Statin Use and the Risk of All-cause Mortality

Abstract

Statins are the cornerstone in primary and secondary prevention of atherosclerotic cardiovascular disease. Most benefits of statin treatment mainly come from lowering low-density lipoprotein cholesterol levels. However, statins have pleiotropic effects on vascular dysfunction, inflammation, and immunomodulation beyond cholesterol-lowering, suggesting a positive impact on various health outcomes. All-cause mortality is a commonly chosen outcome in randomized controlled trials (RCTs) of statins. Nevertheless, the effect of statin treatment on the risk of all-cause mortality remains uncertain since it has usually been evaluated as a secondary outcome or a component of the primary composite outcome. A recent meta-analysis of RCTs also failed to draw a clear conclusion on this issue. Further studies investigating all-cause mortality as a primary endpoint are needed to determine the effect of statins on all-cause mortality from the perspective of evidence-based medicine.