Evidence map›Paper›PMID 41451241›Full record

ArticleEuropean heart journal open2025

Management of atherosclerotic cardiovascular disease risk in diabetes mellitus patients: a population-level observational cohort study in Wales.

Daniel King, Ashley Akbari, Mike B Gravenor, Mathew Lawrence, Clive Weston, Sam Rice, Chris Hopkins, Leighton Phillips, Julian Halcox, Daniel E Harris

Abstract read
In one paragraph

Article in European heart journal open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Daniel KingFaculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.ORCID https://orcid.org/0000-0002-9700-7158
Ashley AkbariFaculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.ORCID https://orcid.org/0000-0003-0814-0801
Mike B GravenorFaculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.ORCID https://orcid.org/0000-0003-0710-0947
Mathew LawrenceTritech Institute, Hywel Dda University Health Board, Llanelli SA14 9TD, UK.
Clive WestonCardiology Department, Hywel Dda University Health Board, Glangwili Hospital, Carmarthen SA31 2AF, UK.ORCID https://orcid.org/0000-0002-8995-8199
Sam RiceTritech Institute, Hywel Dda University Health Board, Llanelli SA14 9TD, UK.
Chris HopkinsTritech Institute, Hywel Dda University Health Board, Llanelli SA14 9TD, UK.ORCID https://orcid.org/0000-0003-2496-3832
Leighton PhillipsTritech Institute, Hywel Dda University Health Board, Llanelli SA14 9TD, UK.ORCID https://orcid.org/0000-0003-4918-8174
Julian HalcoxFaculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.ORCID https://orcid.org/0000-0001-6926-2947
Daniel E HarrisFaculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK.ORCID https://orcid.org/0000-0003-4885-637X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: In patients with diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD), or without ASCVD (primary prevention), the prescribing of lipid lowering therapy (LLT) is an established treatment strategy endorsed by clinical guidelines. This study aimed to document (i) trends in presentation of DM, (ii) treatment, monitoring and achievement of target low-density lipoprotein cholesterol (LDL-C) in DM with ASCVD, and (iii) ASCVD risk assessment and lipid treatment according to risk in the DM primary prevention setting. Methods and results: A retrospective observational population study including 282 581 DM patients using linked health-care data (2010-23) in Wales. The prevalence of DM (documented DM diagnosis in record prior to the beginning of the year) increased from 133 439 in 2010 to 183 948 in 2023 (6504 to 8200 per 100 000), along with increasing incidence (new diagnosis of DM documented in record during specific year) with 11 074 cases in 2010 (540 per 100 000 per year), increasing to 14 539 in 2023 (648 per 100 000 per year). The proportion of prevalent patients with established ASCVD prescribed LLT decreased from 87.5% to 81.8% (2010-23), testing of LDL-C decreased from 70.3% to 67.1%, and of those with documented lipids 41.0% achieved an LDL-C <1.8 mmol/L in 2010 increasing to 52.2% in 2023. Amongst DM without ASCVD, the proportion prescribed LLT decreased from 78.9% to 54.9% in those with chronic kidney disease (CKD) and from 70.7% to 55.6% in those without CKD. Considering DM without ASCVD or CKD (LLT is recommended according to 10-year CVD risk), only 44.2% of incident DM had a documented QRISK score in 2022 and of those with a 10-year risk >20%, only half were prescribed LLT. Conclusion: Increasing incidence and prevalence of DM, together with decreasing quality of risk factor management has the potential to lead to poorer health outcomes in the population if not addressed more effectively.

Indexed as

AtherosclerosisCholesterolLipidsPharmacoepidemiologyStatin

Identifiers

PMID41451241
PMCPMC12730873

What Socratic holds

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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.