Evidence map›Paper›PMID 27671328›Full record

Observational studyAdvances in therapy2016

Clinical Implications of Switching Lipid Lowering Treatment from Rosuvastatin to Other Agents in Primary Care.

Furio Colivicchi, Michele Massimo Gulizia, Laura Franzini, Giuseppe Imperoli, Lorenzo Castello, Alessandro Aiello, Claudio Ripellino, Nazarena Cataldo

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Advances in therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 33% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Furio ColivicchiCardiology Division, S. Filippo Neri Hospital, ASL Roma 1, Rome, Italy.
Michele Massimo GuliziaCardiology Division, Garibaldi Nesima Hospital, Catania, Italy.
Laura FranziniAstraZeneca S.p.A., Milan, Italy.
Giuseppe ImperoliInternal Medicine Division, S. Filippo Neri Hospital, ASL Roma 1, Rome, Italy.
Lorenzo CastelloCardiology Division, S. Filippo Neri Hospital, ASL Roma 1, Rome, Italy.
Alessandro AielloCardiology Division, S. Filippo Neri Hospital, ASL Roma 1, Rome, Italy.
Claudio RipellinoIMS Health Information Solutions Italy S.r.l., Milan, Italy. cripellino@it.imshealth.com.
Nazarena CataldoIMS Health Information Solutions Italy S.r.l., Milan, Italy.
Ospedale San Filippo Neri · ITAstraZeneca (Italy) · ITOspedale Garibaldi · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSwitching from any statin to another non-equipotent lipid lowering treatment (LLT) may cause a low-density lipoprotein cholesterol increase and has been associated with a higher probability of negative cardiovascular outcomes. The aim of the study was to assess the impact of switching from rosuvastatin to any other LLT on clinical outcomes in primary care.

methodsThis was a retrospective analysis based on data from IMS Health Longitudinal Patient Database, which is a general practice database including information of more than 1.0 million patients representative of the Italian population by age, and medical conditions. Patients that started on rosuvastatin (10-40 mg/day) between January 2011 and December 2013 were considered. The date of the first prescription was defined as the index date (ID). The observation period lasted from the ID to September 2015 or until LLT discontinuation, or the occurrence of an acute myocardial infarction (AMI), or death.

resultsThe primary end point of the study was the occurrence of an AMI during the observation period. The final study population included 10,368 patients. During the observation period, 2452 (23.6%) patients were switched from rosuvastatin to another LLT. The majority of patients (55.6%) were switched to atorvastatin, followed by simvastatin (24.9%), simvastatin/ezetimibe combination (10.0%) and other statins (9.5%). Female gender (HR, hazard ratio, 1.10, 95% CI, confidence interval, 1.02-1.19, p = 0.04) and the presence of chronic kidney disease (HR 1.47, 95% CI 1.16-1.86, p = 0.05) were associated with a higher probability of switch. During the observation period, 113 patients experienced an AMI (incidence of 6.7 AMI/1000 patient-years). Multivariate analysis with Cox proportional hazards method, including switching as a time-dependent covariate, demonstrated that changing from rosuvastatin to another LLT was an independent predictor of AMI (HR 2.2, 95% CI 1.4-3.5, p = 0.001).

conclusionWe conclude that switching from rosuvastatin to another non-equipotent LLT may impart an increased risk of AMI and should be avoided.

fundingAstraZeneca SpA.

Indexed as

Drug SubstitutionHypercholesterolemiaMyocardial InfarctionRosuvastatin CalciumAgedCholesterol, LDLFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIncidenceItalyMaleMiddle AgedPrimary Health CareProportional Hazards ModelsRetrospective StudiesCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsRosuvastatin CalciumAcute myocardial infarctionAMICoxEndocrinologyHazardIncidenceLipid loweringRosuvastatinStatinSwitch

Identifiers

PMID27671328
PMCPMC5083763
OpenAlexW2526607159

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.