ArticleCirculation2002
Withdrawal of statins increases event rates in patients with acute coronary syndromes.
Article in Circulation, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01770210 (A Multicenter, Open-label, 30-week Observational Clinical Study to Examine the Progress of Patients After Leaving the Cardiology Clinic or Unit Due to Acute Cardiovascular Event.), which is not on this map. Cited by 101 papers, 3 of them syntheses that pooled it.
What it found
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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.
A Multicenter, Open-label, 30-week Observational Clinical Study to Examine the Progress of Patients After Leaving the Cardiology Clinic or Unit Due to Acute Cardiovascular Event.
Who cites it
101 citing papers in PubMed, 3 syntheses or guidelines pooled it, 483 citations in OpenAlex.
- Clinical review: Statins and trauma--a systematic review.Critical care (London, England) · 2013Pooled it
- Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference.Neurocritical care · 2011Guideline
- Early use of statins in acute coronary syndromes.Current cardiology reports · 2002Guideline
- Central blood pressure lowering effect of telmisartan-rosuvastatin single-pill combination in hypertensive patients combined with dyslipidemia: A pilot study.Journal of clinical hypertension (Greenwich, Conn.) · 2021Trial
- High-Density Lipoprotein Cholesterol Concentration and Acute Kidney Injury After Cardiac Surgery.Journal of the American Heart Association · 2017Trial
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- Trial
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- The UCSD Statin Study: a randomized controlled trial assessing the impact of statins on selected noncardiac outcomes.Controlled clinical trials · 2004 · on this mapTrial
- Visit-to-visit lipid variability on long-term major adverse cardiovascular events: a prospective multicentre cohort from the CORE-Thailand registry.Scientific reports · 2025Article
- Impact of perioperative high-intensity statin treatment on the occurrence of postoperative atrial fibrillation after coronary artery bypass grafting: a meta-analysis.Acute and critical care · 2024Article
- The Health Costs of Cost Sharing.The quarterly journal of economics · 2024Article
- Association between visit-to-visit lipid variability and risk of ischemic heart disease: a cohort study in China.Endocrine · 2024Article
- ANMCO position paper on the management of hypercholesterolaemia in patients with acute coronary syndrome.European heart journal supplements : journal of the European Society of Cardiology · 2023Article
- Variability in Lipid Levels and Risk for Cardiovascular Disease: An Electronic Health Record-Based Population Cohort Study.Journal of the American Heart Association · 2023Article
- Statins: Beneficial Effects in Treatment of COVID-19.Advances in experimental medicine and biology · 2023Article
- Opposing View: A Blind Faith in Meta-Analyses in Academia Could Be a Threat to Public Health.Journal of lipid and atherosclerosis · 2022Article
- Oral Drugs Against COVID-19.Deutsches Arzteblatt international · 2022Article
- Impact of Metabolic Risk Factors on COVID-19 Clinical Outcomes: An Extensive Review.Current cardiology reviews · 2022Review
- Cardiovascular Outcomes and Mortality Associated With Discontinuing Statins in Older Patients Receiving Polypharmacy.JAMA network open · 2021Article
41 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHMG-CoA Reductase Inhibitors (statins) reduce cardiac event rates in patients with stable coronary heart disease. Withdrawal of chronic statin treatment during acute coronary syndromes may impair vascular function independent of lipid-lowering effects and thus increase cardiac event rate. METHODS AND
resultsWe investigated the effects of statins on the cardiac event rate in 1616 patients of the Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) study who had coronary artery disease and chest pain in the previous 24 hours. We recorded death and nonfatal myocardial infarction during the 30-day follow-up. Baseline clinical characteristics did not differ among 1249 patients without statin therapy, 379 patients with continued statin therapy, and 86 patients with discontinued statin therapy after hospitalization. Statin therapy was associated with a reduced event rate at 30-day follow-up compared with patients without statins (adjusted hazard ratio, 0.49 [95% CI, 0.21 to 0.86]; P=0.004). If the statin therapy was withdrawn after admission, cardiac risk increased compared with patients who continued to receive statins (2.93 [95% CI, 1.64 to 6.27]; P=0.005) and tended to be higher compared with patients who never received statins (1.69 [95% CI, 0.92 to 3.56]; P=0.15). This was related to an increased event rate during the first week after onset of symptoms and was independent of cholesterol levels. In a multivariate model, troponin T elevation (P=0.005), ST changes (P=0.02), and continuation of statin therapy (P=0.008) were the only independent predictors of patient outcome.
conclusionsStatin pretreatment in patients with acute coronary syndromes is associated with improved clinical outcome. However, discontinuation of statins after onset of symptoms completely abrogates this beneficial effect.
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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.