authors admit not to have considered adverse effect of statins and include in their "event" definition soft endpoints such as angina, intermittent claudication and, almost certainly, mostly elective revascularizations.
Half the population (48%) considered was over age 69, a group where PROSPER showed that no mortality benefit from statin, a finding also of all placebo controlled studies reporting on women of any age [Medline 23725922].
The non consideration of mortality in this statistical exercise filled with assumptions is stunning since cardiovascular disease is the top adult killer worldwide.
The authors should have constructed their study so that they could have at least commented on mortality in women and in the older regarding discontinuation of statins. My guess is that most people would stop statins forever if told there is no possibility of a life extension but that at most 1 in 344 of them might have at worst a non fatal "event" per year of non statin use.
Authors, be it in the medical or popular press, must be clear when proposing drugs in a fatal disease. As it is, confusion reigns and this study does not help. As opposed to oncology where months of "progression free survival" is routinely reported, this is never done in statin trials where, for example the U.K. based HPS and ASCOT studies have not yet released the full mortality data on women, a dozen years after trial's end.
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Re: Impact of statin related media coverage on use of statins: interrupted time series analysis with UK primary care data
The authors estimated that one cardiovascular "event per year" could happen by 344 people discontinuing statins over a 10 year period. The authors show bias by calling this their most "pessimistic" estimate with the undertone that more patients continuing statins would be beneficial.
The authors admit not to have considered adverse effect of statins and include in their "event" definition soft endpoints such as angina, intermittent claudication and, almost certainly, mostly elective revascularizations.
Half the population (48%) considered was over age 69, a group where PROSPER showed that no mortality benefit from statin, a finding also of all placebo controlled studies reporting on women of any age [Medline 23725922].
The non consideration of mortality in this statistical exercise filled with assumptions is stunning since cardiovascular disease is the top adult killer worldwide.
The authors should have constructed their study so that they could have at least commented on mortality in women and in the older regarding discontinuation of statins. My guess is that most people would stop statins forever if told there is no possibility of a life extension but that at most 1 in 344 of them might have at worst a non fatal "event" per year of non statin use.
Authors, be it in the medical or popular press, must be clear when proposing drugs in a fatal disease. As it is, confusion reigns and this study does not help. As opposed to oncology where months of "progression free survival" is routinely reported, this is never done in statin trials where, for example the U.K. based HPS and ASCOT studies have not yet released the full mortality data on women, a dozen years after trial's end.
Competing interests: No competing interests