Recommendations for participation in leisure time or competitive sports in athletes-patients with coronary artery disease: A position statement from the Sports Cardiology Section of the European Association of Preventive Cardiology (EAPC)

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Mats Borjesson
  • Mikael Dellborg
  • Josef Niebauer
  • Andre LaGerche
  • Christian Schmied
  • Erik E. Solberg
  • Martin Halle
  • Emilio Adami
  • Alessandro Biffi
  • Francois Carré
  • Stefano Caselli
  • Michael Papadakis
  • Axel Pressler
  • Rasmusen, Hanne K.
  • Luis Serratosa
  • Sanjay Sharma
  • Frank Van Buuren
  • Antonio Pelliccia
With statins, the reported rate of adverse events differs widely between randomized clinical trials (RCTs) and observations in clinical practice, the rates being 1–2% in RCTs vs. 10–20% in the so-called real world. One possible explanation is the claim that RCTs mostly use a run-in period with a statin. This would exclude intolerant patients from remaining in the trial and therefore favour a bias towards lower rates of intolerance. We here review data from RCTs with more than 1000 participants with and without a run-in period, which were included in the Cholesterol Treatment Trialists Collaboration. Two major conclusions arise: (i) the majority of RCTs did not have a test dose of a statin in the run-in phase. (ii) A test dose in the run-in phase was not associated with a significantly improved adherence rate within that trial when compared to trials without a test dose. Taken together, the RCTs of statins reviewed here do not suggest a bias towards an artificially higher adherence rate because of a run-in period with a test dose of the statin. Other possible explanations for the apparent disparity between RCTs and real-world observations are also included in this review albeit mostly not supported by scientific data.
TidsskriftEuropean Heart Journal
Udgave nummer1
Sider (fra-til)13-18
Antal sider6
StatusUdgivet - 2018

ID: 221755453