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Efficacy and safety of statins and exercise combination therapy compared to statin monotherapy in patients with dyslipidaemia: A systematic review and meta-analysis.

Abstract

Background Statin treatment in association with physical exercise can substantially reduce mortality in dyslipidaemic individuals. However, the available data to compare the efficacy and safety of statins and exercise combination therapy with statin monotherapy are limited. Design Systematic review and meta-analysis. Methods We systematically searched PubMed, Embase and the Cochrane Library from database inception until December 2016. We included randomised and non-randomised studies that compared the efficacy and safety of statins and exercise combination therapy with statin monotherapy in patients with dyslipidaemia. Standardised mean differences were calculated and pooled by means of fixed effects models. The risk of bias and heterogeneity among trials was also assessed. Seven articles were assessed in terms of the efficacy of therapy and 13 from the viewpoint of therapeutic safety. Results In terms of efficacy, statins and exercise combination decreased the incidence of diabetes mellitus, improved insulin sensitivity and inflammation, but caused no change in lipid profile compared to statins alone. In terms of safety, statins and exercise combination increased peak oxygen uptake (standardised mean difference 1.01, 95% confidence interval 0.46 to 1.57) compared to statins alone. In contrast to statin-induced myopathy, chronic exercise training prior to statin treatment could counteract statin-induced adverse effects in skeletal muscle. Conclusion Statins and exercise combination therapy is more effective than statin monotherapy in terms of insulin sensitivity, inflammation and exercise capacity. The small number of studies warrants the need for more randomised controlled trials evaluating the efficacy and safety of combination therapy.

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  • Authors+Show Affiliations

    ,

    1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, China.

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    2 Department of Geratology, Third Hospital of Changsha, China.

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    1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, China.

    ,

    1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, China.

    ,

    3 Department of Cardiovascular Medicine, Changsha Central Hospital, China.

    ,

    1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, China.

    ,

    1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, China.

    ,

    1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, China.

    1 Department of Cardiovascular Medicine, The Second Xiangya Hospital, China.

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Biomarkers
    Chi-Square Distribution
    Combined Modality Therapy
    Comorbidity
    Diabetes Mellitus
    Dyslipidemias
    Exercise Therapy
    Exercise Tolerance
    Female
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Incidence
    Inflammation
    Insulin Resistance
    Lipids
    Male
    Middle Aged
    Protective Factors
    Risk Factors
    Treatment Outcome
    Young Adult

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    28436720

    Citation

    Gui, Ya-Jun, et al. "Efficacy and Safety of Statins and Exercise Combination Therapy Compared to Statin Monotherapy in Patients With Dyslipidaemia: a Systematic Review and Meta-analysis." European Journal of Preventive Cardiology, vol. 24, no. 9, 2017, pp. 907-916.
    Gui YJ, Liao CX, Liu Q, et al. Efficacy and safety of statins and exercise combination therapy compared to statin monotherapy in patients with dyslipidaemia: A systematic review and meta-analysis. Eur J Prev Cardiol. 2017;24(9):907-916.
    Gui, Y. J., Liao, C. X., Liu, Q., Guo, Y., Yang, T., Chen, J. Y., ... Xu, D. Y. (2017). Efficacy and safety of statins and exercise combination therapy compared to statin monotherapy in patients with dyslipidaemia: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 24(9), pp. 907-916. doi:10.1177/2047487317691874.
    Gui YJ, et al. Efficacy and Safety of Statins and Exercise Combination Therapy Compared to Statin Monotherapy in Patients With Dyslipidaemia: a Systematic Review and Meta-analysis. Eur J Prev Cardiol. 2017;24(9):907-916. PubMed PMID: 28436720.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy and safety of statins and exercise combination therapy compared to statin monotherapy in patients with dyslipidaemia: A systematic review and meta-analysis. AU - Gui,Ya-Jun, AU - Liao,Cai-Xiu, AU - Liu,Qiong, AU - Guo,Yuan, AU - Yang,Tao, AU - Chen,Jing-Yuan, AU - Wang,Ya-Ting, AU - Hu,Jia-Hui, AU - Xu,Dan-Yan, Y1 - 2017/02/13/ PY - 2017/4/25/pubmed PY - 2018/3/20/medline PY - 2017/4/25/entrez KW - Hydroxymethylglutaryl-CoA reductase inhibitors KW - dyslipidemia KW - exercise SP - 907 EP - 916 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 24 IS - 9 N2 - Background Statin treatment in association with physical exercise can substantially reduce mortality in dyslipidaemic individuals. However, the available data to compare the efficacy and safety of statins and exercise combination therapy with statin monotherapy are limited. Design Systematic review and meta-analysis. Methods We systematically searched PubMed, Embase and the Cochrane Library from database inception until December 2016. We included randomised and non-randomised studies that compared the efficacy and safety of statins and exercise combination therapy with statin monotherapy in patients with dyslipidaemia. Standardised mean differences were calculated and pooled by means of fixed effects models. The risk of bias and heterogeneity among trials was also assessed. Seven articles were assessed in terms of the efficacy of therapy and 13 from the viewpoint of therapeutic safety. Results In terms of efficacy, statins and exercise combination decreased the incidence of diabetes mellitus, improved insulin sensitivity and inflammation, but caused no change in lipid profile compared to statins alone. In terms of safety, statins and exercise combination increased peak oxygen uptake (standardised mean difference 1.01, 95% confidence interval 0.46 to 1.57) compared to statins alone. In contrast to statin-induced myopathy, chronic exercise training prior to statin treatment could counteract statin-induced adverse effects in skeletal muscle. Conclusion Statins and exercise combination therapy is more effective than statin monotherapy in terms of insulin sensitivity, inflammation and exercise capacity. The small number of studies warrants the need for more randomised controlled trials evaluating the efficacy and safety of combination therapy. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/28436720/Efficacy_and_safety_of_statins_and_exercise_combination_therapy_compared_to_statin_monotherapy_in_patients_with_dyslipidaemia:_A_systematic_review_and_meta_analysis_ L2 - http://journals.sagepub.com/doi/full/10.1177/2047487317691874?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -