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Benefits and Risks of Antihyperlipidemic Medication in Adults with Different Low-Density Lipoprotein Cholesterol Based on the Number Needed to Treat

Hong-Fei Wang,Yu-Cheng Mao,Su-Fen Qi,Xin-Yi Xu, Zi-Yan Zhang,Chang Geng, Kai Song,Qing-Bao Tian

American Journal of Cardiovascular Drugs(2024)

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Abstract
The objective of this investigation is to examine the benefits and potential risks of these drugs in individuals by varying baseline low-density lipoprotein cholesterol (LDL-C) values, utilizing the concept of the number needed to treat (NNT). We extensively searched electronic databases, such as PubMed, EMBASE, Cochrane, and Web of Science, up to 6 August 2023. Baseline LDL-C values were stratified into four categories: < 100, 100–129, 130–159, and ≥ 160 mg/dL. Risk ratios (RRs) and NNT values were computed. This analysis incorporated data from 46 randomized controlled trials (RCTs), encompassing a total of 237,870 participants. The meta-regression analysis demonstrated an incremental diminishing risk of major adverse cardiovascular events (MACE) with increasing baseline LDL-C values. Statins exhibited a significant reduction in MACE [number needed to treat to benefit (NNTB) 31, 95
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