Evidence map›Statins × lipids›PMID 17984166›Full record

Trial reportThe New England journal of medicine2007

Rosuvastatin in older patients with systolic heart failure.

John Kjekshus, Eduard Apetrei, Vivencio Barrios, Michael Böhm, John G F Cleland, Jan H Cornel, Peter Dunselman, Cândida Fonseca, Assen Goudev, Peer Grande and 19 more

2 registry-linked trialsOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2007. The graph read 2 numbers from its abstract, feeding 1 cell of the map: it favours the comparator in 1. It is linked to 2 registered trials, which are not on this map. Cited by 415 papers, 31 of them syntheses that pooled it.

2numbers the graph read from it
1cell of the map it votes in
415citing papers in PubMed, 31 pooled it
123.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
45.00 · no effect
Lipidsfavours the comparator · against placebo · ascvd, heart_failurefeeds one cell of the map
Δ 45.0P<0.001
RESULTS: As compared with the placebo group, patients in the rosuvastatin group had decreased levels of low-density lipoprotein cholesterol (difference between groups, 45.0%; P<0.001) and of high-sensitivity C-reactive protein (difference between groups, 37.1%; P<0.001).
FeedsStatins×lipids
Lipidsfavours the comparator · against placebo · ascvd, heart_failurefeeds one cell of the map
Δ 37.1P<0.001
RESULTS: As compared with the placebo group, patients in the rosuvastatin group had decreased levels of low-density lipoprotein cholesterol (difference between groups, 45.0%; P<0.001) and of high-sensitivity C-reactive protein (difference between groups, 37.1%; P<0.001).
FeedsStatins×lipids

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×lipids

ContradictsOpen on the map →What to test next →

38 readable studies in this cell: 27 favour the treatment, 5 find no difference, 6 favour the comparator.

Belief with this paper
0.50contested · 21 families support, 7 contradict · against placebo
Without it
0.78This paper moves it by −0.28. It would be replicated.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2007
Δ 45.0
NCT002899002,340 enrolled · 2006
Δ -13.2-16.8 to -9.60
Effect of evolocumab or ezetimibe added to moderate- or high-intensity…PMID 24825642 · 2,067 enrolled · 2013
reduced -66.0-73.0 to -58.0
NCT02546323543 enrolled · 2015
Δ -35.5-40.2 to -30.7
NCT01678820299 enrolled · 2012
Δ 0.50-4.80 to 5.80
NCT01218204287 enrolled · 2010
Δ 5.47-15.7 to 26.7
Lipid-Lowering Effect and Safety of Ezetimibe and Atorvastatin 5 mg in…PMID 40357888 · 252 enrolled · 2022
Δ -47.6
NCT0093525931 enrolled · 2009
Δ -51.7
Effect of Patient Financial Incentives on Statin Adherence and Lipid C…PMID 33034639 · 2020
reductions -33.6-38.8 to -28.4
Icosabutate, a Structurally Engineered Fatty Acid, Improves the Cardio…PMID 27160246 · 2016
Δ -7.40
Evidence for statin pleiotropy in humans: differential effects of stat…PMID 19075102 · 2009
RR 38.0
Efficacy and safety of fluvastatin in patients with non-insulin-depend…PMID 8198023 · 1994
decrease -24.3
L-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with S…PMID 27914033 · 2017
Δ -19.4
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00206310 phase3completednot on this map

Controlled Rosuvastatin Multinational Study in Heart Failure CORONA A Randomized, Double-Blind, Placebo Controlled Phase III Study With Rosuvastatin in Subjects With Chronic Symptomatic Systolic Heart Failure

TypeinterventionalSponsorAstraZenecaRan2003 to 2007Enrolled5,013ConditionsHeart FailureArmsCRESTOR
NCT07490054 phase1recruitingnot on this mapstarted 2025, after this paper: background citation

An Open-Label, Pilot Clinical Trial To Test The Safety And Feasibility Of Intestinal Microbiota Transplantation In Patients With Chronic Heart Failure

