Efficacy and safety of statins for primary prevention of cardiovascular events in women and men: Systemic review and up-to-date meta-analysis

Background: The aim of this study was to perform a meta-analysis comparing by gender the cardiovascular outcomes related to statin therapy in primary prevention including recent large trials. Methods: A systematic search of medical literatures was performed to identify randomized placebo and standard-care- controlled endpoint trials of statins with sex-specific outcome data, which were reported from 1994 to April 2012. Summary estimates of relative risks (RRs) of the therapy were calculated by using a random-effects model for women and men without CVD. Results: Total eight studies with 59,744 participants were included (22,490 women, 37,254 men). Although statin treatment reduced the risk of total mortality (RR 0.70; 95% confidence interval [CI], 0.53 to 0.93), the risks of major coronary events (RR 0.62; 95% CI 0.37 to 1.04) and cerebrovascular events (RR 0.69; 95% CI 0.45 to 1.03) were not reduced by statin treatment in women without CVD. Although major adverse events and total cancer were not increased in both male and female patients taking statin, the stratified analysis by gender revealed higher risk of development of diabetes mellitus (DM) in female patients (RR 1.50; 95% CI 1.11 to 2.01). Conclusions: Statin treatment was less beneficial in women without CVD with regard to lowering adverse clinical outcomes when compared to men.