Evidence map›Paper›PMID 41514303›Full record

Observational studyBMC medicine2026

Trends in lipid-lowering therapies in acute coronary syndromes after Chinese new insurance policy: a real-world analysis.

Xin Zhao, Shujing Wu, Zhen Wang, Luning Zhou, Peng Zhang, Huajie Xu, Mengmeng Yu, Zhiyong Qi, Lili Xu, Neng Dai and 6 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC medicine, 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

16 authors.

Xin Zhao *Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Shujing Wu *Department of Cardiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China.
Zhen Wang *Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Luning ZhouDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Peng ZhangDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Huajie XuDepartment of Infectious Disease, Zhongshan Hospital, Fudan University, Shanghai, China.
Mengmeng YuDepartment of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Shanghai, China.
Zhiyong QiDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Lili XuDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Neng DaiDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Hongbo YangDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Yingnan BaiDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Bing FanDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
Juying QianDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. qian.juying@zs-hospital.sh.cn.
Hongyi WuDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. wu.hongyi@zs-hospital.sh.cn.
Junbo GeDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China. jbge@zs-hospital.sh.cn.

Funding

2021 clinical research navigation project of Shanghai Medical College of Fudan University to Hongyi WuClinical Research Special Fund of Zhongshan Hospital Fudan University 2020ZSLC57; ZSLCYJ 202302National Natural Science Foundation of China 81970298National Natural Science Foundation of China 82102033National Natural Science Foundation of China 82300375National Natural Science Foundation of China 82400156Research Project of Shanghai Municipal Health Commission 20214Y0139Shanghai Clinical Research Center for Interventional Medicine 19MC1910300Shanghai Municipal Key Clinical Specialty shslczdzk06201, shslczdzk01701Shanghai Rising Stars of Medical Talent Youth Development Program SHWRS(2023)-062Shanghai Top Priority research center construction project 2022ZZ01010State Key Clinical Specialty Construction Project YW2021-002
6 · The paper itself

Abstract

backgroundThe Chinese new insurance policy for proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), which made it more affordable to patients from January 1, 2022, may change lipid-lowering therapy (LLT) pattern for acute coronary syndromes (ACS), but real-world data is still lacking. This study assessed to evaluate the impact of the reimbursement policy on LLT trends and its implications.

methodsThis cohort study is based on a large, ongoing, and prospective Chinese Cardiovascular Association Database-Chest Pain Center. Between January 1, 2021, and June 30, 2022, 789,829 patients with ACS from 4441 centers aged 18-80 years were included. Patients discharged after and before the policy were observational and control group, respectively. Propensity score matching (PSM) was performed at discharge, 1 month, and 3 months. Temporal trends in LLT are grouped into the 7 most common strategies: (1) high-intensity statin (HIS) monotherapy, (2) moderate-intensity statin (MIS) monotherapy, (3) MIS plus ezetimibe, (4) MIS plus PCSK9i, (5) MIS plus ezetimibe and PCSK9i, (6) ezetimibe monotherapy, and (7) PCSK9i monotherapy.

resultsA total of 789,829 (age 64 ± 10.7 years; females 37.84%) patients were included (268,089 in observational group). Temporally, MIS plus PCSK9i, MIS plus ezetimibe and PCSK9i, and PCSK9i monotherapy increased, ezetimibe monotherapy decreased, and statins keep relatively constant after the new policy. After PSM in observational group, MIS monotherapy slightly decreased (81.61% vs 89.29%, P < 0.0001) at discharge but increased in 1 month (84.54% vs 80.11%, P < 0.0001) and 3 months (82.97% vs 80.09%, P = 0.0013). MIS plus PCSK9i kept growing (0.86% vs 0.33%, P < 0.0001; 1.99% vs 0.80%, P < 0.0001; and 2.57% vs 0.60%, P < 0.0001, respectively). MIS plus ezetimibe and PCSK9i (0.15% vs 0.06%, P < 0.0001), and PCSK9i monotherapy (0.09% vs 0.03%, P < 0.0001) just increased at discharge. Low-density lipoprotein cholesterol (LDL-C) goal attainment rate increased at 3 months (15.73% vs 14.02%, P = 0.0283, before PSM; 15.73% vs 13.97%, P = 0.0306, after PSM). MIS plus PCSK9i and MIS monotherapy was associated with a higher 3-month LDL-C goal attainment rate.

conclusionsThe PCSK9i reimburse policy adjustment was associated with increased intensive LLT for ACS in China, especially more PCSK9i prescription, which modestly correlated to higher LDL-C goal attainment rate.

Indexed as

Acute Coronary SyndromeHypolipidemic AgentsAdolescentAdultAgedAged, 80 and overAnticholesteremic AgentsChinaEzetimibeFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedPCSK9 InhibitorsProprotein Convertase 9Anticholesteremic AgentsEzetimibeHydroxymethylglutaryl-CoA Reductase InhibitorsHypolipidemic AgentsPCSK9 InhibitorsPCSK9 protein, humanProprotein Convertase 9Acute coronary syndromesInsuranceLipid-lowering therapiesProprotein convertase subtilisin/kexin type 9 inhibitors

Identifiers

PMID41514303
PMCPMC12882403

What Socratic holds

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LicenceCC BY-NC-ND
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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.