ABC | Volume 111, Nº6, December 2018

Original Article Radaelli et al Statin treatment in children: meta-analysis Arq Bras Cardiol. 2018; 111(6):810-821 Figure 2 – Forest plots showing the effect of statin therapy (high, intermediate and low dose) on total cholesterol (TC) levels. 44 44 88 183.00 293.00 293.00 195.00 36.00 18.28 18.28 44.00 15 15 30 24 140 106 106 106 126 126 874 63 35 42 208.70 207.00 199.50 246.00 251.22 223.60 167.02 179.84 194.00 194.09 41.60 3.10 49.98 37.00 48.62 43.00 6.06 46.10 3.75 3.67 27 47 69 69 108 59 19 120 120 654 16 308.90 293.20 281.15 293.00 279.76 306.00 308.70 277.70 200.20 210.15 58.70 8.89 56.74 17.44 57.10 39.00 7.07 46.10 3.79 3.76 26 26 18 90 17 18 106 63 63 35 462 1424 1053 224.60 206.00 257.58 246.00 239.08 246.80 243.34 243.57 276.66 237.60 43.60 47.82 6.06 35.60 7.68 62.10 8.41 8.33 6.06 54.60 27 27 6 6 6 61 19 369 88 69 60 308.90 285.62 321.30 308.90 294.69 300.40 294.69 294.69 318.15 275.80 58.70 56.69 7.07 58.70 5.70 5.70 5.70 7.07 53.70 56.00 –110.00 –98.00 –104.61 –100.20 –99.20 –87.06 –86.00 –80.26 –60.00 –57.48 –54.10 –33.18 –30.31 –67.60 –84.30 –79.62 –63.72 –62.90 –55.61 –53.60 –51.35 –51.12 –41.49 –38.20 –56.96 –66.41 [–124.10; –95.90] [–113.96; –82.04] [–116.31; –92.91] [–127.90; –72.50] [–101.79; –96.61] [–103.48; –70.64] [–100.08; –71.92] [–96.61; –63.91] [–71.00; –49.00] [–59.82; –55.14] [–79.85; –28.35] [–34.12; –32.24] [–31.24; –29.38] [–81.67; –53.53] [–112.07; –56.53] [–95.80; –63.44] [–66.05; –61.39] [–88.93; –36.87] [–61.39; –49.83] [–70.96; –36.24] [–57.41; –45.29] [–57.09; –45.15] [–43.81; –39.17] [–68.37; –8.03] [–65.85; –48.07] [–75.52; –57.30] 4.6% 4.5% 9.1% 3.5% 5.2% 4.4% 4.6% 4.4% 4.8% 5.2% 5.2% 5.2% 46.1% 44.8% 100% 3.5% 4.5% 5.2% 3.6% 5.1% 4.4% 5.1% 5.1% 5.2% 3.3% 3.7% –100 100 –50 50 0 dose_statins = high dose_statins = intermediate dose_statins = low Braamskamp 2015, Pitavastatin 2 mg de Jongh 2002, Simvastatin 10 mg Stein 1999, Lovastatin 20 mg Braamskamp 2015, Pitavastatin 1 mg Knipscheer 1996, Pravastatin 20 mg Rodenburg 2006, Pravastatin 40 mg Knipscheer 1996, Pravastatin 10 mg Knipscheer 1996, Pravastatin 5 mg Stein 1999, Lovastatin 10 mg Clauss 2005, Lovastatin 20 mg Braamskamp 2015, Pitavastatin 4 mg McCrindle 2003, Atorvastatin 10 mg–20 mg de Jongh 2002, Simvastatin 40 mg Avis 2010, Rosuvastatin 40 mg de Jongh 2002, Simvastatin 20 mg Wegman 2004, Pravastatin 20 mg–40 mg Stein 1999, Lovatatin 40 mg Clauss 2005, Lovatatin 40 mg Van der Graaf 2008, Simvastatin 40 mg/Ezetimibe 10 mg Van der Graaf 2008, Simvastatin 10 mg–20 mg–40 mg/Ezetimibe 10 mg Avis 2010, Rosuvastatin 20 mg Avis 2010, Rosuvastatin 10 mg Random effects model Heterogeneity: I-squared = 18%, tau-squared = 13, p = 0.2693 Random effects model Heterogeneity: I-squared = 99.7%, tau-squared = 463.6, p < 0.0001 Random effects model Heterogeneity: I-squared = 95.4%, tau-squared = 153.3, p < 0.0001 Random effects model Heterogeneity: I-squared = 99.4%, tau-squared = 417, p < 0.0001 Study Total Total SD SD Mean difference statins placebo Mean Mean MD W(random) 95%–Cl Figure 3 – Forest plots showing the effect of statin therapy (high, intermediate and low dose) on low-density lipoprotein (LDL) cholesterol levels. 