Evidence map›Paper›PMID 26864092›Full record

ArticleCirculation2016

Long-Term Safety and Efficacy of Lowering Low-Density Lipoprotein Cholesterol With Statin Therapy: 20-Year Follow-Up of West of Scotland Coronary Prevention Study.

Ian Ford, Heather Murray, Colin McCowan, Chris J Packard

Open access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
103citing papers in PubMed, 9 pooled it
36.1field-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.

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

3 · Its place in the literature

Who cites it

103 citing papers in PubMed, 9 syntheses or guidelines pooled it, 230 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Pooled it
  8. Pooled it
  9. Clinical significance of 'cardiometabolic memory': a systematic review of randomized controlled trials.Hypertension research : official journal of the Japanese Society of Hypertension · 2017
    Pooled it
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Review
  20. Cardiovascular disease: everybody's business.Clinical medicine (London, England) · 2026
    Article

43 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Ian FordFrom Robertson Centre for Biostatistics (I.F., H.M., C.M.) and College of Medical, Veterinary, and Life Sciences (C.J.P.), University of Glasgow, UK.
Heather MurrayFrom Robertson Centre for Biostatistics (I.F., H.M., C.M.) and College of Medical, Veterinary, and Life Sciences (C.J.P.), University of Glasgow, UK.
Colin McCowanFrom Robertson Centre for Biostatistics (I.F., H.M., C.M.) and College of Medical, Veterinary, and Life Sciences (C.J.P.), University of Glasgow, UK. colin.mccowan@glasgow.ac.uk.
Chris J PackardFrom Robertson Centre for Biostatistics (I.F., H.M., C.M.) and College of Medical, Veterinary, and Life Sciences (C.J.P.), University of Glasgow, UK.
MRC Biostatistics Unit · GB

Funding

Medical Research Council MC_PC_13040Medical Research Council MR/K007017/1
6 · The paper itself

Abstract

backgroundExtended follow-up of statin-based low-density lipoprotein cholesterol lowering trials improves the understanding of statin safety and efficacy. Examining cumulative cardiovascular events (total burden of disease) gives a better appreciation of the clinical value of statins. This article evaluates the long-term impact of therapy on mortality and cumulative morbidity in a high-risk cohort of men. METHODS AND

resultsThe West of Scotland Coronary Prevention Study was a primary prevention trial in 45- to 64-year-old men with high low-density lipoprotein cholesterol. A total of 6595 men were randomized to receive pravastatin 40 mg once daily or placebo for an average of 4.9 years. Subsequent linkage to electronic health records permitted analysis of major incident events over 20 years. Post trial statin use was recorded for 5 years after the trial but not for the last 10 years. Men allocated to pravastatin had reduced all-cause mortality (hazard ratio, 0.87; 95% confidence interval, 0.80-0.94; P=0.0007), attributable mainly to a 21% decrease in cardiovascular death (hazard ratio, 0.79; 95% confidence interval, 0.69-0.90; P=0.0004). There was no difference in noncardiovascular or cancer death rates between groups. Cumulative hospitalization event rates were lower in the statin-treated arm: by 18% for any coronary event (P=0.002), by 24% for myocardial infarction (P=0.01), and by 35% for heart failure (P=0.002). There were no significant differences between groups in hospitalization for noncardiovascular causes.

conclusionStatin treatment for 5 years was associated with a legacy benefit, with improved survival and a substantial reduction in cardiovascular disease outcomes over a 20-year period, supporting the wider adoption of primary prevention strategies.

Indexed as

Cardiovascular DiseasesCause of DeathCholesterol, LDLDiabetes ComplicationsDiabetes MellitusFollow-Up StudiesHospitalizationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaMaleMiddle AgedMortalityNeoplasmsPravastatinProportional Hazards ModelsCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatinclinical trial [publication type]coronary diseaseheart failureprimary preventionsafety

Identifiers

PMID26864092
PMCPMC4894764
OpenAlexW2300129093

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC-ND
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.