Evidence mapPaperPMID 33294229Full record

ArticleAdvances in preventive medicine2020

Role of Statins in the Primary Prevention of Atherosclerotic Cardiovascular Disease and Mortality in the Population with Mean Cholesterol in the Near-Optimal to Borderline High Range: A Systematic Review and Meta-Analysis.

Bishnu M Singh, Hari K Lamichhane, Sanjay S Srivatsa, Prabhat Adhikari, Bikash J Kshetri, Sijan Khatiwada, Dhan B Shrestha

Open access · hybridAbstract read
In one paragraph

Article in Advances in preventive medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from 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 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
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  4. Rhabdomyolysis-Induced AKI (RIAKI) Including the Role of COVID-19.International journal of molecular sciences · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Bishnu M SinghDepartment of Internal Medicine, Hetauda City Hospital, Hetauda 44107, Nepal.ORCID https://orcid.org/0000-0002-5711-9948
Hari K LamichhaneDepartment of Internal Medicine, Manipal College of Medical Sciences, Pokhara 33700, Nepal.ORCID https://orcid.org/0000-0001-7775-9101
Sanjay S SrivatsaDepartment of Cardiovascular Diseases and Vascular Medicine, Heart Artery and Vein Center of Fresno, Fresno 93722, USA.
Prabhat AdhikariDepartment of Infectious Diseases and Critical Care, Grande International Hospital, Kathmandu 44600, Nepal.
Bikash J KshetriDepartment of Internal Medicine, Manipal College of Medical Sciences, Pokhara 33700, Nepal.ORCID https://orcid.org/0000-0002-6310-8751
Sijan KhatiwadaDepartment of Internal Medicine, Angeles University Foundation School of Medicine, Angeles 2009, Philippines.
Dhan B ShresthaDepartment of Emergency Medicine and General Practice, Mangalbare Hospital, Morang 56604, Nepal.
Manipal College of Medical Sciences · NPAngeles University Foundation · PHGrande International Hospital · NP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this meta-analysis was to analyze the benefits and harms of treating the population with statins in those having mean low-density lipoprotein cholesterol (LDL-C) in the near-optimal (100 to 129 mg/dl) to borderline high (130 to 159 mg/dl) range and free of cardiovascular disease (CVD).

methodsWe searched PubMed, PubMed Central, Cochrane Library, and Google Scholar databases for randomized controlled trials (RCTs) published between 1994 and July 2020. We included RCTs with greater than 90% of participants free of CVD. Two reviewers independently screened the articles using the Covidence software, assessed the methodological quality using the risk of bias 2 tool, and analyzed the data using the RevMan 5.4 software.

resultsEleven trials were included. Statin therapy was associated with a decreased risk of myocardial infarction (RR = 0.56, 95% CI: 0.47 to 0.67), major cerebrovascular events (RR = 0.78, 95% CI: 0.63 to 0.96), major coronary events (RR = 0.67, 95% CI: 0.57 to 0.80), composite cardiovascular outcome (RR = 0.71, 95% CI: 0.62 to 0.82), revascularizations (RR = 0.65, 95% CI: 0.57 to 0.74), angina (RR = 0.76, 95% CI: 0.63 to 0.92), and hospitalization for cardiovascular causes (RR = 0.74, 95% CI: 0.64 to 0.86). There was no benefit associated with statin therapy for cardiovascular mortality and coronary heart disease mortality. All-cause mortality benefit with statin therapy was seen in the population with diabetes and increased risk of CVD. Statin therapy was associated with no significant increased risk of myalgia, creatine kinase elevation, rhabdomyolysis, myopathy, incidence of any cancer, incidence of diabetes, withdrawal of the drug due to adverse events, serious adverse events, fatal cancer, and liver enzyme abnormalities.

conclusionStatin therapy was associated with a reduced risk of cardiovascular disease and procedures without increased risk of harm in populations with mean LDL-C in the near-optimal to the borderline high range and without prior atherosclerotic cardiovascular disease.

Identifiers

PMID33294229
PMCPMC7700057
OpenAlexW3109767985

What Socratic holds

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LicenceCC BY
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Registered trials

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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.