TypeinterventionalSponsorMelana Yuzefpolskaya, MDRan2025 to 2027Enrolled40ConditionsChronic Heart FailureArmsMTP-101-C encapsulated Microbiota, Vancomycin, Neomycin
5 · Its place in the literature

Who cites it

415 citing papers in PubMed, 31 syntheses or guidelines pooled it, 1,484 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Statins for the primary prevention of venous thromboembolism.The Cochrane database of systematic reviews · 2024
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. The association of statin therapy and cancer: a meta-analysis.Lipids in health and disease · 2023 · on this map
    Pooled it
  9. Pooled it
  10. Pooled it
  11. Is a PCSK9 Inhibitor Right for Your Patient? A Review of Treatment Data for Individualized Therapy.International journal of environmental research and public health · 2022
    Pooled it
  12. Pooled it
  13. Pooled it
  14. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
    Pooled it
  15. Pooled it
  16. Re-appraisal of the obesity paradox in heart failure: a meta-analysis of individual data.Clinical research in cardiology : official journal of the German Cardiac Society · 2021
    Pooled it
  17. Pooled it
  18. Pooled it
  19. Pooled it
  20. Pooled it

355 more citing papers are in PubMed but not listed here.

6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

29 authors at 1 institution in 1 country.

John KjekshusDepartment of Cardiology, University of Oslo, Rikshospitalet University Hospital, Oslo, Norway. john.kjekshus@medisin.uio.no
Eduard Apetrei
Vivencio Barrios
Michael Böhm
John G F Cleland
Jan H Cornel
Peter Dunselman
Cândida Fonseca
Assen Goudev
Peer Grande
Lars Gullestad
Ake Hjalmarson
Jaromir Hradec
András Jánosi
Gabriel Kamenský
Michel Komajda
Jerzy Korewicki
Timo Kuusi
François Mach
Vyacheslav Mareev
John J V McMurray
Naresh Ranjith
Maria Schaufelberger
Johan Vanhaecke
Dirk J van Veldhuisen
Finn Waagstein
Hans Wedel
John Wikstrand
CORONA Group
Oslo University Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundPatients with systolic heart failure have generally been excluded from statin trials. Acute coronary events are uncommon in this population, and statins have theoretical risks in these patients.

methodsA total of 5011 patients at least 60 years of age with New York Heart Association class II, III, or IV ischemic, systolic heart failure were randomly assigned to receive 10 mg of rosuvastatin or placebo per day. The primary composite outcome was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Secondary outcomes included death from any cause, any coronary event, death from cardiovascular causes, and the number of hospitalizations.

resultsAs compared with the placebo group, patients in the rosuvastatin group had decreased levels of low-density lipoprotein cholesterol (difference between groups, 45.0%; P<0.001) and of high-sensitivity C-reactive protein (difference between groups, 37.1%; P<0.001). During a median follow-up of 32.8 months, the primary outcome occurred in 692 patients in the rosuvastatin group and 732 in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.83 to 1.02; P=0.12), and 728 patients and 759 patients, respectively, died (hazard ratio, 0.95; 95% CI, 0.86 to 1.05; P=0.31). There were no significant differences between the two groups in the coronary outcome or death from cardiovascular causes. In a prespecified secondary analysis, there were fewer hospitalizations for cardiovascular causes in the rosuvastatin group (2193) than in the placebo group (2564) (P<0.001). No excessive episodes of muscle-related or other adverse events occurred in the rosuvastatin group.

conclusionsRosuvastatin did not reduce the primary outcome or the number of deaths from any cause in older patients with systolic heart failure, although the drug did reduce the number of cardiovascular hospitalizations. The drug did not cause safety problems. (ClinicalTrials.gov number, NCT00206310.)

Indexed as

AgedCardiovascular DiseasesFemaleFluorobenzenesFollow-Up StudiesHeart FailureHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedMyocardial IschemiaProportional Hazards ModelsPyrimidinesRosuvastatin CalciumSingle-Blind MethodFluorobenzenesHydroxymethylglutaryl-CoA Reductase InhibitorsPyrimidinesRosuvastatin CalciumSulfonamides

Identifiers

PMID17984166
OpenAlexW2126452437

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.