The review includes 8 trials involving over 63,000 patients. All trials had a similar lipid reducing effect and statistical analysis showed minimal heterogeneity between the effect sizes.
Overall, there was no difference between the three statins in reduction of fatal coronary heart disease and nonfatal myocardial infarctions. Similarly, there were no detectable differences in fatal and nonfatal strokes, all cardiovascular deaths, and all-cause mortality.
Action: Clinicians can be confident that using Simvastatin 40mg first line, as recommended here, will reduce the risk of cardiovascular events to a similar extent compared to other statin therapies.