SynthesisInternational journal of cardiology2015
Effects of add-on lipid-modifying therapy on top of background statin treatment on major cardiovascular events: A meta-analysis of randomized controlled trials.
Synthesis in International journal of cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Niacin for primary and secondary prevention of cardiovascular events.The Cochrane database of systematic reviews · 2017 · on this mapPooled it
- Fibrates for primary prevention of cardiovascular disease events.The Cochrane database of systematic reviews · 2016 · on this mapPooled it
- Classical and Novel Lipid-Lowering Therapies for Diabetic Patients with Established Coronary Artery Disease or High Risk of Coronary Artery Disease-A Narrative Clinical Review.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Novel Selective PPARα Modulator Pemafibrate for Dyslipidemia, Nonalcoholic Fatty Liver Disease (NAFLD), and Atherosclerosis.Metabolites · 2023Review
- Therapeutics in Metabolic Diseases.Advances in experimental medicine and biology · 2023Article
- Association between statin use and the prognosis of patients with acute myocardial infarction complicated with diabetes.Frontiers in cardiovascular medicine · 2022Article
- Level of Control of Dyslipidemia Among Patients Followed in Family Medicine Clinics in Riyadh, Saudi Arabia.Cureus · 2021Article
- Cardiovascular Disease Risk Reduction in Mild-Moderate Hypertriglyceridemia: Integrating Prescription of Omega-3 with Standard Treatment.Current atherosclerosis reports · 2021Review
- The Ratio of Triglyceride to High-density Lipoprotein Cholesterol as an Indicator of Risk Stratification for Atherosclerotic Cardiovascular Disease in a Clinical Setting.Internal medicine (Tokyo, Japan) · 2020Article
- Pemafibrate, a New Selective PPARα Modulator: Drug Concept and Its Clinical Applications for Dyslipidemia and Metabolic Diseases.Current atherosclerosis reports · 2020Review
- Evidence for changing lipid management strategy to focus on non-high density lipoprotein cholesterol.Lipids in health and disease · 2019Review
- Increased triglyceride/high-density lipoprotein cholesterol ratio may be associated with reduction in the low-density lipoprotein particle size: assessment of atherosclerotic cardiovascular disease risk.Heart and vessels · 2019Article
- Cardiovascular risk profile of patients with atherogenic dyslipidemia in middle age Lithuanian population.Lipids in health and disease · 2018Article
- Effect and safety of combination lipid-lowering therapies based on statin treatment versus statin monotherapies on patients with high risk of cardiovascular events.Aging medicine (Milton (N.S.W)) · 2018Review
- High-density Lipoprotein and Low-density Lipoprotein Therapeutic Approaches in Acute Coronary Syndromes.Current cardiology reviews · 2017Review
- Cholesteryl ester transfer protein: ace of spades, queen of hearts, or the joker?Frontiers in pharmacology · 2015Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients at high risk of atherosclerotic cardiovascular diseases (ASCVDs), residual cardiovascular risk persists despite the achievement of target LDL cholesterol levels with statin therapy. It is still unclear whether adding lipid-modifying agent to statin treatment can further improve clinical outcomes.
methodsRandomized controlled trials (RCTs) in terms of adding lipid-modifying agent to statin versus statin monotherapy in patients at high risk of ASCVD were identified by electronic and manual searches. Results were expressed as relative risk (RR) with 95% confidence intervals (CIs).
resultsEleven RCTs with 109,244 patients were included in this meta-analysis. Overall, the incidences of major adverse cardiovascular events (MACEs) were 9.70% in the statin combination groups and 9.92% in the statin monotherapy groups. No significant difference was observed in the risk of MACEs either in overall (RR 0.99, 95% CI 0.93-1.05, P=0.76) or subgroup analysis (CETP inhibitor: RR 1.07, 95% CI 0.93-1.23, P=0.37; niacin: RR 1.03, 95% CI 0.85-1.25, P=0.79; n-3 fatty acid: RR 0.98, 95% CI 0.88-1.09, P=0.70; fenofibrate: RR 0.93, 95% CI 0.80-1.09, P=0.38), with the exception of the statin/ezetimibe combination subgroup (RR 0.92, 95% CI 0.87-0.97, P=0.004). Adding lipid-modifying agent to statin significantly increased liver injury risk. Adding ezetimibe to statin did not alter side effect profile.
conclusionAdding niacin, CETP inhibitors, n-3 fatty acid or fibrates to statin therapy has all failed to achieve a clinical benefit. Adding ezetimibe to statin therapy further lowers LDL-cholesterol safely and translates into a clinical benefit in patients at high risk of ASCVD.
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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.