Trial reportDiabetologia2009
Apolipoproteins, cardiovascular risk and statin response in type 2 diabetes: the Collaborative Atorvastatin Diabetes Study (CARDS).
Trial report in Diabetologia, 2009. The graph read 1 number from its abstract, feeding 1 cell of the map, but it casts no vote: the report of the main result of NCT00327418 is not on the map. It also reports an association that does not count as treatment evidence, such as difference -32.0 (-51.2 to -5.40) for lipids. An erratum has been issued. It reports registered trial NCT00327418. Cited by 16 papers, 1 of them a synthesis that pooled 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.
Read, but not usablea number the graph found but could not read as for or against
The 27% decrease in the ApoB:ApoA-I ratio on atorvastatin predicted a 32% (95% CI 5.4-51.2%) risk reduction in CHD, close to the 36% decrease observed.
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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.
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×lipids
No readable resultOpen on the map →What to test next →38 readable studies in this cell: 25 favour the treatment, 5 find no difference, 8 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
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 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)
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Statins for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2013 · on this mapPooled it
- Ability of traditional lipid ratios and apolipoprotein ratios to predict cardiovascular risk in people with type 2 diabetes.Diabetologia · 2010Trial
- Development and validation of an in-hospital cardiogenic shock prediction model for AMI patients based on machine learning.BMC cardiovascular disorders · 2026Article
- Association of apolipoprotein B and excess apolipoprotein B with cardiovascular risk in type 2 diabetes: a prospective cohort study of the UK Biobank.Lipids in health and disease · 2026Article
- Is Targeting LDL-C Levels Below 70 mg/dL Beneficial for Cardiovascular and Overall Health? A Critical Examination of the Evidence.Journal of clinical medicine · 2025Review
- Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis.Communications medicine · 2024Article
- Effects of isoflavones on lipid and apolipoprotein levels in patients with type 2 diabetes in Heilongjiang Province in China.Journal of clinical biochemistry and nutrition · 2016Article
- [Diagnosis and prevalence of metabolic syndrome in diabetics followed in a context of limited resources: the case of Burkina Faso].The Pan African medical journal · 2014Article
- Clinical and biological relevance of statin-mediated changes in HDL metabolism.Current atherosclerosis reports · 2014Review
- Comparison of various lipid variables as predictors of coronary heart disease in Japanese men and women with type 2 diabetes: subanalysis of the Japan Diabetes Complications Study.Diabetes care · 2012Article
- On-treatment non-high-density lipoprotein cholesterol, apolipoprotein B, triglycerides, and lipid ratios in relation to residual vascular risk after treatment with potent statin therapy: JUPITER (justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin).Journal of the American College of Cardiology · 2012Article
- The effects of cranberry juice on serum glucose, apoB, apoA-I, Lp(a), and Paraoxonase-1 activity in type 2 diabetic male patients.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2012Article
- Opening a new lipid "apo-thecary": incorporating apolipoproteins as potential risk factors and treatment targets to reduce cardiovascular risk.Mayo Clinic proceedings · 2011Review
- Lipid parameters for measuring risk of cardiovascular disease.Nature reviews. Cardiology · 2011Review
- Apolipoproteins and diabetic retinopathy.Diabetes care · 2011Article
- Apolipoprotein B but not LDL cholesterol is associated with coronary artery calcification in type 2 diabetic whites.Diabetes · 2009Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors at 9 institutions in 2 countries.
Funding
Abstract
The marked sentences are the ones the graph read a number from.
aims/hypothesisControversy surrounds whether the ratio of apolipoprotein B (ApoB) to apolipoprotein A-I (ApoA-I) is the best lipoprotein discriminator of CHD risk in non-diabetic populations, but the issue has never been investigated in type 2 diabetes.
methodsIn 2,627 participants without known vascular disease in the Collaborative Atorvastatin Diabetes Study, ApoB, ApoA-I, LDL-cholesterol (LDLC) and HDL-cholesterol (HDLC) were assayed at baseline.
resultsThere were 108 CHD and 59 stroke endpoints over 3.9 years. The ApoB:A-I ratio at baseline was the lipoprotein variable most closely predicting CHD risk both by comparison of the hazard ratio for a 1 SD change or tertiles of frequency distribution. The areas under the receiver-operator curve for the ApoB:ApoA-I and the LDLC to HDLC [corrected] ratios, although not significantly different from each other, were greater (p = 0.0005 and p = 0.0125 respectively) than that of non-HDLC:HDLC. The 27% decrease in the ApoB:ApoA-I ratio on atorvastatin predicted a 32% (95% CI 5.4-51.2%) risk reduction in CHD, close to the 36% decrease observed. Neither the ApoB:ApoA-I nor any other lipoprotein concentration or ratio predicted the stroke outcome. CONCLUSIONS/
interpretationOverall, the ApoB:ApoA-I ratio improved on the non-HDLC:HDLC ratio in predicting CHD, but, depending on the assessment chosen, its superiority over LDLC:HDLC may be marginal. The statin-induced decrease in stroke risk may not be lipoprotein mediated.
trial registrationClinicalTrials.gov NCT00327418.
fundingThe study was supported by unrestricted grants from Diabetes UK, the Department of Health and Pfizer to the University of Manchester and to University College, London.
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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.