Efficacy And Safety Evaluation Of Intensive Statin Therapy In Coronary Heart Disease With Diabetes Mellitus Patients: A Systematic Review And Meta-analysis

Objective:To systematically assess the efficacy and safety of intensivestatin in coronary heart disease with diabetes mellitus patients.Methods:This task searched Databases including PubMed,EM base,The Cochrane library, CNKI, CBM, VIP and Google academic searchprofessional website ect,which were searched from inception to March1,2014,to collect rangdomized controlled trials(RCTs) on the efficacy andsafety of intensive statin in coronary heart disease with diabetes mellituspatients.According to the inclusion criterion,irrelevant articles werescreened.The basis of the study assessment was revised Jadad Scores andbias risk assessment.With data extraction conducted by two reviewersindependently, meta-analysis and systematic review were performed byRevMan5.0software.Results:A total of6trials(n=3356) were included(intensive statintreatment group had1689patients and in the control group of1667patients).They were high quality and low bias risk studies.The results showed that:The serum lipid levels obviously decreased,including lowdensity lipoprotein cholesterol(LDL-C),total cholesterol(TC) andtriglyceride (TG)[LDL-C: MD=-0.60,95%CI (-0.73,-0.46), P <0.00001;TC: MD=-0.71,95%CI(-0.77,-0.64), P <0.00001;TG:MD=-0.39,95%CI(-0.56,-0.21),P<0.0001),except for HDL-Celevation[HDL-C:MD=0.29,95%CI (-0.29,0.86), P=0.33).Meanwhile,theintensive statin could reduce the risk of major cardiovascular events(majorcardiovascular events include: cardiacdeath,fatal and nonfatal myocardialinfarction, cardiac arrest, fatal and nonfatal stroke, etc.)[RR=0.77,95%CI(0.64,0.93), P=0.007).In the aspect of safety,the intensive statin on bloodglucose in patients was no statistical significance[MD=-0.08,95%CI(-0.52,0.35), P=0.71).There were a total of97adverse events caused bydrugs,of which45were cases in myopathy(intensive statin treatmentgroup:18cases, control group:27cases),liver dysfunction were a total of13cases (intensive statin treatment group:9cases, control group:4cases).Nomuscle dissolved,acute renal failure or even death and other serious adverseevents had been reported.Conclusion:Intensive statin can significantly lower the level of LDL-C,TC,TG and prevent from major cardiovascular events.On the contrary,therewere a few slight adverse events in all these included trails embodyingsignificantly good safety performance.Therefore,intensive statin therapycan be used to the patients with coronary heart disease and diabetes mellitus.