Cochrane · systematic review · CD009868
Fixed‐dose combination therapy for the prevention of atherosclerotic cardiovascular diseases
Bahiru, E, de Cates, AN, Farr, MRB, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 3 · 42.9%Moderate 4 · 57.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyFixed‐dose combination therapy for the prevention of atherosclerotic cardiovascular diseases (ASCVD)
Population: adults older than 18 years, with no restriction regarding presence of ASCVD; participants generally had elevated risk of ASCVD (as estimated by the presence of at least one abnormal cardiovascular risk factor) without prevalent CVD (two studies included > 10% of participants with prior ASCVD)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Median | RR 1.1 [0.64, 1.89] | 5 studies · 5300 participants | Low Downgraded: risk of bias, imprecision, indirectness |
ASCVD event, such as fatal or non‐fatal myocardial infarction or stroke. Median | RR 1.26 [0.95, 1.66] | 6 studies · 4517 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Any investigator‐defined adverse event Median | RR 1.16 [1.09, 1.25] | 11 studies · 6906 participants | Moderate Downgraded: indirectness |
Systolic blood pressure, mmHg Median | no estimate extracted | 13 studies · 7638 participants | Moderate Downgraded: inconsistency |
Total cholesterol, mmol/L Median | no estimate extracted | 11 studies · 6565 participants | Low Downgraded: inconsistency, publication bias |
LDL cholesterol, mmol/L Median | no estimate extracted | 12 studies · 7153 participants | Moderate Downgraded: inconsistency |
Adherence, variable definitions Median | RR 1.44 [1.26, 1.65] | 4 studies · 3835 participants | Moderate Downgraded: risk of bias, indirectness |
Comparison
Population: Adults older than 18 years, with no restriction regarding presence of CVD; participants generally had elevated risk of CVD (as estimated by the presence of at least one abnormal cardiovascular risk factor) without prevalent CVD (two studies included > 10% of participants with prior CVD)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality | RR 1.26 | 2 studies · 3465 participants | Low |
CVD event | RR 1.38 | 2 studies · 2479 participants | Low |
Any adverse event 6 weeks to 15 months | RR 1.19 | 7 studies · 4864 participants | Low |
Systolic blood pressure mmHg | no estimate extracted | 9 studies · 5787 participants | Moderate |
Diastolic blood pressure mmHg | no estimate extracted | 9 studies · 5787 participants | Moderate |
Total cholesterol mmol/L | no estimate extracted | 9 studies · 5569 participants | Low |
LDL cholesterol mmol/L | no estimate extracted | 8 studies · 5365 participants | Moderate |
Discontinuation for any reason 6 weeks to 15 months | RR 1.26 | 6 studies · 2423 participants | Low |