September 14th, 2009 
Von Cholesterol-lowering therapy with statins effectively prevents cardiovascular disease, but treatment with statins does not guarantee that cholesterol targets are reached. In cases where intensive lipid-lowering is needed, physicians sometimes combine statins with other lipid-modifying medications. However, according to a review published online before print September 1, 2009 in Annals of Internal Medicine, limited evidence suggests that combinations of lipid-lowering agents do not improve clinical outcomes more than high-dose statins alone.
Researchers from the University of Ottawa in Ontario, Canada and their colleagues reviewed 102 studies to compare the benefits and harms of high-dose statins versus combination lipid-lowering therapy in adults at high risk for coronary artery disease. They found very-low-strength evidence that combination lipid-lowering therapy did not reduce mortality more than high-dose statins, though two trials did show that combination therapy was more likely to attain cholesterol-lowering goals.
Overall, the researchers found no benefit for combination lipid-lowering therapy over high-dose statins for mortality, heart attack, stroke, or the need for a revascularization procedure. However, a limitation of the review was that most of the studies reviewed were short. Further research is needed to see if there is a difference in clinical outcomes between combination lipid-lower therapy and high-dose statins in the long term.
Source:
Ann Intern Med. Published online before print September 1, 2009.
Created on: 09/09/2009
Reviewed on: 09/09/2009
Reviewed on: 09/09/2009
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