OBJECTIVES: Secondary prevention of cardiovascular disease (CVD) means 1) prevention of premature death, 2) reduction in the progression of coronary artery atherosclerosis or achievement of its partial regression and 3) prevention of clinically significant complications. It is generally accepted, that the most effective lipid-lowering medicines are statins; but at the present time there is no clear answer which of the statins are clinically and economically more effective in clinical practice. This research aim was to evaluate clinical effectiveness, safety and economic effectiveness of statins for secondary prevention of CVD in Kazakhstani clinical practice.

METHODS: For opportunity to evaluate clinical effectiveness and safety of statins for secondary prevention of CVD the systematic literature search was conducted in databases named MEDLINE, EMBASE, NICE, The Cochrane Library. Types of articles: systematic review, meta-analysis. Publication date: no later than 10 years (since 2007).

RESULTS: As a result of systematic search we found 5 meta-analysis, which had the strong evidences confirmed clinical effectiveness and safety of statins for secondary prevention of major coronary events (OR 0.69, 95% CI 0.62–0.77) and all-cause mortality (OR 0.82, 95% CI 0.75–0.90). In the group of statins, using Atorvastatin in clinical practice is more preferred and should be as the first-line therapy. For economic analysis we took Atorvastatin, Simvastatin, Rosuvastatin, because these statins are reimbursed free of charge by the government. The costs of 1 year of treatment for 1 patient in a standard dose are 1 652 USD for Atorvastatin (20 mg/day); 2 343 USD for Simvastatin (20 mg/day); and 6 699 USD for Rosuvastatin (20 mg/day).

CONCLUSIONS: We found the strong evidences confirmed clinical effectiveness and safety of statins for secondary prevention of major coronary events and all-cause mortality. In the group of statins, Atorvastatin has advantages in clinical and economic effectiveness and сan be recommended as the first-line therapy.