Evidence mapPaperPMID 40095039Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2026

Statins for primary prevention of cardiovascular disease in Germany: benefits and costs.

Alexander Dressel, Felix Fath, Bernhard K Krämer, Gerald Klose, Winfried März

Abstract read
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
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

1 citing paper in PubMed.

  1. Article
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

5 authors.

Alexander DresselD-A-CH-Society for Prevention of Cardiovascular Diseases e. V., Hamburg, Germany.
Felix FathD-A-CH-Society for Prevention of Cardiovascular Diseases e. V., Hamburg, Germany. felix.fath@carehigh.de.
Bernhard K KrämerEuropean Center for Angioscience, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
Gerald KloseDrs. T. Beckenbauer and S. Maierhof, Bremen, Germany.
Winfried MärzD-A-CH-Society for Prevention of Cardiovascular Diseases e. V., Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe reduction of LDL cholesterol lowers the risk of coronary and cerebrovascular events in individuals without manifest cardiovascular diseases. In Germany, statins at the expense of statutory health insurance had only been permitted for patients with atherosclerosis-related diseases or those at high cardiovascular risk (over 20 percent event probability within the next 10 years, calculated using one of the "available risk calculators"). However, international guidelines recommend lower risk thresholds for the use of statins.

methodsThe health and economic impacts of different risk thresholds for statin use in primary prevention within the German population are estimated for thresholds of 7.5, 10, and 15 percent over 10 years, based on the US Pooled Cohort Equation (PCE) which is valid for Germany, using Markov models.

findingsCost-effectiveness increases with a rising risk threshold, while individual benefit decreases with age at the start of treatment. The use of statins at a risk of 7.5 percent or more is cost-effective at any age (cost per QALY between 410 and 2100 Euros). In none of the examined scenarios does the proportion of the population qualifying for statin therapy exceed 25 percent.

interpretationLowering the threshold for statin therapy to a risk of 7.5 percent of either non-fatal myocardial infarction, coronary heart disease death, non-fatal or fatal stroke would align statin prescription in Germany with international standards. There is no urgent rationale for applying age-stratified risk thresholds.

Indexed as

Cardiovascular DiseasesDrug CostsHydroxymethylglutaryl-CoA Reductase InhibitorsPrimary PreventionAdultAgedCholesterol, LDLCost-Benefit AnalysisFemaleGermanyHumansMaleMarkov ChainsMiddle AgedQuality-Adjusted Life YearsRisk AssessmentCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsCostEffectivenessLDL cholesterolPrimary preventionRisk thresholdsStatins

Identifiers

PMID40095039
PMCPMC12823704

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

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.