44 44 88 15 15 30 117.00 128.00 33.00 40.00 227.00 227.00 16.58 16.58 140 24 106 106 63 35 126 126 768 42 131.09 144.40 125.77 143.00 133.33 183.23 155.50 103.47 114.10 2.71 40.90 48.44 31.00 46.89 6.12 47.20 3.65 3.50 47 27 69 69 59 19 120 120 546 16 228.93 239.20 214.85 227.00 215.91 242.50 206.30 134.60 144.08 8.12 61.10 54.51 15.83 55.69 7.14 44.80 3.69 3.59 26 106 18 63 26 17 18 90 106 63 35 568 1424 1053 477 19 61 108 88 6 6 6 27 60 69 27 158.80 140.07 173.85 190.76 176.30 179.75 183.89 180.90 182.00 208.33 168.50 38.60 46.14 20.88 6.06 34.50 29.39 25.13 59.70 40.00 6.12 53.30 239.20 208.47 239.57 255.00 239.20 239.57 239.57 238.50 237.00 252.00 209.00 61.10 54.36 4.40 7.14 61.10 4.16 4.40 56.20 36.00 7.07 55.50 –110.00 –99.00 –105.03 –97.84 –94.80 –89.08 –84.00 –82.58 –59.27 –50.80 –31.13 –29.98 –67.85 –82.40 –68.40 –65.72 –64.24 –62.90 –59.82 –55.68 –55.60 –55.00 –43.67 –40.50 –58.97 –67.04 [–122.86; –97.14] [–113.49; –84.51] [–115.76; –94.30] [–100.20; –95.48] [–123.06; –66.54] [–104.91; –73.25] [–96.17; –71.83] [–98.47; –66.69] [–61.64; –56.90] [–76.30; –25.30] [–32.05; –30.21] [–30.87; –29.09] [–83.36; –52.35] [–109.81; –54.99] [–83.95; –52.85] [–75.99; –52.45] [–66.59; –61.89] [–89.49; –36.31] [–74.18; –45.46] [–67.81; –43.55] [–72.63; –38.57] [–65.20; –44.80] [–46.00; –41.34] [–71.07; –9.93] [–58.97; –50.11] [–76.74; –57.35] 4.7% 4.6% 9.3% 5.1% 3.6% 4.5% 4.8% 4.5% 5.1% 3.8% 5.1% 5.1% 41.6% 3.6% 4.5% 4.9% 5.1% 3.7% 4.6% 4.8% 4.4% 4.9% 5.1% 3.4% 49.0% 100.0% –100 100 –50 50 0 dose_statins = high dose_statins = intermediate dose_statins = low Braamskamp 2015, Pitavastatin 2 mg de Jongh 2002, Simvastatin 10 mg Stein 1999, Lovastatin 20 mg Braamskamp 2015, Pitavastatin 1 mg Knipscheer 1996, Pravastatin 10 mg Rodenburg 2006, Pravastatin 40 mg Wiegman 2004, Pravastatin 20 mg–40 mg Knipscheer 1996, Pravastatin 20 mg Knipscheer 1996, Pravastatin 5 mg Stein 1999, Lovastatin 10 mg Clauss 2005, Lovastatin 20 mg McCrindle 2003, Atorvastatin 10 mg–20 mg Braamskamp 2015, Pitavastatin 4 mg de Jongh 2002, Simvastatin 40 mg Avis 2010, Rosuvastatin 5 mg de Jongh 2002, Simvastatin 20 mg Stein 1999, Lovatatin 40 mg Clauss 2005, Lovatatin 40 mg Van der Graaf 2008, Simvastatin 40 mg/Ezetimibe 10 mg Van der Graaf 2008, Simvastatin 10 mg–20 mg–40 mg/Ezetimibe 10 mg Avis 2010, Rosuvastatin 20 mg Avis 2010, Rosuvastatin 10 mg Random effects model Heterogeneity: I-squared = 19.2%, tau-squared = 11.62, p = 0.2659 Random effects model Heterogeneity: I-squared = 99.8%, tau-squared = 510.8, p < 0.0001 Random effects model Heterogeneity: I-squared = 93.8%, tau-squared = 163.3, p < 0.0001 Random effects model Heterogeneity: I-squared = 99.5%, tau-squared = 476.6, p < 0.0001 Study Total Total SD SD Mean difference statins placebo Mean Mean MD W(random) 95%–Cl 815