Prevention of myocardial infarction and death by antidyslipidemic therapy

The NNT for secondary prevention of myocardial infarction and all-cause death by antidyslipidemic therapy is around 37, and the NNT for primary prevention is around 190.

A systematic review including 63 trials was abstracted in DARE. Primary, secondary and tertiary prevention trials and both pharmacological and non-pharmacological interventions were included. In the primary prevention studies, NNT = 53 to prevent a nonfatal myocardial infarction (MI) and 190 to prevent all cause death. In trials assessing treatment of dyslipidaemia in people with atherosclerosis, NNT = 37 to prevent one death from any cause. Benefits for niacin or dietary therapy did not reach statistical significance.

Comment: The benefits are comparable to other secondary prevention measures such as aspirin or beta-blockers.

The following decision support rules contain links to this evidence summary:

• Message to intensify antilipemic therapy in patients with established cardiovascular disease

Ədəbiyyat

1. Rembold CM. Number-needed-to-treat analysis of the prevention of myocardial infarction and death by antidyslipidemic therapy. J Fam Pract 1996 Jun;42(6):577-86.