Evidence map›Paper›PMID 17065671›Full record

Trial reportDiabetes care2006

Analysis of efficacy and safety in patients aged 65-75 years at randomization: Collaborative Atorvastatin Diabetes Study (CARDS).

H Andrew W Neil, David A DeMicco, Don Luo, D John Betteridge, Helen M Colhoun, Paul N Durrington, Shona J Livingstone, John H Fuller, Graham A Hitman, CARDS Study Investigators

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Diabetes care, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00327418. Cited by 38 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 8 pooled it
7.0field-weighted citation impact, top 3% 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.

NCT00327418 phase4completed

A Double Blind Placebo Controlled Study of Atorvastatin as Prevention of CHD in High Risk Patients With Non-Insulin Dependent Diabetes Mellitus (Collaborative Atorvastatin Study - CARDS)

Ran1997Enrolled2,800Registered outcomes7Posted comparisons0ConditionsAngina, Unstable, Cerebrovascular Accident, Coronary Artery Bypass Graft, Major Coronary EventArmsAtorvastatin
Open the trial in the graph
3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 8 syntheses or guidelines pooled it, 113 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. 2018 Guidelines for the management of dyslipidemia.The Korean journal of internal medicine · 2019
    Guideline
  6. Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2019
    Guideline
  7. Pooled it
  8. Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2013 · on this map
    Pooled it
  9. Article
  10. Article
  11. Review
  12. Article
  13. Management of patients with statin intolerance.Best practice & research. Clinical endocrinology & metabolism · 2023
    Review
  14. Review
  15. Review
  16. Review
  17. Challenges and Strategies for Diabetes Management in Community-Living Older Adults.Diabetes spectrum : a publication of the American Diabetes Association · 2020
    Article
  18. Review
  19. Article
  20. 2018 Guidelines for the Management of Dyslipidemia in Korea.Journal of lipid and atherosclerosis · 2019
    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

10 authors at 6 institutions in 3 countries.

H Andrew W NeilDivision of Public Health and Primary Health Care, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK. andrew.neil@wolfson.ox.ac.uk
David A DeMicco
Don Luo
D John Betteridge
Helen M Colhoun
Paul N Durrington
Shona J Livingstone
John H Fuller
Graham A Hitman
CARDS Study Investigators
University College London · GBPfizer (United States) · USOxford Centre for Diabetes, Endocrinology and Metabolism · GBQueen Mary University of London · GBUniversity College Dublin · IEUniversity of Manchester · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveRates of cardiovascular disease are highest in the elderly. Lipid-lowering statin therapy reduces the proportional risk as effectively in older patients as in younger individuals; however, limited data are available for elderly patients with type 2 diabetes. We conducted a post hoc analysis to compare the efficacy and safety of atorvastatin among 1,129 patients aged 65-75 years at randomization with 1,709 younger patients in the Collaborative Atorvastatin Diabetes Study (CARDS). RESEARCH DESIGN AND

methodsCARDS was a randomized placebo-controlled trial of 10 mg/day atorvastatin for primary prevention of cardiovascular disease in patients aged 40-75 years with LDL cholesterol concentrations </=4.14 mmol/l followed for a median of 3.9 years. The primary end point was time to first occurrence of acute coronary heart disease events, coronary revascularizations, or stroke.

resultsAtorvastatin treatment resulted in a 38% reduction in relative risk ([95% CI -58 to -8], P = 0.017) of first major cardiovascular events in older patients and a 37% reduction ([-57 to -7], P = 0.019) in younger patients. Corresponding absolute risk reductions were 3.9 and 2.7%, respectively (difference 1.2% [95% CI -2.8 to 5.3], P = 0.546); numbers needed to treat for 4 years to avoid one event were 21 and 33, respectively. All-cause mortality was reduced nonsignificantly by 22% ([-49 to 18], P = 0.245) and 37% ([-64 to 9], P = 0.98), respectively. The overall safety profile of atorvastatin was similar between age-groups.

conclusionsAbsolute and relative benefits of statin therapy in older patients with type 2 diabetes are substantial, and all patients warrant treatment unless specifically contraindicated.

Indexed as

AdultAgedAge DistributionAngina, UnstableAnticholesteremic AgentsAtorvastatinCoronary DiseaseDiabetes Mellitus, Type 2FemaleHeptanoic AcidsHumansMaleMiddle AgedMyocardial InfarctionPyrrolesRisk FactorsAnticholesteremic AgentsAtorvastatinHeptanoic AcidsPyrroles

Identifiers

PMID17065671
OpenAlexW2166202023

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.