Evidence map›Paper›PMID 27853916›Full record

ArticleJournal of general internal medicine2017

Comparing Strategies for Lipid Lowering in Argentina: An Analysis from the CVD Policy Model-Argentina.

Jonatan Konfino, Alicia Fernandez, Joanne Penko, Antoinette Mason, Eugenio Martinez, Pamela Coxson, David Heller, Andrew Moran, Kirsten Bibbins-Domingo, Eliseo J Pérez-Stable and 1 more

Open access · bronzeAbstract readComparative Study
In one paragraph

Article in Journal of general internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 10% 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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Hypertension and Dyslipidaemia in Argentina: Patient Journey Stages.International journal of general medicine · 2022
    Review
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

11 authors at 7 institutions in 2 countries.

Jonatan KonfinoCentro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina. jkonfino@gmail.com.
Alicia FernandezCentro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina.
Joanne PenkoDivision of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Antoinette MasonUniversity of California San Diego School of Medicine, La Jolla, CA, USA.
Eugenio MartinezInstituto de Investigaciones Económicas, Facultad de Cs. Económicas, Universidad Nacional de Salta, Salta, Argentina.
Pamela CoxsonDivision of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
David HellerArnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Andrew MoranDivision of General Internal Medicine, Columbia University Medical Center, New York, NY, USA.
Kirsten Bibbins-DomingoDivision of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Eliseo J Pérez-StableDivision of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California San Francisco, San Francisco, CA, USA.
Raul MejíaCentro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina.
Center for the Study of State and Society · ARUniversity of California, San Francisco · USColumbia University · USIcahn School of Medicine at Mount Sinai · USNational Institute on Minority Health and Health Disparities · USNational University of Salta · ARUniversity of California, San Diego · US

Funding

Mentoring in the Context of Improving Care for Latinos with DiabetesK24DK102057 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FERNANDEZ, ALICIA · 2014 to 2018
$919k
NIDDK NIH HHS K24 DK102057
6 · The paper itself

Abstract

introductionIn Argentina, the national guidelines for lipid control emphasize the use of relatively inexpensive low- or moderate-potency statins by patients at high risk (>20 %) of a cardiovascular event. The objective of this study was to compare the impact and costs of the current national CVD prevention guidelines with regard to morbidity and mortality in Argentina with the impact and costs of three strategies that incorporate high-potency statins.

methodsWe used the CVD Policy Model-Argentina to model the proposed interventions. This model is a national-scale, state-transition (Markov) computer simulation model of the CVD incidence, prevalence, mortality, and costs in adults 35-84 years of age. We modeled three scenarios: scenario 1 lowers the risk threshold for treatment to >10 % according the Framingham Risk Score (FRS); scenario 2 intensifies statin potency under current treatment thresholds; and scenario 3 combines both scenarios by lowering the treatment threshold to ≥10 % FRS and intensifying statin potency.

resultsScenario 1 would translate into 1400 fewer MIs and 500 fewer CHD deaths every year, a 3 % and 2 % reduction, respectively. Scenario 2 would lead to 2000 fewer MIs and 1000 fewer CHD deaths every year. Scenario 3 would result in the greatest reduction in MIs and CHD deaths, with 3400 fewer MIs and 1400 fewer CHD deaths every year, which translates to a 7 % and 6 % reduction, respectively. All scenarios were cost-effective if the cost of a high-potency statin pill was under US$0.25.

conclusionIncorporating those individuals with greater than 10 % cardiovascular risk and the use of high-potency statins into Argentina's national lipid guidelines could result in fewer CHD deaths and events at a reasonable cost.

Indexed as

AdultAgedAged, 80 and overArgentinaCardiovascular DiseasesCholesterol, HDLCholesterol, LDLCost-Benefit AnalysisFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedPractice Guidelines as TopicPrimary PreventionRisk FactorsCholesterol, HDLCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsArgentinacardiovascular diseasecoronary heart diseasehydroxy-3-methylglutaryl-coenzyme A reductase inhibitorpreventionstatin

Identifiers

PMID27853916
PMCPMC5400755
OpenAlexW2556917071

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.