Trial reportEuropean heart journal2011
The Anglo-Scandinavian Cardiac Outcomes Trial: 11-year mortality follow-up of the lipid-lowering arm in the U.K.
Trial report in European heart journal, 2011. The graph read 3 numbers from its abstract, feeding 2 cells of the map: it supports the treatment in 1, finds no clear difference in 1. Cited by 50 papers, 7 of them syntheses that pooled 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.
CV deaths were fewer, but not significant (HR 0.89, CI 0.72-1.11, P=0.32) and non-CV deaths were significantly lower (HR 0.85, CI 0.73-0.99, P=0.03) in those formerly assigned atorvastatin attributed to a reduction in deaths due to infection and respiratory illness.
A median 11 years after initial randomization and ∼8 years after closure of LLA, all-cause mortality (n=520 and 460 in placebo and atorvastatin, respectively) remained significantly lower in those originally assigned atorvastatin (HR 0.86, CI 0.76-0.98, P=0.02).
CV deaths were fewer, but not significant (HR 0.89, CI 0.72-1.11, P=0.32) and non-CV deaths were significantly lower (HR 0.85, CI 0.73-0.99, P=0.03) in those formerly assigned atorvastatin attributed to a reduction in deaths due to infection and respiratory illness.
clause the extractor read what became the number
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.
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×cardiovascular events
InconclusiveOpen on the map →What to test next →30 readable studies in this cell: 18 favour the treatment, 11 find no difference, 1 favour the comparator.
Statins×all-cause mortality
SupportsOpen on the map →What to test next →14 readable studies in this cell: 3 favour the treatment, 9 find no difference, 2 favour the comparator.
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.
Who cites it
50 citing papers in PubMed, 7 syntheses or guidelines pooled it, 123 citations in OpenAlex.
- HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis.The Cochrane database of systematic reviews · 2023Pooled it
- Assessment of Long-term Follow-up of Randomized Trial Participants by Linkage to Routinely Collected Data: A Scoping Review and Analysis.JAMA network open · 2018Pooled it
- Legacy effects of statins on cardiovascular and all-cause mortality: a meta-analysis.BMJ open · 2018 · on this mapPooled it
- Clinical significance of 'cardiometabolic memory': a systematic review of randomized controlled trials.Hypertension research : official journal of the Japanese Society of Hypertension · 2017Pooled it
- Is there sufficient enhancement of the reduction in CVD rates after a decade of statin therapy to justify continuation?Current atherosclerosis reports · 2014Pooled it
- Statins and the risk of lung cancer: a meta-analysis.PloS one · 2013Pooled it
- Systematic review and meta-analysis on the association between outpatient statins use and infectious disease-related mortality.PloS one · 2012Pooled it
- Statin Use is Not Associated with Future Long-Term Care Admission: Extended Follow-Up of Two Randomised Controlled Trials.Drugs & aging · 2018Trial
- Trial
- Long-Term Mortality in Hypertensive Patients With Coronary Artery Disease: Results From the US Cohort of the International Verapamil (SR)/Trandolapril Study.Hypertension (Dallas, Tex. : 1979) · 2016Trial
- Rationale and design of LAPLACE-2: a phase 3, randomized, double-blind, placebo- and ezetimibe-controlled trial evaluating the efficacy and safety of evolocumab in subjects with hypercholesterolemia on background statin therapy.Clinical cardiology · 2014 · on this mapTrial
- Trial
- Clinical Efficacy with Evolocumab among Japanese Patients in PROFICIO: A Pooled Analysis of 1,040 Patients.Journal of atherosclerosis and thrombosis · 2026Article
- Cumulative LDL cholesterol exposure and the risk of coronary artery lesion progression: a linear association.BMC cardiovascular disorders · 2026Article
- Impact of Age on Lipid-Lowering Therapy Prescriptions and LDL-Cholesterol Control: Insights from the PORTRAIT-DYS Study.Global heart · 2026Article
- From ASCOT to Asia: A More Active and Successful Approach in Preventing Cardiovascular Disease.Acta Cardiologica Sinica · 2026Review
- Longitudinal Control of Lipid Levels in Patients With Premature Coronary Artery Disease.JACC. Advances · 2023Article
- Clinical and Prognostic Value of Non-Fasting Lipoproteins and Apolipoproteins in Chinese Patients with Coronary Heart Disease.Reviews in cardiovascular medicine · 2023Article
- Earlier treatment in adults with high lifetime risk of cardiovascular diseases: What prevention trials are feasible and could change clinical practice? Report of a National Heart, Lung, and Blood Institute (NHLBI) Workshop.American journal of preventive cardiology · 2022Review
- Real-world Evidence for Adherence and Persistence with Atorvastatin Therapy.Cardiology and therapy · 2021Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
aimsThe aim of this study was to determine the outcome benefits in those originally assigned atorvastatin in the Anglo-Scandinavian Cardiac Outcomes Trial-8 years after closure of the lipid-lowering arm (LLA) of the trial (ASCOT-LLA) among the U.K. population. METHODS AND
resultsASCOT-LLA was a factorially designed double-blind placebo-controlled trial of atorvastatin in 10 305 hypertensive patients enrolled into the ASCOT-Blood Pressure Lowering Arm (BPLA) of the trial and with total cholesterol concentrations, at baseline, of <6.5 mmol/L. ASCOT-LLA was stopped prematurely after a median 3.3-year follow-up because of a 36% relative risk reduction (RRR) in non-fatal myocardial infarction and fatal coronary heart disease (CHD) (the primary outcome) in favour of atorvastatin and a non-significant reduction in CV deaths (16%) and all-cause mortality (13%). After a further 2.2 years at the end of ASCOT-BPLA, despite extensive crossovers from and to statin usage, the RRR in all endpoints remained essentially unchanged. A median 11 years after initial randomization and ∼8 years after closure of LLA, all-cause mortality (n=520 and 460 in placebo and atorvastatin, respectively) remained significantly lower in those originally assigned atorvastatin (HR 0.86, CI 0.76-0.98, P=0.02). CV deaths were fewer, but not significant (HR 0.89, CI 0.72-1.11, P=0.32) and non-CV deaths were significantly lower (HR 0.85, CI 0.73-0.99, P=0.03) in those formerly assigned atorvastatin attributed to a reduction in deaths due to infection and respiratory illness.
conclusionLegacy effects of those originally assigned atorvastatin may contribute to long-term benefits on all-cause mortality. An explanation for long-term benefits on non-CV deaths has not been established.
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What Socratic holds
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.