Evidence map›Paper›PMID 12020481›Full record

ArticleJournal of the American College of Cardiology2002

Statins and chronic heart failure: do we need a large-scale outcome trial?

Henry Krum, John J McMurray

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Journal of the American College of Cardiology, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00795912 (A Study Of The Usage Of Statins In A Community Heart Failure Population), which is not on this map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
11.9field-weighted citation impact, top 1% of its field
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.

NCT00795912 phase4completedstarted 2003, after this paper: background citation

A Study Of The Usage Of Statins In A Community Heart Failure Population: The Impact of HMG Co-Enzyme A Reductase Inhibitors on Heart Structural Parameters, Brain Naturetic Peptide, Markers of Inflammation and Fibrosis

Ran2003Enrolled56Registered outcomes2Posted comparisons0ConditionsHeart FailureArmsAtorvastatin
PMID 11555537PMID 15302013PMID 11996626PMID 11036910PMID 15926863PMID 15313958PMID 14726474PMID 12034159PMID 12009719PMID 11806812PMID 11094035PMID 9922372other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 131 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Review
  8. Pharmaceuticals (Basel, Switzerland) · 2022
    Article
  9. Article
  10. Hydrophilic or Lipophilic Statins?Frontiers in cardiovascular medicine · 2021
    Review
  11. Review
  12. Review
  13. Article
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Review
  20. Relative safety profiles of high dose statin regimens.Vascular health and risk management · 2008 · on this map
    Review
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

2 authors at 2 institutions in 2 countries.

Henry KrumDepartment of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Prahan Victoria, Australia. henry.krum@med.monash.edu.au
John J McMurray
Monash Alfred Psychiatry Research centre · AUUniversity of Glasgow · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) are of proven clinical benefit in coronary heart disease, at least in those patients who do not have overt chronic heart failure (CHF). However, as there have been no prospective clinical trials of statins in CHF patients, the question arises as to whether the benefits observed in the absence of CHF can be necessarily inferred in those patients in whom CHF is established. In this review, the evidence base stating support of the use of statins in CHF is presented, as well as theoretical considerations as to why these agents may not necessarily be of benefit in this setting. The beneficial potential of statins clearly relates to their plaque stabilization properties and associated improvements in endothelial function, which together should reduce the risk of further infarction and, perhaps, the ischemic burden on the failing ventricle. Furthermore, these agents may have beneficial effects independent of lipid lowering. These include actions on neoangiogenesis, downregulation of AT(1) receptors, inhibition of proinflammatory cytokine activity and favorable modulation of the autonomic nervous system. The potential adverse effects of statins in CHF include reduction in levels of coenzyme Q10 (which may further exacerbate oxidative stress in CHF) and loss of the protection that lipoproteins may provide through binding and detoxifying endotoxins entering the circulation via the gut. In support of these possibilities are epidemiologic data linking a lower serum cholesterol with a poorer prognosis in CHF. These uncertainties indicate the need for a definitive outcome trial to assess the efficacy and safety of statins in CHF, despite their current widespread, non-evidence based use in this population.

Indexed as

Anticholesteremic AgentsCholesterolChronic DiseaseHeart FailureHumansHydroxymethylglutaryl-CoA Reductase InhibitorsOutcome Assessment, Health CareProspective StudiesSurvival RateUbiquinoneAnticholesteremic AgentsCholesterolHydroxymethylglutaryl-CoA Reductase InhibitorsUbiquinone

Identifiers

PMID12020481
OpenAlexW2162393927

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

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.