Evidence map›Paper›PMID 34327459›Full record

ArticleAmerican journal of preventive cardiology2020

Lipid-lowering therapy for primary prevention of premature atherosclerotic coronary artery disease: Eligibility, utilization, target achievement, and predictors of initiation.

Diana N Vikulova, Ilia S Skorniakov, Brendon Bitoiu, Chad Brown, Emilie Theberge, Christopher B Fordyce, Gordon A Francis, Karin H Humphries, G B John Mancini, Simon N Pimstone and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of preventive cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
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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

11 authors at 1 institution in 1 country.

Diana N VikulovaDepartment of Medicine, University of British Columbia, Vancouver, Canada.
Ilia S SkorniakovDepartment of Family Practice, University of British Columbia, Vancouver, Canada.
Brendon BitoiuDepartment of Medicine, University of British Columbia, Vancouver, Canada.
Chad BrownCentre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada.
Emilie ThebergeCentre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada.
Christopher B FordyceDivision of Cardiology, University of British Columbia, Vancouver, Canada.
Gordon A FrancisDepartment of Medicine, University of British Columbia, Vancouver, Canada.
Karin H HumphriesCentre for Health Evaluation and Outcomes Science, University of British Columbia, Vancouver, Canada.
G B John ManciniDivision of Cardiology, University of British Columbia, Vancouver, Canada.
Simon N PimstoneDepartment of Medicine, University of British Columbia, Vancouver, Canada.
Liam R BrunhamDepartment of Medicine, University of British Columbia, Vancouver, Canada.
University of British Columbia · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDespite advances in screening and prevention, rates of premature coronary artery disease (CAD) have been stagnant. The goals of this study were to investigate the barriers to early risk detection and preventive treatment in patients with premature CAD. In particular, we: 1) assessed the performance of the latest versions of major international guidelines in detection of risk of premature CAD and eligibility for preventive treatment; and, 2) investigated real-life utilization of primary prevention with lipid-lowering therapies in these patients.

methodsWe included patients in the Study to Avoid cardioVascular Events in British Columbia (SAVE BC), an observational study of patients with premature (males ​≤ ​50 years, females ​≤ ​55 years) angiographically confirmed CAD. Eligibility for primary prevention and treatment received were assessed retrospectively based on information recorded prior to or at the index presentation with CAD.

resultsOf 417 patients (28.1% females) who met the criteria, 94.3% had at least one major cardiovascular risk factor. In the retrospective risk assessment, 41.7%, 61.4%, and 34.3% (p ​< ​0.001) of patients met criteria for initiation of statin therapy, and an additional 13.9%, 8.4%, and 46.8% may be considered for treatment using the American College of Cardiology/American Heart Association, Canadian Cardiovascular Society, and European Society of Cardiology guidelines, respectively. Only 17.1% of patients received statins and 11.0% achieved guideline-recommended lipid goals before presentation. Diabetes and elevated plasma lipid levels were positively associated with treatment initiation, while smoking was associated with non-treatment.

conclusionsThe current versions of major guidelines fail to recognize many patients who develop premature CAD as being at risk. The vast majority of these patients, including patients who have guideline-directed indications, do not receive lipid-lowering therapy before presenting with CAD. Our findings highlight the need for more effective screening and prevention strategies for premature CAD

Indexed as

Clinical practice guidelinesEligibility determinationPremature cardiovascular diseasePrimary prevention

Identifiers

PMID34327459
PMCPMC8315606
OpenAlexW3042975627

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.