Comparative efficacy of LDL-C-lowering therapies in first-time vs. recurrent myocardial infarction prevention: a meta-analysis of large-scale randomized controlled trials.
Eur J Prev CardiolSep 4, 2026
Clinical ResearchCardiology
Bao-Qiang Guo, Hong-Bin Li, Bing Zhao et al.
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In 30 seconds
This meta-analysis evaluated the efficacy of LDL-C-lowering therapies in preventing first-time versus recurrent myocardial infarction (MI) across 22 randomized controlled trials involving 180,304 participants. The study found a 38% reduction in MI risk for first-time prevention (RR, 0.62) compared to a 16% reduction for recurrent prevention (RR, 0.84), with significant differences in benefit magnitude.
Key findings
- LDL-C-lowering therapies reduced first-time MI risk by 38% (RR, 0.62; P < 0.001).
- For recurrent MI prevention, these therapies achieved a 16% risk reduction (RR, 0.84; P < 0.001).
- The difference in benefit magnitude between first-time and recurrent MI prevention was significant (Q = 22.63; P < 0.001).
- The study included 22 large-scale RCTs with a total of 180,304 participants.
Why it matters
Understanding the differential efficacy of LDL-C-lowering therapies in first-time versus recurrent MI prevention can guide clinicians in optimizing treatment strategies and improving patient outcomes in cardiovascular care.