[77] There was a statistically significant reduction in major CV and cerebrovascular events in favor of the more intensive statin dose group versus standard dose (RR: 0.91, 95% CI: 0.84 0.98). Another meta-analysis, Koskinas et al. (2018), compared more intensive lipid-lowering therapy (n=76,678) to less intensive therapy.[78] It evaluated 19 clinical trials (n=75,829) conducted primarily in secondary prevention populations. Of the 15 statin trials, six compared a higher dose statin to a lower or moderate- dose statin. The primary outcome was a composite of major vascular events (e.g., CV death, MI or other ACS, coronary revascularization, and stroke). The high-dose statin therapy reduced events compared to less intensive statin therapy (RR: 0.88, 95% CI: 0.82 0.93). A meta-analysis included in the 2014 VA/DoD Dyslipidemia CPG s systematic evidence review, Preiss et al. (2011), analyzed five studies of moderate- versus high-dose statins.[58] Although its primary objective was to determine the risk for incident DM with high- versus moderate-dose statins, the authors also reported composite CV events, including all-cause mortality, CV death, non-fatal MI, non-fatal stroke and coronary revascularization. Cardiovascular events occurred less often in the high-dose statin group (OR: 0.84, 95% CI: 0.75 0.94, NNT=155), resulting in 6.5 fewer CVD events per 1,000 patient-years treated in the high- dose group over a mean follow-up period of 4.9 years. Of the individual CV events, only non-fatal MI (OR: were statistically different. The CTT meta-analysis by Baigent et al. (2010) analyzed five trials comparing a high- to moderate-dose statin and demonstrated a statistically significant reduction in any major vascular event (non-fatal MI, coronary heart disease [CHD] death, coronary revascularization, stroke) in favor of the higher dose (unweighted RR: 0.85, 95% CI: 0.82 0.89, NNT=125) versus the moderate statin dose.