Evidence map›Paper›PMID 35512860›Full record

ArticleJournal of the American College of Cardiology2022

High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.

Adam J Nelson, Kevin Haynes, Sonali Shambhu, Zubin Eapen, Mark J Cziraky, Michael G Nanna, Sara B Calvert, Kerrin Gallagher, Neha J Pagidipati, Christopher B Granger

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

71 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
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  7. Article
  8. Mechanistic elucidation ofJournal of ginseng research · 2026
    Article
  9. Observational
  10. Article
  11. Electronic Health Record Alerts to Improve Lipid Lowering After a Recent Myocardial Infarction.Journal of the American Heart Association · 2026 · on this map
    Observational
  12. Article
  13. Article
  14. Article
  15. Effects of the 2019 guideline update on lipid-lowering therapy in patients with acute coronary syndromes.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  16. Treatment pathways of lipid-lowering therapies in Germany 2016-2022.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
  17. Article
  18. Review
  19. Article
  20. Review

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Adam J NelsonDuke Clinical Research Institute, Durham, North Carolina, USA.
Kevin HaynesHealthCore, Wilmington, Delaware, USA.
Sonali ShambhuHealthCore, Wilmington, Delaware, USA.
Zubin EapenElement Science, San Francisco, California, USA.
Mark J CzirakyHealthCore, Wilmington, Delaware, USA.
Michael G NannaSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Sara B CalvertDuke Clinical Research Institute, Durham, North Carolina, USA; Clinical Trials Transformation Initiative, Durham, North Carolina, USA.
Kerrin GallagherHealthCore, Wilmington, Delaware, USA.
Neha J PagidipatiDuke Clinical Research Institute, Durham, North Carolina, USA.
Christopher B GrangerDuke Clinical Research Institute, Durham, North Carolina, USA. Electronic address: christopher.granger@duke.edu.

Funding

Increasing the Quality and Efficiency of Clinical Trials (U18)U18FD005292 · FDA · DUKE UNIVERSITY · PI ALEXANDER, JOHN H · 2019 to 2025
$23.1M
Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
FDA HHS U18 FD005292NHLBI NIH HHS T32 HL069749
6 · The paper itself

Abstract

backgroundPreventive therapy among patients with established atherosclerotic cardiovascular disease (ASCVD) is generally underused. Whether new guideline recommendations and a focus on implementation have improved the use of high-intensity statins is unknown.

objectivesThis study sought to evaluate the patterns and predictors of statin use among patients with ASCVD.

methodsIn this retrospective cohort study, pharmacy and medical claims data from a commercial health plan were queried for patients with established ASCVD between January 31, 2018, and January 31, 2019. Statin use on an index date of January 31, 2019, was evaluated, as was 12-month adherence and discontinuation. Multivariable logistic regression was used to determine independent associations with statin use of varying intensities.

resultsOf the 601,934 patients with established ASCVD, 41.7% were female, and the mean age was 67.5 ± 13.3 years. Overall, 22.5% of the cohort were on a high-intensity statin, 27.6% were on a low- or moderate-intensity statin, and 49.9% were not on any statin. In multivariable analysis, younger patients, female patients, and those with higher Charlson comorbidity score were less likely to be prescribed any statin. Among statin users, female patients, older patients, and those with peripheral artery disease were less likely to be on a high-intensity formulation, whereas a cardiology encounter in the prior year increased the odds. The majority of high-intensity stain users achieved high levels of adherence.

conclusionsSubstantial underuse of statins persists in a large, insured, and contemporary cohort of patients with ASCVD from the United States. In particular, concerning gaps in appropriate statin use remain among younger patients, women, and those with noncoronary ASCVD.

Indexed as

AtherosclerosisCardiologyCardiovascular DiseasesHydroxymethylglutaryl-CoA Reductase InhibitorsPeripheral Arterial DiseaseAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesUnited StatesHydroxymethylglutaryl-CoA Reductase Inhibitorsatherosclerosispredictorspreventionsecondary preventionstatins

Identifiers

PMID35512860
PMCPMC9344279

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

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.