Systematic review of lipid lowering for primary prevention of coronary heart disease in diabetes

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Abstract
Methods and results The review protocol is available from the authors. We searched Medline and eight other electronic databases (including five clinical trials databases) and proceedings from pertinent scientific meetings. We attempted to contact the authors of trials reporting incomplete data but received no responses. We reviewed the bibliographies of all retrieved publications. Eligible trials randomised patients to lipid lowering interventions; included patients without coronary heart disease; and measured myocardial infarction, death from coronary heart disease, or all cause mortality. Eligible meta-analyses pooled data from similar trials. We excluded studies available only as abstracts. There were no language exclusions. We also included the Medical Research Council/British Heart Foundation heart protection study, which was published after our search.2 A list of included trials and meta-analyses is available on bmj.com The 14 eligible trials randomised 132 977 patients without coronary heart disease, and diabetes status was stated for 1799 patients (1.3%). Three trials provided clinical endpoints for 454 diabetic patients. In addition, the heart protection study randomised 3982 diabetic patients without coronary heart disease (table). View this table: In this window In a new window Randomised controlled trials of lipid lowering for primary prevention of coronary heart disease. Data for patients without coronary heart disease at baseline We found 13 meta-analyses that included up to 38 trials and 146 854 patients. None presented data for diabetes subgroups. One meta-analysis postulated that diabetes might account for differences between trials, but incomplete reporting in the trials limited the analysis.