Observational studyEuropean heart journal2019
Cardiovascular effect of discontinuing statins for primary prevention at the age of 75 years: a nationwide population-based cohort study in France.
Observational study in European heart journal, 2019. The graph read 4 numbers from its abstract, feeding 1 cell 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 1.46 (1.21 to 1.75) for coronary event. Cited by 65 papers, 2 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
The adjusted hazard ratios for statin discontinuation were 1.33 [95% confidence interval (CI) 1.18-1.50] (any cardiovascular event), 1.46 (95% CI 1.21-1.75) (coronary event), 1.26 (95% CI 1.05-1.51) (cerebrovascular event), and 1.02 (95% CI 0.74-1.40) (other vascular event).
The adjusted hazard ratios for statin discontinuation were 1.33 [95% confidence interval (CI) 1.18-1.50] (any cardiovascular event), 1.46 (95% CI 1.21-1.75) (coronary event), 1.26 (95% CI 1.05-1.51) (cerebrovascular event), and 1.02 (95% CI 0.74-1.40) (other vascular event).
The adjusted hazard ratios for statin discontinuation were 1.33 [95% confidence interval (CI) 1.18-1.50] (any cardiovascular event), 1.46 (95% CI 1.21-1.75) (coronary event), 1.26 (95% CI 1.05-1.51) (cerebrovascular event), and 1.02 (95% CI 0.74-1.40) (other vascular event).
The adjusted hazard ratios for statin discontinuation were 1.33 [95% confidence interval (CI) 1.18-1.50] (any cardiovascular event), 1.46 (95% CI 1.21-1.75) (coronary event), 1.26 (95% CI 1.05-1.51) (cerebrovascular event), and 1.02 (95% CI 0.74-1.40) (other vascular event).
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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
No readable resultOpen 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.
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
65 citing papers in PubMed, 2 syntheses or guidelines pooled it, 156 citations in OpenAlex.
- Statin liver safety in non-alcoholic fatty liver disease: A systematic review and metanalysis.British journal of clinical pharmacology · 2022Pooled it
- Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review.BMC medical research methodology · 2021Pooled it
- Lipid-lowering therapy for primary prevention of cardiovascular disease in adults aged 75 years and older: a narrative review.International journal of cardiology. Cardiovascular risk and prevention · 2026Review
- [Austrian lipid consensus : Interdisciplinary evidence-based recommendations on prevention and treatment of lipid-associated diseases from 15 medical specialist societies].Wiener klinische Wochenschrift · 2026Article
- Suboptimal Achievement of Guideline-Recommended LDL-C Targets in Older Patients Undergoing Comprehensive Geriatric Care.Journal of clinical medicine · 2026Article
- Statin Therapy for Primary Prevention and Clinical Outcomes in Adults Aged 80 and Older: A Retrospective Comparative Cohort Study.Journal of the American Geriatrics Society · 2026Article
- Appropriateness and Outcome of a Statin Deprescription Intervention in Hospitalized Frail Older Adults: A Retrospective Study.Geriatrics (Basel, Switzerland) · 2026Article
- The SLCO1B1 c.521 T>C variant (rs4149056) is not associated with muscular symptoms or PCSK9-inhibitor prescription in patients with severe hypercholesterolemia and contemporary lipid lowering therapy.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Frailty and Cardiovascular Risk.European cardiology · 2026Review
- Analysis of the association betweenFrontiers in cardiovascular medicine · 2026Article
- Target trial emulation of statin discontinuation in multimorbid older adults with polypharmacy.European journal of clinical investigation · 2026Article
- Article
- Association of human immunodeficiency virus with acute myocardial infarction and presumed sudden cardiac death.Resuscitation plus · 2025Article
- Review
- Managing Hypercholesterolemia in Adults Older Than 75 years Without a History of Atherosclerotic Cardiovascular Disease: An Expert Clinical Consensus From the National Lipid Association and the American Geriatrics Society.Journal of the American Geriatrics Society · 2025Article
- Article
- Review
- Efficacy and diabetes risk of moderate-intensity statin plus ezetimibe versus high-intensity statin after percutaneous coronary intervention.Cardiovascular diabetology · 2024Article
- Article
- Statin treatment for primary and secondary prevention in elderly patients-a cross-sectional study in Stockholm, Sweden.European journal of clinical pharmacology · 2024Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 3 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.
aimsThe role of statin therapy in primary prevention of cardiovascular disease in persons older than 75 years remains a subject of debate with little evidence to support or exclude the benefit of this treatment. We assessed the effect of statin discontinuation on cardiovascular outcomes in previously adherent 75-year-olds treated for primary prevention. METHODS AND
resultsA population-based cohort study using French national healthcare databases was performed, studying all subjects who turned 75 in 2012-14, with no history of cardiovascular disease and with a statin medication possession ratio ≥80% in each of the previous 2 years. Statin discontinuation was defined as three consecutive months without exposure. The outcome was hospital admission for cardiovascular event. The hazard ratio comparing statin discontinuation with continuation was estimated using a marginal structural model adjusting for both baseline and time-varying covariates (cardiovascular drug use, comorbidities, and frailty indicators). A total of 120 173 subjects were followed for an average of 2.4 years, of whom 17 204 (14.3%) discontinued statins and 5396 (4.5%) were admitted for a cardiovascular event. The adjusted hazard ratios for statin discontinuation were 1.33 [95% confidence interval (CI) 1.18-1.50] (any cardiovascular event), 1.46 (95% CI 1.21-1.75) (coronary event), 1.26 (95% CI 1.05-1.51) (cerebrovascular event), and 1.02 (95% CI 0.74-1.40) (other vascular event).
conclusionStatin discontinuation was associated with a 33% increased risk of admission for cardiovascular event in 75-year-old primary prevention patients. Future studies, including randomized studies, are needed to confirm these findings and support updating and clarification of guidelines on the use of statins for primary prevention in the elderly.
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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.