SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2011
Efficacy of statins for primary prevention in people at low cardiovascular risk: a meta-analysis.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2011. The graph read 3 numbers from its abstract, feeding 2 cells of the map: it supports the treatment in 2. Cited by 45 papers, 9 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.
Patients in the statin group were also significantly less likely than controls to have nonfatal myocardial infarction (RR 0.64, 95% CI 0.49-0.84) and nonfatal stroke (RR 0.81, 95% CI 0.68-0.96).
All-cause mortality was significantly lower among patients receiving a statin than among controls (relative risk [RR] 0.90, 95% confidence interval [CI] 0.84-0.97) for trials with a 10-year risk of cardiovascular disease < 20% [primary analysis] and 0.83, 95% CI 0.73-0.94, for trials with 10-year risk < 10% [sensitivity analysis]).
Patients in the statin group were also significantly less likely than controls to have nonfatal myocardial infarction (RR 0.64, 95% CI 0.49-0.84) and nonfatal stroke (RR 0.81, 95% CI 0.68-0.96).
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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
SupportsOpen 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.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Statins×all-cause mortality
SupportsOpen on the map →What to test next →14 readable studies in this cell: 4 favour the treatment, 9 find no difference, 1 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
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
45 citing papers in PubMed, 9 syntheses or guidelines pooled it, 152 citations in OpenAlex.
- Interventions for primary prevention of cardiovascular disease: umbrella review of systematic reviews.Health technology assessment (Winchester, England) · 2024Pooled it
- A systematic review and meta-analysis of the prevalence of dyslipidaemia among adults in Malaysia.Scientific reports · 2023Pooled it
- Comparative Lipid-Lowering/Increasing Efficacy of 7 Statins in Patients with Dyslipidemia, Cardiovascular Diseases, or Diabetes Mellitus: Systematic Review and Network Meta-Analyses of 50 Randomized Controlled Trials.Cardiovascular therapeutics · 2020 · on this mapPooled it
- Reporting bias in the literature on the associations of health-related behaviors and statins with cardiovascular disease and all-cause mortality.PLoS biology · 2018Pooled it
- Acute myocardial infarction and influenza: a meta-analysis of case-control studies.Heart (British Cardiac Society) · 2015Pooled it
- Statins for Primary Prevention of Cardiovascular Disease in Elderly Patients: Systematic Review and Meta-Analysis.Drugs & aging · 2015 · on this mapPooled it
- Statins and Cardiovascular Primary Prevention in CKD: A Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2015 · on this mapPooled it
- Guideline
- Clinical review: Statins and trauma--a systematic review.Critical care (London, England) · 2013Pooled it
- Statin Use in Patients With Advanced Prostate Cancer in the TITAN and SPARTAN Trials.JAMA network open · 2025Trial
- Enhancement of Statin Effects on Lipid Lowering and Reduction of Cardiovascular Risk Score by (-)-Epicatechin in Proof-of-Concept Pilot Study.Clinical and translational science · 2025Trial
- Red yeast rice lowers cholesterol in physicians - a double blind, placebo controlled randomized trial.BMC complementary and alternative medicine · 2013Trial
- Systematic Coronary Risk Evaluation 2 (SCORE2), arterial stiffness, and subclinical coronary atherosclerosis in a population-based study.Scandinavian journal of primary health care · 2025Article
- Effectiveness of patient-oriented intervention in primary prevention of cardiovascular diseases with statins: Open-label randomized study.Caspian journal of internal medicine · 2025Article
- High-sensitivity C-reactive Protein in Atherosclerotic Cardiovascular Disease: To Measure or Not to Measure?US cardiology · 2025Review
- Thermal Remodeling of Human HDL Particles Reveals Diverse Subspecies.Journal of the American Society for Mass Spectrometry · 2024Article
- Canadian Cost-Effectiveness of Coronary Artery Calcium Screening Based on the Multi-Ethnic Study of Atherosclerosis.JACC. Advances · 2024Article
- Trends of Lipid Concentrations, Awareness, Evaluation, and Treatment in Severe Dyslipidemia in US Adults.Mayo Clinic proceedings · 2024Article
- Navigating the Statin Landscape: A Comprehensive Review of Stroke Prevention Strategies.Cureus · 2024Review
- Association of statin use and increase in lipoprotein(a): a real-world database research.European journal of medical research · 2023Article
Corrections and comments
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Authors and funding
11 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.
backgroundStatins were initially used to improve cardiovascular outcomes in people with established coronary artery disease, but recently their use has become more common in people at low cardiovascular risk. We did a systematic review of randomized trials to assess the efficacy and harms of statins in these individuals.
methodsWe searched MEDLINE and EMBASE (to Jan. 28, 2011), registries of health technology assessments and clinical trials, and reference lists of relevant reviews. We included trials that randomly assigned participants at low cardiovascular risk to receive a statin versus a placebo or no statin. We defined low risk as an observed 10-year risk of less than 20% for cardiovascular-related death or nonfatal myocardial infarction, but we explored other definitions in sensitivity analyses.
resultsWe identified 29 eligible trials involving a total of 80,711 participants. All-cause mortality was significantly lower among patients receiving a statin than among controls (relative risk [RR] 0.90, 95% confidence interval [CI] 0.84-0.97) for trials with a 10-year risk of cardiovascular disease < 20% [primary analysis] and 0.83, 95% CI 0.73-0.94, for trials with 10-year risk < 10% [sensitivity analysis]). Patients in the statin group were also significantly less likely than controls to have nonfatal myocardial infarction (RR 0.64, 95% CI 0.49-0.84) and nonfatal stroke (RR 0.81, 95% CI 0.68-0.96). Neither metaregression nor stratified analyses suggested statistically significant differences in efficacy between high-and low-potency statins, or larger reductions in cholesterol.
interpretationStatins were found to be efficacious in preventing death and cardiovascular morbidity in people at low cardiovascular risk. Reductions in relative risk were similar to those seen in patients with a history of coronary artery disease.
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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.