Evidence map›Statins × all-cause mortality›PMID 19423108›Full record

Trial reportAtherosclerosis2009

Pravastatin and cardiovascular risk in moderate chronic kidney disease.

Haruo Nakamura, Kyoichi Mizuno, Yasuo Ohashi, Tomowo Yoshida, Koichi Hirao, Yasufumi Uchida, MEGA Study Group

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Atherosclerosis, 2009. The graph read 4 numbers from its abstract, feeding 2 cells of the map: it . Cited by 31 papers, 6 of them syntheses that pooled it.

4numbers the graph read from it
2cells of the map it votes in
31citing papers in PubMed, 6 pooled it
6.5field-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.

← favours the treatmentfavours the comparator →
-48.073.00 · no effect
CHDpravastatin vs diet alone, in moderate CKDfavours the treatment · ascvd, ckdfeeds one cell of the map
reduced -48.0P=0.02
Notably, in the moderate CKD group pravastatin significantly reduced CHD by 48% (P=0.02), stroke by 73% (P<0.01), CVD by 55% (P<0.01), and total mortality by 51% (P=0.02).
FeedsStatins×all-cause mortality
CVDpravastatin vs diet alone, in moderate CKDfavours the comparator · ascvd, ckdfeeds one cell of the map
RR 55.0<0.01
Notably, in the moderate CKD group pravastatin significantly reduced CHD by 48% (P=0.02), stroke by 73% (P<0.01), CVD by 55% (P<0.01), and total mortality by 51% (P=0.02).
FeedsStatins×cardiovascular events
Strokepravastatin vs diet alone, in moderate CKDfavours the comparator · ascvd, ckdfeeds one cell of the map
RR 73.0<0.01
Notably, in the moderate CKD group pravastatin significantly reduced CHD by 48% (P=0.02), stroke by 73% (P<0.01), CVD by 55% (P<0.01), and total mortality by 51% (P=0.02).
FeedsStatins×cardiovascular events
Total mortalitypravastatin vs diet alone, in moderate CKDfavours the comparator · ascvd, ckdfeeds one cell of the map
RR 51.00.02
Notably, in the moderate CKD group pravastatin significantly reduced CHD by 48% (P=0.02), stroke by 73% (P<0.01), CVD by 55% (P<0.01), and total mortality by 51% (P=0.02).
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

No readable resultOpen 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 itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2009
reduced -48.0
Atorvastatin therapy may reduce the incidence of sudden cardiac death …PMID 18325461 · 2008
RR 2.30

Statins×cardiovascular events

No readable resultOpen on the map →What to test next →

29 readable studies in this cell: 18 favour the treatment, 10 find no difference, 1 favour the comparator.

Belief with this paper
0.86replicated · 12 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2009
RR 55.0
NCT002899002,340 enrolled · 2006
Δ -0.10-0.40 to 0.60
NCT01294683977 enrolled · 2011
Δ 0.00-0.97 to 0.97
NCT00728988499 enrolled · 2008
Δ 1.00-7.30 to 9.30
Effect of pravastatin on cardiovascular events in older patients with …PMID 9841599 · 1998
absolute reduction -2.90-4.50 to -0.30
Cardiovascular events and their reduction with pravastatin in diabetic…PMID 9843456 · 1998
reduced -32.0
Reduced coronary events in simvastatin-treated patients with coronary …PMID 10597756
RR 0.58
Prevention of cardiovascular events and death with pravastatin in pati…PMID 9841303 · 1998
reduction -29.0
Primary prevention of cardiovascular disease with atorvastatin in type…PMID 15325833
reduction -37.0-52.0 to -17.0
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

31 citing papers in PubMed, 6 syntheses or guidelines pooled it, 86 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Statins and Cardiovascular Primary Prevention in CKD: A Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2015 · on this map
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Atherosclerotic Diseases in Chronic Kidney Disease.Journal of atherosclerosis and thrombosis · 2025
    Review
  13. Article
  14. Observational
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. 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 5 institutions in 1 country.

Haruo NakamuraMitsukoshi Health and Welfare Foundation, STEC Jyoho Building, 1-24-1 Nishishinjuku Shinjuku, Tokyo, 160-0023, Japan. nakamura@mhwf.or.jp
Kyoichi Mizuno
Yasuo Ohashi
Tomowo Yoshida
Koichi Hirao
Yasufumi Uchida
MEGA Study Group
Fukuyama Cardiovascular Hospital · JPMitsukoshi Health and Welfare Foundation · JPNippon Medical School · JPSaga Medical School Hospital · JPThe University of Tokyo · JP

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.

objectivesTo investigate the relation between chronic kidney disease (CKD) and cardiovascular disease (CVD) and retrospectively to evaluate the effect of low dose of pravastatin in Japanese hypercholesterolemic patients with CKD enrolled in the large-scale randomized MEGA Study.

methodsIn this post hoc analysis, effect of low dose pravastatin treatment (10-20mg daily) on the primary prevention of the cardiovascular disease and renal function after 5 years was evaluated in 7196 patients with normal kidney function/mild CKD or moderate CKD. Patients were classified based on an estimated glomerular filtration rate (eGFR) >or=60 or 30-<60mL/min/1.73m(2) as having normal renal function/mild CKD or moderate CKD, respectively. Since Japanese guidelines do not allow statin use in patients with severe kidney disease, such individuals were excluded.

resultsThe incidence of CVD events was 35-49% higher in patients with moderate CKD than in those with normal renal function/mild CKD. Notably, in the moderate CKD group pravastatin significantly reduced CHD by 48% (P=0.02), stroke by 73% (P<0.01), CVD by 55% (P<0.01), and total mortality by 51% (P=0.02). Moreover, the change in eGFR during follow-up in patients with moderate CKD was significantly (P=0.03) higher in those assigned to receive diet plus pravastatin (+6.3%) compared with those on diet alone (+5.1%).

conclusionsRisk of CVD is higher in patients with moderate CKD compared with those with normal renal function/mild CKD, and was significantly reduced by treatment with pravastatin. Pravastatin also exerted beneficial effects on renal function in patients with moderate CKD.

Indexed as

AdultAgedCardiovascular DiseasesFemaleGlomerular Filtration RateHumansHydroxymethylglutaryl-CoA Reductase InhibitorsJapanKidney Failure, ChronicMaleMiddle AgedPravastatinRiskHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatin

Identifiers

PMID19423108
OpenAlexW2099618318

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.