Evidence map›Paper›PMID 28124099›Full record

ReviewClinical research in cardiology : official journal of the German Cardiac Society2017

Evidence-based goals in LDL-C reduction.

Handrean Soran, Ricardo Dent, Paul Durrington

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PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical research in cardiology : official journal of the German Cardiac Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 6 pooled it
–field-weighted citation impact
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

43 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Pooled it
  6. Ezetimibe in high-risk, previously treated statin patients: a systematic review and network meta-analysis of lipid efficacy.Clinical research in cardiology : official journal of the German Cardiac Society · 2019
    Pooled it
  7. Trial
  8. Trial
  9. Article
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  11. Review
  12. Review
  13. Article
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  17. Anti-Apo B-100 Autoantibody is a Marker of Unstable Coronary Plaque.Journal of atherosclerosis and thrombosis · 2021
    Article
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  20. 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

3 authors.

Handrean SoranCardiovascular Research Group, School of Biomedicine, University of Manchester, Core Technology Facility, Manchester, UK. Handrean.Soran@cmft.nhs.uk.
Ricardo DentAmgen (Europe) GmbH, Zug, Switzerland.
Paul DurringtonCardiovascular Research Group, School of Biomedicine, University of Manchester, Core Technology Facility, Manchester, UK.

Funding

Wellcome Trust
6 · The paper itself

Abstract

The evidence from trials of statin therapy suggests that benefits in cardiovascular disease (CVD) event reduction are proportional to the magnitude of low-density lipoprotein cholesterol (LDL-C) lowering. The lack of a threshold at which LDL-C lowering is not beneficial, in terms of CVD prevention observed in these trials, is supported by epidemiological and genetic studies reporting the cardio-protective effects of lifelong low exposure to atherogenic cholesterol in a graded fashion. Providing that intensive LDL-C lowering is safe, these observations suggest that many individuals even at current LDL-C treatment targets could benefit. Here, we review recent safety and efficacy data from trials of adjunctive therapy, with LDL-C lowering beyond that achieved by statin therapy, and their potential implications for current guideline targets. Finally, the application of current guidance in the context of pre-treatment LDL-C concentration and deployment of statin therapy is also discussed. The number of patients requiring treatment to prevent a CVD event with statin treatment has been shown to differ markedly according to the pre-treatment LDL-C concentration even when absolute CVD risk is similar. It produces more likelihood of benefit when absolute LDL-C reduction is greater which is largely dependent on pre-treatment LDL-C concentration. This also has to be taken in consideration when deploying new agents like proprotein convertase subtilisin/kexin type 9 monoclonal antibodies. Patients with highest LDL-C concentration despite maximum statin and ezetimibe therapy will attain most absolute LDL-C reduction when treated with proprotein convertase subtilisin/kexin type 9 monoclonal antibodies, hence benefit most in term of CVD risk reduction.

Indexed as

GoalsAnticholesteremic AgentsCardiovascular DiseasesCholesterol, LDLDrug Therapy, CombinationHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaRisk FactorsAnticholesteremic AgentsCholesterol, LDLHydroxymethylglutaryl-CoA Reductase InhibitorsEzetimibeLDL cholesterolPCSK9Residual riskStatin

Identifiers

PMID28124099
PMCPMC5360845

What OpenQuestion holds

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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.