The effect of statins on average survival in randomised trials, an analysis of end point postponement.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials
PubMed 26408281 · doi:10.1136/bmjopen-2014-007118
What was done
A systematic literature review was conducted of all statin randomized trials comparing statin treatment to placebo that presented all-cause survival curves for treated and untreated groups. The outcome measured was the average postponement of death, calculated as the area between the survival curves.
What was found
Eleven studies were identified: 6 for primary prevention and 5 for secondary prevention, with study follow-up ranging from 2.0 to 6.1 years. Death was postponed between -5 and 19 days in primary prevention trials and between -10 and 27 days in secondary prevention trials. The median postponement of death was 3.2 days for primary prevention and 4.1 days for secondary prevention.
Why it matters
Expressing trial efficacy as average days of life gained over the study duration contextualizes statin benefits for individual decision-making, particularly in patients with short life expectancy or intolerable side effects.
Limits
The analysis is restricted to the duration of the trials (2.0–6.1 years) and cannot measure lifetime postponement of death. Inclusion was limited strictly to trials publishing all-cause survival curves, and the abstract does not report the total participant sample size or confidence intervals.
Cited by
- context Research published by Dr. Aseem Malhotra found that taking statins for several years only extends lifespan by an average of a few days.
- supports A Danish meta-analysis of statin trials for secondary prevention showed that the average gain in life expectancy across the analyzed group was approximately 4 days.