Trial reportJournal of atherosclerosis and thrombosis2010

Association between lowering low-density lipoprotein cholesterol with pravastatin and primary prevention of cardiovascular disease in mild to moderate hypercholesterolemic Japanese.

Tamio Teramoto, Noriaki Nakaya, Shinji Yokoyama, Yasuo Ohashi, Kyoichi Mizuno, Haruo Nakamura, MEGA Study Group

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of atherosclerosis and thrombosis, 2010. The graph read 1 number from its abstract, feeding 1 cell of the map: it . Cited by 8 papers, 1 of them a synthesis that pooled it.

1number the graph read from it
1cell of the map it votes in
8citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 10% 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 →
1 · no effect
Lipidsfavours the treatment · head-to-head · ascvd, dyslipidemiafeeds one cell of the map
HR 0.57p=0.01
RESULTS: In the tertiles of the diet plus pravastatin group, HR was lowest in the second tertile against the diet group (HR 0.57, p=0.01) with on-treatment LDL-C range of 119.8-133.4 mg/dL.

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

No readable resultOpen 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 itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2013 · on this map
    Pooled it
  2. Clinical perspectives on ischemic stroke.Experimental neurology · 2021
    Review
  3. Article
  4. LDL cholesterol performance of beta quantification reference measurement procedure.Clinica chimica acta; international journal of clinical chemistry · 2014
    Article
  5. Review
  6. Statins in the primary prevention of cardiovascular disease.Nature reviews. Cardiology · 2013 · on this map
    Review
  7. Article
  8. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Tamio TeramotoDepartment of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan. ttera@med.teikyo-u.ac.jp
Noriaki Nakaya
Shinji Yokoyama
Yasuo Ohashi
Kyoichi Mizuno
Haruo Nakamura
MEGA Study Group
Mitsukoshi Health and Welfare Foundation · JPNippon Medical School · JPTeikyo University · JPThe University of Tokyo · JP

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.

aimsTo evaluate the relationship between low-density lipoprotein cholesterol (LDL-C) change and reduction of cardiovascular disease in the Management of Elevated cholesterol in the primary prevention Group of Adult Japanese (MEGA) study.

methodsPatients in the diet plus pravastatin group were divided into tertiles by their on-treatment LDL-C level, and the hazard ratios (HRs) in each tertile were compared with the diet group at 5 years using the Cox proportional hazards model. In addition, the treatment groups were combined and divided into quintiles according to the on-treatment LDL-C level during follow-up, and the incidence of cardiovascular events was compared among the 5 groups.

resultsIn the tertiles of the diet plus pravastatin group, HR was lowest in the second tertile against the diet group (HR 0.57, p=0.01) with on-treatment LDL-C range of 119.8-133.4 mg/dL. In the analysis of quintiles of the total population, a significant risk reduction of CVD was found in the fourth quintile (HR 0.48, p=0.0015) with an on-treatment LDL-C range of 120.9-133.3 mg/dL, and in the fifth quintile (HR 0.64, p=0.048) with an on-treatment LDL-C range of 56.7-120.8 mg/dL against tertile 1 with an on-treatment LDL-C range of 157.5-206.2 mg/dL.

conclusionsThe usual Japanese dose of pravastatin therapy is sufficient in this low-risk patient population to reduce cardiovascular risk, with an achieved LDL-C level <133.4 mg/dL. Further risk reduction was not found with an achieved LDL <120 mg/dL.

Indexed as

AdultAgedAsian PeopleCardiovascular DiseasesCholesterol, LDLFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaMaleMiddle AgedPravastatinRisk FactorsTreatment OutcomeCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatin

Identifiers

PMID20543522
OpenAlexW1979755481

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

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.