Ken Williams
KenAnCo Biostatistics
University of Texas
USA
Title: A meta-analysis of meta-analyses comparing LDL cholesterol, non-HDL cholesterol, and apo-lipoprotein B as markers of vascular risk
Biography
Biography: Ken Williams
Abstract
This talk will combine and compare two meta-analyses. One included all the published epidemiological studies that contained estimates of the relative risks of LDL-C, non-HDL-C, and apoB predicting fatal or non-fatal ischemic cardiovascular events. Twelve independent reports, including 233,455 subjects and 22,950 events, were analyzed. Standardized relative risk ratios and confidence intervals were LDL-C: 1.25 (1.18, 1.33), non-HDL-C: 1.34 (1.24, 1.44) and apoB: 1.43 (1.35, 1.51), 5.7%>non-HDL-C (p<0.001) and 12.0%>LDL-C (p<0.001). The other meta-analysis included 7 placebo-controlled statin trials in which LDL-C, non-HDL-C, and apoB values were available. Mean CHD risk reduction (95% CI) per standard deviation decrease in each marker across these 7 trials were 20.1% (15.6%, 24.3%) for LDL-C; 20.0% (15.2%, 24.7%) for non-HDL-C; and 24.4% (19.2%, 29.2%) for apoB, 21.6% (12.0%, 31.2%)>LDL-C (p<0.001) and 24.3% (22.4%, 26.2%)>non-HDL-C (p<0.001). The inverse of treatment HRs from the trial meta-analysis were similar to the risk ratios from the observational meta-analysis indicating that parameters from both kinds of studies may be useful for projecting the number of events which can be avoided under different preventive treatment strategies.
