SynthesisBMC cardiovascular disorders2014
Effect of statins on cardiovascular events in patients with mild to moderate chronic kidney disease: a systematic review and meta-analysis of randomized clinical trials.
Synthesis in BMC cardiovascular disorders, 2014. The graph read 9 numbers from its abstract, feeding 2 cells of the map: it supports the treatment in 1. Cited by 15 papers, 3 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.
The pooled RR for the effect of myocardial infarction in patients receiving statin therapy compared with that of the control treatment was 0.66 (RR, 0.66; 95% CI, 0.52-0.83; p = 0.001; Figure 4).
Read, but not usablea number the graph found but could not read as for or against
Overall, statin therapy resulted in a 24% reduction in the risk of cardiovascular disease (RR = 0.76,95% confidence interval [CI], 0.72- 0.80), a 21% reduction in the risk of total mortality (RR = 0.79,95% CI, 0.72-0.86), a 34% reduction in the risk of myocardial infarction (RR = 0.66,95% CI, 0.52-0.83), a 30% reduction in the risk of stroke (RR = 0.70,95% CI, 0.57-0.85), and a 17% reduction in the risk of cardiovascular mortality (RR = 0.83,95% CI, 0.73- 0.93).
The pooled results revealed that total mortality was significantly lower among patients undergoing stain therapy (RR, 0.79; 95% CI, 0.72-0.86; Figure 3) by using a random-effects model.
Overall, statin therapy resulted in a 24% reduction in the risk of cardiovascular disease (RR = 0.76,95% confidence interval [CI], 0.72- 0.80), a 21% reduction in the risk of total mortality (RR = 0.79,95% CI, 0.72-0.86), a 34% reduction in the risk of myocardial infarction (RR = 0.66,95% CI, 0.52-0.83), a 30% reduction in the risk of stroke (RR = 0.70,95% CI, 0.57-0.85), and a 17% reduction in the risk of cardiovascular mortality (RR = 0.83,95% CI, 0.73- 0.93).
Overall, statin therapy resulted in a 24% reduction in the risk of cardiovascular disease (RR = 0.76,95% confidence interval [CI], 0.72- 0.80), a 21% reduction in the risk of total mortality (RR = 0.79,95% CI, 0.72-0.86), a 34% reduction in the risk of myocardial infarction (RR = 0.66,95% CI, 0.52-0.83), a 30% reduction in the risk of stroke (RR = 0.70,95% CI, 0.57-0.85), and a 17% reduction in the risk of cardiovascular mortality (RR = 0.83,95% CI, 0.73- 0.93).
Superior efficacy of statin therapy on cardiovascular events was found in the majority of subgroup analyses, except for patients with a baseline creatinine level ≥1.5 mg/dL (RR, 0.71; 95% CI, 0.45-1.12; p = 0.139; Table 2).
Overall, statin therapy resulted in a 24% reduction in the risk of cardiovascular disease (RR = 0.76,95% confidence interval [CI], 0.72- 0.80), a 21% reduction in the risk of total mortality (RR = 0.79,95% CI, 0.72-0.86), a 34% reduction in the risk of myocardial infarction (RR = 0.66,95% CI, 0.52-0.83), a 30% reduction in the risk of stroke (RR = 0.70,95% CI, 0.57-0.85), and a 17% reduction in the risk of cardiovascular mortality (RR = 0.83,95% CI, 0.73- 0.93).
Overall, statin therapy resulted in a 24% reduction in the risk of cardiovascular disease (RR = 0.76,95% confidence interval [CI], 0.72- 0.80), a 21% reduction in the risk of total mortality (RR = 0.79,95% CI, 0.72-0.86), a 34% reduction in the risk of myocardial infarction (RR = 0.66,95% CI, 0.52-0.83), a 30% reduction in the risk of stroke (RR = 0.70,95% CI, 0.57-0.85), and a 17% reduction in the risk of cardiovascular mortality (RR = 0.83,95% CI, 0.73- 0.93).
