SynthesisCirculation2013
Levels and changes of HDL cholesterol and apolipoprotein A-I in relation to risk of cardiovascular events among statin-treated patients: a meta-analysis.
Synthesis in Circulation, 2013. The graph read 4 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. It also reports 3 associations that do not count as treatment evidence, such as HR 0.83 (0.81 to 0.86) for cardiovascular events. Cited by 89 papers, 5 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.
Read, but not usablea number the graph found but could not read as for or against
HDL-C levels were associated with a reduced risk of major cardiovascular events (adjusted hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.81-0.86 per 1 standard deviation increment), as were apoA-I levels (HR, 0.79; 95% CI, 0.72-0.82).
HDL-C levels were associated with a reduced risk of major cardiovascular events (adjusted hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.81-0.86 per 1 standard deviation increment), as were apoA-I levels (HR, 0.79; 95% CI, 0.72-0.82).
An increase of HDL-C was not associated with reduced cardiovascular risk (HR, 0.98; 95% CI, 0.94-1.01 per 1 standard deviation increment), whereas a rise in apoA-I was (HR, 0.93; 95% CI, 0.90-0.97).
An increase of HDL-C was not associated with reduced cardiovascular risk (HR, 0.98; 95% CI, 0.94-1.01 per 1 standard deviation increment), whereas a rise in apoA-I was (HR, 0.93; 95% CI, 0.90-0.97).
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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.
Other lipid agents×cardiovascular events
No readable resultOpen on the map →What to test next →10 readable studies in this cell: 5 favour the treatment, 5 find no difference, 0 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.
Other lipid agents×lipids
No readable resultOpen on the map →What to test next →28 readable studies in this cell: 17 favour the treatment, 2 find no difference, 9 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
89 citing papers in PubMed, 5 syntheses or guidelines pooled it, 193 citations in OpenAlex.
- HDL-cholesterol concentration and its association with coronary artery calcification: a systematic review and meta-analysis.Lipids in health and disease · 2023Pooled it
- Estimating the Effect of Aerobic Exercise Training on Novel Lipid Biomarkers: A Systematic Review and Multivariate Meta-Analysis of Randomized Controlled Trials.Sports medicine (Auckland, N.Z.) · 2023Pooled it
- Meta-analysis of genome-wide association studies of HDL cholesterol response to statins.Journal of medical genetics · 2016Pooled it
- Safety and efficacy of anti-PCSK9 antibodies: a meta-analysis of 25 randomized, controlled trials.BMC medicine · 2015Pooled it
- Seven functional polymorphisms in the CETP gene and myocardial infarction risk: a meta-analysis and meta-regression.PloS one · 2014Pooled it
- Impact of a 12-week High-Intensity Interval Training With Spirulina Supplementation on Insulin Resistance-Mediated by Apo-A, -B, and -J in Men With Obesity HIIT With Spirulina on Apolipoproteins.European journal of sport science · 2025Trial
- Effects of niacin and omega-3 fatty acids on HDL-apolipoprotein A-I exchange in subjects with metabolic syndrome.PloS one · 2024Trial
- MDCO-216 Does Not Induce Adverse Immunostimulation, in Contrast to Its Predecessor ETC-216.Cardiovascular drugs and therapy · 2017Trial
- Trial
- Efficacy and Safety of the PCSK9 Inhibitor Evolocumab in Patients with Mixed Hyperlipidemia.Cardiovascular drugs and therapy · 2016Trial
- A single infusion of MDCO-216 (ApoA-1 Milano/POPC) increases ABCA1-mediated cholesterol efflux and pre-beta 1 HDL in healthy volunteers and patients with stable coronary artery disease.European heart journal. Cardiovascular pharmacotherapy · 2016Trial
- A pilot study of ezetimibe vs. atorvastatin for improving peripheral microvascular endothelial function in stable patients with type 2 diabetes mellitus.Lipids in health and disease · 2015 · on this mapTrial
- High HDL cholesterol level after treatment with pitavastatin is an important factor for regression in carotid intima-media thickness.Heart and vessels · 2015Trial
- Trial
- Associations Between High-Density Lipoprotein Subfraction Profiles and Heart Rate Response Following Submaximal Exercise.Biology · 2026Article
- DELTA: Strengthening human biological resilience with an N=1 digital health and dynamic biomarker protocol.PloS one · 2026Article
- Development and external validation of a machine learning model for cardiac valve calcification early screening in dialysis patients: a multicenter study.Renal failure · 2025Article
- Standardising lipid testing and reporting in the United Kingdom; a joint statement by HEART UK and The Association for Laboratory Medicine.Annals of clinical biochemistry · 2025Review
- Association between blood triglycerides and stroke-associated pneumonia: a prospective cohort study.BMC neurology · 2025Article
- Recent advances in precision nutrition and cardiometabolic diseases.Revista espanola de cardiologia (English ed.) · 2025Review
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 2 institutions in 2 countries.
Funding
Abstract
The marked sentences are the ones the graph read a number from.
backgroundIt is unclear whether levels of high-density lipoprotein cholesterol (HDL-C) or apolipoprotein A-I (apoA-I) remain inversely associated with cardiovascular risk among patients who achieve very low levels of low-density lipoprotein cholesterol on statin therapy. It is also unknown whether a rise in HDL-C or apoA-I after initiation of statin therapy is associated with a reduced cardiovascular risk. METHODS AND
resultsWe performed a meta-analysis of 8 statin trials in which lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up. Individual patient data were obtained for 38,153 trial participants allocated to statin therapy, of whom 5387 suffered a major cardiovascular event. HDL-C levels were associated with a reduced risk of major cardiovascular events (adjusted hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.81-0.86 per 1 standard deviation increment), as were apoA-I levels (HR, 0.79; 95% CI, 0.72-0.82). This association was also observed among patients achieving on-statin low-density lipoprotein cholesterol levels <50 mg/dL. An increase of HDL-C was not associated with reduced cardiovascular risk (HR, 0.98; 95% CI, 0.94-1.01 per 1 standard deviation increment), whereas a rise in apoA-I was (HR, 0.93; 95% CI, 0.90-0.97).
conclusionsAmong patients treated with statin therapy, HDL-C and apoA-I levels were strongly associated with a reduced cardiovascular risk, even among those achieving very low low-density lipoprotein cholesterol. An apoA-I increase was associated with a reduced risk of major cardiovascular events, whereas for HDL-C this was not the case. These findings suggest that therapies that increase apoA-I concentration require further exploration with regard to cardiovascular risk reduction.
Indexed as
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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.