"Statins produce large cardiovascular benefits, particularly
in the secondary prevention of cardiovascular
disease. In a meta-analysis of 14 randomized trials,
participants with a history of heart disease who were taking
statins for 5 years had 48 fewer vascular events per 1000
than those in the control group.1 Importantly, cardiovascular
events occurred about 3 times more frequently than
cases of cancer in these trials. In this issue, Bonovas and
Sitaras report a possible association between the use of
pravastatin (a hydrophilic statin) and cancer among elderly
patients in their meta-analysis of 12 randomized controlled
trials.2 Their study is generally well performed and follows
the QUOROM guidelines for meta-analyses; however, readers
may have several questions about the clinical significance
of these findings. Although one may choose to simply
dismiss subgroup analyses as merely being hypothesis generating,
a Bayesian paradigm, which explicitly states prior
beliefs and incorporates new findings according to the rules
of probability, may provide additional insights for interpreting
this new evidence."
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