We noted that statin therapy had no effect on total mortality in patients with a history of cardiovascular disease (RR, 1.48; 95% CI, 0.41-5.36; p = 0.55), baseline GFR <60 mL . min-1 . 1.73 m-2 (RR, 0.68; 95% CI, 0.47, 1.00; p = 0.050), and baseline creatinine level >1.5 mg/dL (RR, 0.82; 95% CI, 0.58-1.15; p = 0.251; Table 3).
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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
No readable resultOpen 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
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Effectiveness of exercise interventions for children with cerebral palsy: A systematic review and meta-analysis of randomized controlled trials.Journal of rehabilitation medicine · 2021Pooled it
- Pooled it
- High-intensity statin therapy in patients with chronic kidney disease: a systematic review and meta-analysis.BMJ open · 2015Pooled it
- Effect of statins and antihyperglycemics on chronic kidney disease in patients with type 2 diabetes mellitus: a retrospective cohort study with a 12-year follow-up.Journal of pharmaceutical policy and practice · 2025Article
- Ten things to know about ten cardiovascular disease risk factors - 2022.American journal of preventive cardiology · 2022Review
- Elevated atherogenic index and higher triglyceride increase risk of kidney function decline: a 7-year cohort study in Chinese adults.Renal failure · 2021Article
- Article
- Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation.Journal of clinical medicine · 2021Article
- Ten things to know about ten cardiovascular disease risk factors.American journal of preventive cardiology · 2021Review
- Ten things to know about ten cardiovascular disease risk factors ("ASPC Top Ten - 2020").American journal of preventive cardiology · 2020Review
- Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country.BMC rheumatology · 2020Article
- Cholesterol-Lowering Treatment in Chronic Kidney Disease: Multistage Pairwise and Network Meta-Analyses.Scientific reports · 2019Article
- Lipid lowering in renal disease.Australian prescriber · 2017Review
- Effects of simvastatin and atorvastatin on biochemical and hematological markers in patients with risk of cardiovascular diseases.International journal of clinical and experimental medicine · 2015Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions 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 are commonly used to lower total cholesterol levels in the general population to prevent cardiovascular events. However, the effects of statins in patients with chronic kidney disease remain unclear. We therefore performed a meta-analysis to assess the effects of statin therapy on cardiovascular outcomes in patients with mild to moderate chronic kidney disease.
methodsWe systematically searched PubMed, EmBase, the Cochrane Central Register of Controlled Trials, proceedings of major meetings, and reference lists of articles for relevant literature. Only randomized clinical trials were included. Outcomes analysed included cardiovascular disease, total mortality, myocardial infarction, stroke, cardiovascular death, and possible drug-related adverse events. Subgroup analyses were also performed based on the population characteristics and clinical indexes.
resultsTwelve trials met our inclusion criteria. Overall, statin therapy resulted in a 24% reduction in the risk of cardiovascular disease (RR = 0.76,95% confidence interval [CI], 0.72- 0.80), a 21% reduction in the risk of total mortality (RR = 0.79,95% CI, 0.72-0.86), a 34% reduction in the risk of myocardial infarction (RR = 0.66,95% CI, 0.52-0.83), a 30% reduction in the risk of stroke (RR = 0.70,95% CI, 0.57-0.85), and a 17% reduction in the risk of cardiovascular mortality (RR = 0.83,95% CI, 0.73- 0.93). No statistically significant drug-related adverse events were noted. Subgroup analysis indicated that some important factors such as baseline creatinine level ≥1.5 mg/dL, baseline glomerular filtration rate (GFR), and cardiovascular disease history could affect cardiovascular outcomes.
conclusionStatin therapy had a clear effect on cardiovascular disease, total mortality, stroke, and myocardial infarction in patients with mild to moderate renal disease. Subgroup analysis indicated that baseline GFR, baseline creatinine level, and a history of cardiovascular disease might play an important role in the cardiovascular outcomes.
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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.