Click here to see all the TRIP Evidence Reviews.
Clinical Guidelines
- Lipids management. PRODIGY, October 2006
- Who requires treatment to lower lipid levels? PRODIGY, October 2006
- What lipid-lowering drugs should I prescribe? PRODIGY, October 2006
- Medicines Management: statins. This section of the guideline covers which statin, which dose, contraindications for statins, adverse effects, monitoring patients on statins, drug interactions with statins. PRODIGY, October 2006
- Statins for the prevention of cardiovascular events in patients at increased risk of developing cardiovascular disease or those with established cardiovascular disease. NICE, January 2006
- Guidelines on the prevention of cardiovascular disease in clinical practice. Joint British Societies 2 (JBS2), 2005
Evidence for statins
- Update on statins. MeReC, 2005
- Effects of early treatment with statins on short-term clinical outcomes in acute coronary syndromes: a meta-analysis of randomized controlled trials. DARE, 2006
- Comparison of Intensive and Moderate Lipid lowering with Statins after Acute Coronary Syndromes. Northern and Yorkshire Drug and Therapeutics Centre, 2004
- Effectiveness of statin therapy in adults with coronary heart disease. DARE, 2004
- Effects of statins on stroke prevention in patients with and without coronary heart disease: a meta-analysis of randomized controlled trials. DARE, 2004
- Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet, 2005
- Primary prevention of cardiovascular diseases with statin therapy: a meta-analysis of randomized controlled trials. DARE, 2006
- Statins for secondary prevention: what is IDEAL? MeReC, 2006
Choice of statin
- Which statin? Northern and Yorkshire Drug and Therapeutics Centre, 2006
Adverse effects
- Risks associated with statin therapy: a systematic overview of randomized clinical trials. Circulation, 2006
- Rhabdomyolysis with statins. Bandolier, 2005
- Statin safety: a perspective. Bandolier, 2006
- A patient develops painful muscles on a statin. It settles on stopping the meds. Is it worth retrying the same statin, switching to another statin, or avoiding all statins? NLH Q&A Service, 2006 View answer OR Can you answer this question for extra CPD?
- In a patient who has had an adverse reaction to simvastatin, swollen tongue and lips, would it be ok to give an alternative statin or should an alternative cholesterol / lipid lowering medication be used? NLH Q&A Service, 2006
- Is there any evidence that taking statins is related to deterioration in memory? NLH Q&A Service. 2006
- A patient taking a statin has raised ALT 10 times the normal, how long do you stop the statins for and is it alright to go back on similar dose of statin after the enzyme level returns to normal? NLH Q&A Service, 2006
- GP Notebook
Monitoring
- What evidence is there for routine monitoring of liver function tests in patients established on statins? NLH Q&A Service, 2006
- What monitoring is necessary for a patient on a statin? NLH Q&A Service, 2005 View answer OR Can you answer this question for extra CPD?
- If a patient on a statin has had 2 consecutive stable cholesterol test results could the test interval be lengthened to every 24 months? NLH Q&A Service, 2006
Statins and the elderly
- Special report: The efficacy and safety of statins in the elderly. Health Technology Assessment, 2007
- Statins in older people. Bandolier. 2003
- Lipid-lowering therapy with statins in high-risk elderly patients: the treatment-risk paradox. JAMA, 2004
- Statins and the risk of lung, breast, and colorectal cancer in the elderly. Circulation, 2007
- What is the upper age limit for the use of statins? NLH Q&A Service, 2006 View answer OR Can you answer this question for extra CPD?
Statins and Diabetes
- Should statin therapy be offered to all patients with type 2 diabetes? FPIN, 2005
- Should all diabetic (type I or II) patients, regardless of the lipid levels receive statin therapy? ATTRACT, 2006
- Above what age group should all diabetics be offered a statin irrespective of the cholesterol levels? NLH Q&A Service, 2006
Statins and Renal Disease
- Statins for improving renal outcomes: a meta-analysis. Journal of the American Society of Nephrology, 2006
- In patients with chronic kidney disease, is there any evidence to suggest that simvastatin is more likely to worsen renal function than atorvastatin? Is there any evidence to suggest that a particular statin is preferred? NLH Q&A Service, 2007
- Should all patients with renal dysfunction be prescribed a statin? NLH Q&A Service, 2006
Use of statins in other concomitant disease
- Statins in heart failure. Bandolier Extra, 2004
- Statins and stroke outcome. Bandolier, 2004
- HMG CoA reductase inhibitors (statins) for dialysis patients. Cochrane Database of Systematic Reviews, 2004
- Statin therapy and risks for death and hospitalization in chronic heart failure. JAMA, 2006
- What is the place of statins in a patient who has had a subarachnoid haemorrhage? NLH Q&A Service, 2007
Miscellaneous
- Effect of Very High-Intensity Statin Therapy on Regression of Coronary Atherosclerosis: the ASTEROID trial. Northern and Yorkshire Drug and Therapeutics Centre, 2006
- Statins and colorectal cancer. Bandolier, 2006
- Non-lipid effects of statins. Bandolier Extra, 2004
- Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis. JAMA, 2007
- Statins and cancer risk: a meta-analysis. DARE, 2006
- Can statins be taken in the morning rather than at night as patients often forget night time medication? NLH Q&A Service, 2007 View answer OR Can you answer this question for extra CPD?
- Can a cholesterol level be too low when treated with a statin or is there a level below which it causes other problems? NLH Q&A Service, 2007
- Does grapefruit juice increase plasma concentrations of statins and fibrates other than simvastatin? NLH Q&A Service, 2006
- Current Problems in Pharmacovigilance. Committee on Safety of Medicines, 2004
Patient Information
