Trial reportInternational journal of cardiology2018
The nonalcoholic fatty liver disease (NAFLD) fibrosis score, cardiovascular risk stratification and a strategy for secondary prevention with ezetimibe.
Trial report in International journal of cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00202878. Cited by 26 papers, 3 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.
A Multicenter, Double-Blind, Randomized Study to Establish the Clinical Benefit and Safety of Vytorin (Ezetimibe/Simvastatin Tablet) vs Simvastatin Monotherapy in High-Risk Subjects Presenting With Acute Coronary Syndrome (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial - IMPROVE IT)
Open the trial in the graphWho cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Potential impact of ezetimibe on patients with NAFLD/NASH: a meta-analysis of randomized controlled trials.Frontiers in endocrinology · 2024Pooled it
- HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis.The Cochrane database of systematic reviews · 2023Pooled it
- KASL clinical practice guidelines: Management of nonalcoholic fatty liver disease.Clinical and molecular hepatology · 2021Guideline
- Use of a Micronutrient Cocktail to Improve Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Adults with Obesity: A Randomized, Double-Blinded Pilot Clinical Trial.Medicina (Kaunas, Lithuania) · 2024Trial
- Interrelationships Between Key Cardiovascular Risk Factors, Chronic Kidney Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease.Current cardiology reports · 2026Review
- Effect of Non-Statin Lipid-Lowering Therapy on Hepatic Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease and Steatohepatitis: A Systematic Review.Journal of lipid and atherosclerosis · 2025Review
- Association Between Visceral Adiposity and the Prediction of Hepatic Steatosis and Fibrosis in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Journal of clinical medicine · 2025Article
- The pan-PPAR agonist lanifibranor improves cardiometabolic health in patients with metabolic dysfunction-associated steatohepatitis.Nature communications · 2024Article
- Expanding the therapeutic landscape: ezetimibe as non-statin therapy for dyslipidemia.The Korean journal of internal medicine · 2023Review
- Impacts of Non-alcoholic Fatty Liver Disease on Acute Coronary Syndrome: Evidence and Controversies.Current atherosclerosis reports · 2023Review
- Article
- Reduction in the risk of major adverse cardiovascular events with the BET protein inhibitor apabetalone in patients with recent acute coronary syndrome, type 2 diabetes, and moderate to high likelihood of non-alcoholic fatty liver disease.American journal of preventive cardiology · 2022Article
- The Ability of Lipoprotein (a) Level to Predict Early Carotid Atherosclerosis Is Impaired in Patients With Advanced Liver Fibrosis Related to Metabolic-Associated Fatty Liver Disease.Clinical and translational gastroenterology · 2022Article
- Management of Dyslipidemia in Patients with Non-Alcoholic Fatty Liver Disease.Current atherosclerosis reports · 2022Review
- Association of Metabolomic Change and Treatment Response in Patients with Non-Alcoholic Fatty Liver Disease.Biomedicines · 2022Article
- Is there a role of lipid-lowering therapies in the management of fatty liver disease?World journal of hepatology · 2022Review
- Low Screening Rates Despite a High Prevalence of Significant Liver Fibrosis in People with Diabetes from Primary and Secondary Care.Journal of clinical medicine · 2021Article
- Non-alcoholic fatty liver disease and heart failure with preserved ejection fraction: from pathophysiology to practical issues.ESC heart failure · 2021Review
- Liver Fibrosis Biomarkers Accurately Exclude Advanced Fibrosis and Are Associated with Higher Cardiovascular Risk Scores in Patients with NAFLD or Viral Chronic Liver Disease.Diagnostics (Basel, Switzerland) · 2021Article
- Association between noninvasive assessment of liver fibrosis and coronary artery calcification progression in patients with nonalcoholic fatty liver disease.Scientific reports · 2020Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe nonalcoholic fatty liver disease fibrosis score (NFS) is comprised of unique metabolic risk indicators that may accurately predict residual cardiovascular (CV) risk in patients with established coronary disease and metabolic dysfunction.
methodsWe applied the NFS prospectively to 14,819 post-ACS patients randomized to ezetimibe/simvastatin (E/S) or placebo/simvastatin (P/S), in the IMPROVE-IT trial, using validated NFS cutoffs. The primary endpoint included CV death, myocardial infarction, unstable angina, revascularization or stroke. Outcomes were compared between NFS categories and treatment arms using frequency of events, KM rates and adjusted Cox proportional hazard models. The ability of the NFS to predict recurrent CV events was independently validated in 5395 placebo-treated patients enrolled in the SOLID-TIMI 52 trial.
resultsAmong 14,819 patients enrolled in IMPROVE-IT, 14.2% (N = 2106) were high-risk (NFS > 0.67). The high-risk group had a 30% increased risk of recurrent major CV events, compared to the low-risk NFS group (HR 1.30 [1.19-1.43]; p < 0.001). Among high-risk patients, ezetimibe/simvastatin conferred a 3.7% absolute reduction in risk of recurrent CV events, compared to placebo/simvastatin (HR 0.85 [0.74-0.98]), translating to a number-needed-to-treat of 27. Similar benefit was not found in the low-risk group (HR ezetimibe/simvastatin vs. placebo/simvastatin, 1.01 [0.91-1.12]; p-interaction = 0.053). The relationship between NFS category and recurrent CV events was independently validated in patients enrolled in SOLID-TIMI 52 (HR for NFS > 0.67 vs. NFS < -1.455 = 1.55 [1.32-1.81]; p < 0.001).
conclusionStratification of cardiovascular risk by NFS identifies an independent population of patients who are at highest risk of recurrent events, and most likely to benefit from dual lipid-lowering therapy. Clinical trials.gov: NCT00202878.
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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.