A systematic review 1 including 97 studies with a total of 276,116 subjects was abstracted in DARE. Of these RCTs, 35 assessed statins, 17 assessed fibrates, 8 assessed resins, 2 assessed niacin, 14 assessed n-3 fatty acids and 17 assessed dietary interventions. Overall mortality was significantly reduced with statins both in primary and secondary prevention (RR 0.87, 95% CI: 0.81 to 0.94) and n- 3 fatty acids in secondary prevention (RR 0.77, 95% CI: 0.63 to 0.94; some heterogeneity appeared to be due to one lower quality RCT). For n-3 fatty acids, there was insufficient evidence to assess the effects on mortality in primary prevention studies. Cardiac mortality was significantly reduced with statins (RR 0.78, 95% CI: 0.72 to 0.84), resins (RR 0.70, 95% CI: 0.50 to 0.99) and n-3 fatty acids (RR 0.68, 95% CI: 0.52 to 0.90; some heterogeneity appeared to be due to one lower quality RCT). Fibrates significantly increased noncardiovascular mortality compared with the control (RR 1.13, 95% CI: 1.01, 1.27). There was no statistically significant difference in mortality for the other interventions examined.
Primary/Secondary Keywords