Evidence map›Statins × all-cause mortality›PMID 18325461›Full record

Trial reportJournal of cardiac failure2008

Atorvastatin therapy may reduce the incidence of sudden cardiac death in patients with advanced chronic heart failure.

Bojan Vrtovec, Renata Okrajsek, Alenka Golicnik, Mateja Ferjan, Vito Starc, Todd T Schlegel, Branislav Radovancevic

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of cardiac failure, 2008. The graph read 1 number from its abstract, feeding 1 cell of the map: it supports the treatment in 1. Cited by 18 papers, 4 of them syntheses that pooled it.

1number the graph read from it
1cell of the map it votes in
18citing papers in PubMed, 4 pooled it
2.9field-weighted citation impact, top 8% 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.

← favours the comparatorfavours the treatment →
2.300 · no effect
SCD-free survivalatorvastatin vs no statinsfavours the treatment · dyslipidemia, heart_failurefeeds one cell of the map
RR 2.300.01
SCD-free survival was 2.3-times higher in the statin group than in controls (P = .01).
FeedsStatins×all-cause mortality

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×all-cause mortality

SupportsOpen on the map →What to test next →

13 readable studies in this cell: 4 favour the treatment, 8 find no difference, 1 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 2 contradict · against placebo
Without it
0.48This paper moves it by +0.02.
← favours the comparatorfavours the treatment →
0 · no effect
This paper · 2008
RR 2.30
Pravastatin and cardiovascular risk in moderate chronic kidney disease…PMID 19423108 · 2009
reduced -48.0
4 · 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Review
  8. Hydrophilic or Lipophilic Statins?Frontiers in cardiovascular medicine · 2021
    Review
  9. Review
  10. Article
  11. Article
  12. Review
  13. Review
  14. The role of statins in chronic heart failure.Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2014
    Article
  15. Review
  16. Article
  17. Statins in heart failure: do we need another trial?Vascular health and risk management · 2013
    Review
  18. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Bojan VrtovecAdvanced Heart Failure Center, Department of Cardiology, Ljubljana University Medical Center, Ljubljana, Slovenia. bojan.vrtovec@gmail.com
Renata Okrajsek
Alenka Golicnik
Mateja Ferjan
Vito Starc
Todd T Schlegel
Branislav Radovancevic
Ljubljana University Medical Centre · SINational Space Biomedical Research Institute · USSt. Luke's Episcopal Hospital · USUniversity of Ljubljana · SI

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundIn retrospective studies, statin therapy has been related to decreased incidence of sudden cardiac death (SCD) in heart failure. We sought to prospectively investigate a relation between atorvastatin therapy and SCD in patients with advanced chronic heart failure. METHODS AND

resultsWe enrolled 110 patients with heart failure with a left ventricular ejection fraction less than 30% and cholesterol level greater than 150 mg/dL. Fifty-five patients were randomized to atorvastatin (10 mg/day) (statin group); the remaining 55 patients received no statins (controls). Patients were followed for 1 year. At baseline, the two groups did not differ in age, sex, left ventricular ejection fraction, cholesterol, B-type natriuretic peptide, heart rate variability, or QT variability. During follow-up, 29 patients died (26%) and 2 patients (2%) underwent heart transplantation. Of the 29 deaths, 13 were attributed to pump failure, 15 were attributed to SCD, and 1 was attributed to noncardiac causes. All-cause mortality was lower in the statin group (9/55, 16%) than in controls (20/55, 36%) (P = .017). The same was true of the SCD rate (3/55 [5%] vs. 12/55 [22%], P = .012), but not of the pump failure (5/55 [9%] vs. 8/55 [15%], P = .38). SCD-free survival was 2.3-times higher in the statin group than in controls (P = .01).

conclusionsAtorvastatin therapy seems to be associated with decreased incidence of SCD in patients with advanced chronic heart failure. Larger studies are ongoing to confirm this hypothesis.

Indexed as

AtorvastatinDeath, Sudden, CardiacDisease ProgressionFemaleHealth Status IndicatorsHeart FailureHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIncidenceMaleMiddle AgedNatriuretic Peptide, BrainProspective StudiesPyrrolesRisk FactorsAtorvastatinHeptanoic AcidsHydroxymethylglutaryl-CoA Reductase InhibitorsNatriuretic Peptide, BrainPyrroles

Identifiers

PMID18325461
OpenAlexW2127263245

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

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.