Evidence map›Paper›PMID 23546564›Full record

ArticleAnnals of internal medicine2013

Discontinuation of statins in routine care settings: a cohort study.

Huabing Zhang, Jorge Plutzky, Stephen Skentzos, Fritha Morrison, Perry Mar, Maria Shubina, Alexander Turchin

2 registry-linked trialsAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 234 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
234citing papers in PubMed, 13 pooled it
58.4field-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.

NCT04826354 phase4completedstarted 2021, after this paper: background citation

Effects of High-dose StAtin Versus Low-dose Statin Plus Ezetimibe on Statin-Associated Muscle Symptoms & on Reaching Target LDL-C Levels Among Elderly Patients With Atherosclerotic Cardiovascular Disease

Ran2021Enrolled582Registered outcomes11Posted comparisons0ConditionsAtheroscleroses, CoronaryArmsRosuvastatin, rosuvastatin and ezetimibe
PMID 30423391PMID 28249067PMID 30403574PMID 28007331PMID 28304224PMID 26039521PMID 28444290PMID 16453090PMID 22686958PMID 29020411PMID 30580575PMID 28421332other papers from this trial
Open the trial in the graph
NCT02341664 completednot on this mapstarted 2015, after this paper: background citation

Patient and Provider Assessment of Lipid Management Registry

Typeobservational_patient_registrySponsorDuke UniversityRan2015 to 2016Enrolled7,658ConditionsHyperlipidemia, Hypercholesterolemia, Cardiovascular Disease, Diabetes
3 · Its place in the literature

Who cites it

234 citing papers in PubMed, 13 syntheses or guidelines pooled it, 532 citations in OpenAlex.

  1. Pooled it
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  3. Bempedoic Acid can Reduce Cardiovascular Events in Combination with Statins or As Monotherapy: A Systematic Review and Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2023 · on this map
    Pooled it
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  5. Prevalence of statin intolerance: a meta-analysis.European heart journal · 2022 · on this map
    Pooled it
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  12. Guideline
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  14. Trial
  15. A Combination ofNutrients · 2021
    Trial
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174 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Huabing ZhangKey Laboratory of Endocrinology, Ministry of Health, PekingUnion Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Jorge Plutzky
Stephen Skentzos
Fritha Morrison
Perry Mar
Maria Shubina
Alexander Turchin
Peking Union Medical College Hospital · CNChinese Academy of Medical Sciences & Peking Union Medical College · CN

Funding

Natural Language Processing to Study Epidemiology of Statin Side EffectsRC1LM010460 · NLM · BRIGHAM AND WOMEN'S HOSPITAL · PI TURCHIN, ALEXANDER · 2009 to 2010
$1000k
NLM NIH HHS 5RC1LM010460NLM NIH HHS RC1 LM010460
6 · The paper itself

Abstract

backgroundSystematic data on discontinuation of statins in routine practice of medicine are limited.

objectiveTo investigate the reasons for statin discontinuation and the role of statin-related events (clinical events or symptoms believed to have been caused by statins) in routine care settings.

designA retrospective cohort study.

settingPractices affiliated with Brigham and Women's Hospital and Massachusetts General Hospital in Boston. PATIENTS: Adults who received a statin prescription between 1 January 2000 and 31 December 2008. MEASUREMENTS: Information on reasons for statin discontinuations was obtained from a combination of structured electronic medical record entries and analysis of electronic provider notes by validated software.

resultsStatins were discontinued at least temporarily for 57 292 of 107 835 patients. Statin-related events were documented for 18 778 (17.4%) patients. Of these, 11 124 had statins discontinued at least temporarily; 6579 were rechallenged with a statin over the subsequent 12 months. Most patients who were rechallenged (92.2%) were still taking a statin 12 months after the statin-related event. Among the 2721 patients who were rechallenged with the same statin to which they had a statin-related event, 1295 were receiving the same statin 12 months later, and 996 of them were receiving the same or a higher dose. LIMITATIONS: Statin discontinuations and statin-related events were assessed in practices affiliated with 2 academic medical centers. Utilization of secondary data could have led to missing or misinterpreted data. Natural-language-processing tools used to compensate for the low (30%) proportion of reasons for statin discontinuation documented in structured electronic medical record fields are not perfectly accurate.

conclusionStatin-related events are commonly reported and often lead to statin discontinuation. However, most patients who are rechallenged can tolerate statins long-term. This suggests that many of the statin-related events may have other causes, are tolerable, or may be specific to individual statins rather than the entire drug class. PRIMARY FUNDING SOURCE: National Library of Medicine, Diabetes Action Research and Education Foundation, and Chinese National Key Program of Clinical Science.

Indexed as

DocumentationElectronic Health RecordsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaNatural Language ProcessingRetrospective StudiesWithholding TreatmentHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID23546564
PMCPMC3692286
OpenAlexW1998569580

What OpenQuestion holds

Textmetadata
LicenceTDM
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.