SynthesisBritish journal of clinical pharmacology2001
Statins for primary prevention: at what coronary risk is safety assured?
Synthesis in British journal of clinical pharmacology, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2013 · on this mapPooled it
- Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2011 · on this mapPooled it
- Primary prevention of CVD: treating dyslipidaemia.BMJ clinical evidence · 2010Pooled it
- Primary prevention of CVD: treating dyslipidaemia.BMJ clinical evidence · 2008Pooled it
- [Role of the Pharmacotherapeutic Monitoring Service (PMS) of the Community Pharmacy in the detection and resolution of adverse reactions to statins linked to possible diagnostic errors in elderly patients].Farmaceuticos comunitarios · 2024Article
- Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? No.BMJ (Clinical research ed.) · 2007Article
- [Cardiovascular PAPPS 2005: a critical analysis].Atencion primaria · 2007Review
- Validity of an adaptation of the Framingham cardiovascular risk function: the VERIFICA Study.Journal of epidemiology and community health · 2007Article
- [Primary prevention with statins, consensus and risk tables].Atencion primaria · 2005Article
- Physicians' ability to predict the risk of coronary heart disease.BMC health services research · 2003Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsIncreasingly HMG CoA reductase inhibitors (statins) are being used for primary prevention of vascular disease in patients with a raised cholesterol but at low absolute risk of coronary heart disease (CHD). This study uses clinical trial results to explore the limits of absolute safety for statin use in such patients.
methodsThe major placebo controlled statin outcome trials were identified by automated and manual literature searches. Principal results including all cause mortality in placebo and intervention groups and baseline values of standard coronary risk factors were abstracted for each trial. For the trials identified the reduction in overall mortality with statin treatment for each study was regressed against the underlying CHD risk of the population recruited into that trial using a statistically robust method.
resultsThe regression line describing the relationship between mortality benefit and risk suggests that statin use could be associated with an increase in mortality of 1% in 10 years. This would be sufficiently large to negate statin's beneficial effect on CHD mortality in patients with a CHD event risk less than 13% over 10 years.
conclusionsAbsolute safety of statins has not been demonstrated for patients at low risk of CHD. Patients absolute risk of CHD should be calculated before starting statin treatment for primary prevention. Extensions of such treatment to low risk patients should await further evidence of safety.
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What OpenQuestion holds
Registered trials
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 OpenQuestion graph.