Application Of Network Meta Analysis Model To Study The Lipid-regulating Effect Of Different Statins On Patients With Cardiovascular And Cerebrovascular Diseases Complicated With Hyperlipidemia

Objective:Several studies have confirmed that statins can effectively regulate blood lipids and reduce the risk of cardiovascular and cerebrovascular diseases(CVD),and have been strongly recommended by various guidelines for primary and secondary prevention of CVD.However,different statins have different pharmacological properties.Whether the lipid-regulating effect of different kinds of statins is different is still controversial,and the evidence of direct comparison is very little and inconsistent.The purpose of this study was to systematically evaluate the lipid-regulating effects of different statins on patients with cardio-cerebrovascular diseases complicated with hyperlipidemia by network meta-analysis.Methods:VIP,PubMed,Embase,CNKI,The Cochrane Library,Wang Fang Data,CBM,and other databases were electronically searched to collect randomized controlled trials on 6 kinds of statins in the treatment of cardiovascular or cerebrovascular disease complicated with hyperlipidemia from inception to December 1st,2020.After two professional researchers independently extracted the relevant literature,extracted the required data,and included it in the research quality evaluation.Then,the software STATA15.1 was used for the network meta-analysis.Results:Finally,a total of 47288 patients of CVD were included in 13 RCTs,including 6kinds of interventions,and the quality of inclusion in RCT was relatively high.The result of network Meta analysis shows that: in terms of reducing LDL-C,six kinds of statins were involved,and the ranking diagram showed that atorvastatin(SUCRA:88.1)was the best,followed by simvastatin(79.5),rosuvastatin(58.6),fluvastatin(43.2),pitavastatin(40.6),and pravastatin(39.6);in terms of reducing TG,five statins were involved,and the ranking diagram showed that atorvastatin(SUCRA:87.8)was the best,followed by rosuvastatin(85.2),simvastatin(62.7),pravastatin(39.7),and fluvastatin(17.9);in terms of reducing TC,four statins were involved,and the ranking diagram showed that atorvastatin(SUCRA:87.6)was the best,followed by simvastatin(79.6),fluvastatin(41.9),and pravastatin(40.8);in terms of increasing HDL-C,six kinds of statins were involved,and the ranking diagram showed that simvastatin(SUCRA:92.2)was the best,followed by rosuvastatin(79.9),pitavastatin(67.3),Atto vastatin(44.9),pravastatin(39.4),and fluvastatin(22.2).Conclusion:Different statins can effectively regulate blood lipids,among which atorvastatin has the best effect on reducing LDL-C,TG,and TC,while simvastatin has a better effect on increasing HDL-C.Due to the limitations of the quantity and quality of the research,this study still needs more RCT with reasonable design and appropriate methods to verify.