Evidence map›Paper›PMID 12505111›Full record

ArticleThe American journal of medicine2002

Statins do not meet expectations for lowering low-density lipoprotein cholesterol levels when used in clinical practice.

Joseph P Frolkis, Gregory L Pearce, Vijay Nambi, Stephen Minor, Dennis L Sprecher

Registry-linked trialAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in The American journal of medicine, 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 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
11.6field-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.

NCT01770210 completedstarted 2013, after this paper: background citation

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.

Ran2013Enrolled670Registered outcomes6Posted comparisons0ConditionsCardiovascular DisordersArmsPatients on atorvastatin treatment
PMID 20425272PMID 12132975PMID 12132976PMID 12181210PMID 15883224PMID 19367148PMID 11966668PMID 8604188PMID 9416884PMID 9851392PMID 11914253other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 112 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Joseph P FrolkisDepartment of Preventive Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Gregory L Pearce
Vijay Nambi
Stephen Minor
Dennis L Sprecher
Cleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStatins have become a mainstay in the treatment of hyperlipidemia, based on their potency and favorable side-effect profile. Drug choice is presumed to be guided by the estimated degree of low-density lipoprotein (LDL) cholesterol lowering required in a particular patient and the projected efficacy of any drug-dose combination, as contained in the package inserts for each medication. We investigated whether these expectations were met in a clinical practice.

methodsData were analyzed for 367 hyperlipidemic patients in a preventive cardiology practice who were not taking statins at entry, who were given a standard statin dose at their first visit, and who had at least one follow-up visit on the same drug/dose. Expected LDL cholesterol reductions were calculated for each patient based on guidelines in the package inserts for each drug.

resultsThe mean (+/-SD) observed LDL cholesterol reduction of 26% +/- 20% was significantly less than expected (34% +/- 7%, P < 0.001). The ratio of observed to expected reduction was not different for the three statins used (atorvastatin, 0.79 +/- 0.48; simvastatin, 0.88 +/- 0.61; pravastatin, 0.75 +/- 0.69; P = 0.39).

conclusionsThe use of statins in a clinical practice led to observed reductions in LDL cholesterol level that were significantly less than those projected by package insert guidelines. We believe this gap reflects the reduced patient compliance frequently observed in clinical practice settings, rather than any inherent difference in statin responsiveness of a practice versus a trial population. Physicians should be aware of this disparity when using statins in the clinical setting.

Indexed as

Patient ComplianceAgedAtorvastatinCardiologyCholesterol, LDLCohort StudiesDose-Response Relationship, DrugDrug Administration ScheduleFemaleFollow-Up StudiesHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaMaleMiddle AgedAtorvastatinCholesterol, LDLHeptanoic AcidsHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatinPyrrolesSimvastatin

Identifiers

PMID12505111
OpenAlexW2035081010

What OpenQuestion holds

Textmetadata
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.