Evidence map›Paper›PMID 28673901›Full record

ArticleJournal of the American Heart Association2017

Implications of American College of Cardiology/American Heart Association (ACC/AHA) Cholesterol Guidelines on Statin Underutilization for Prevention of Cardiovascular Disease in Diabetes Mellitus Among Several US Networks of Community Health Centers.

Ehimare Akhabue, Sarah S Rittner, Joseph E Carroll, Phillip M Crawford, Lydia Dant, Reesa Laws, Michael C Leo, Jon Puro, Stephen D Persell

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in Journal of the American Heart Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Therapeutic effects of statins on chromosomal DNA damage of dyslipidemic patients.Experimental biology and medicine (Maywood, N.J.) · 2019
    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

9 authors at 5 institutions in 1 country.

Ehimare AkhabueDivision of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Sarah S RittnerAlliance of Chicago Community Health Services, Chicago, IL.
Joseph E CarrollOpen Door Community Health Centers, Arcata, CA.
Phillip M CrawfordKaiser Permanente Center for Health Research, Portland, OR.
Lydia DantFenway Health, Boston, MA.
Reesa LawsKaiser Permanente Center for Health Research, Portland, OR.
Michael C LeoKaiser Permanente Center for Health Research, Portland, OR.
Jon PuroOCHIN, Inc, Portland, OR.
Stephen D PersellDivision of General Internal Medicine and Geriatrics, Center for Primary Care Innovation, Feinberg School of Medicine, Northwestern University, Chicago, IL spersell@nm.org.
Kaiser Permanente Center for Health Research · USNorthwestern University · USCommunity Health Center · USFenway Health · USOchin · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLittle is known about statin underutilization among diabetes mellitus patients cared for in community health centers, which tend to serve socioeconomically disadvantaged populations. Implications of the American College of Cardiology/American Heart Association (ACC/AHA) guidelines on preexisting gaps in statin treatment in this population are unclear. METHODS AND

resultsWe included 32 440 adults (45% male, 63% nonwhite, 29% uninsured/Medicaid) aged 40 to 75 years with diabetes mellitus who received care within 16 community health center groups in 11 states in the Community Health Applied Research Network during 2013. Statin prescribing was analyzed as a function of concordance with the National Cholesterol Education Program Adult Treatment Panel 2001 and ACC/AHA 2013 guidelines. More patients' treatments were concordant with the ACC/AHA (52.8%) versus the National Cholesterol Education Program Adult Treatment Panel (36.2%) guideline. Female sex was associated with lower concordance for both (odds ratio [OR] 0.90, CI 0.85-0.94; and OR 0.84, CI 0.80-0.88, respectively). Being insured, an Asian/Pacific Islander, or primarily Spanish speaking were associated with greater concordance for both guidelines: 35.5% (11 526/32 440) were concordant with neither guideline, the majority (79.7%) having no statin prescribed; 28.2% (9168/32 440) were concordant with ACC/AHA but not the National Cholesterol Education Program Adult Treatment Panel. 8.7% of these patients had a low-density lipoprotein cholesterol >160 mg/dL despite having a moderate- or high-intensity statin prescribed. And 11.6% (3772/32 440) were concordant with the National Cholesterol Education Program Adult Treatment Panel but not with ACC/AHA. Most of these patients had a low-density lipoprotein cholesterol between 70 and 99 mg/dL with no or a low-intensity statin prescribed.

conclusionsOpportunities exist to improve cholesterol management in diabetes mellitus patients in community health centers. Addressing care gaps could improve cardiovascular disease prevention in this high-risk population.

Indexed as

American Heart AssociationAdultAgedBiomarkersCardiovascular DiseasesCholesterolCommunity Health CentersCross-Sectional StudiesDiabetes MellitusDrug Utilization ReviewDyslipidemiasElectronic Health RecordsFemaleGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsBiomarkersCholesterolHydroxymethylglutaryl-CoA Reductase Inhibitorscardiovascular disease preventioncholesterol‐lowering drugscommunity health centerscommunity medicinediabetes mellitusguideline adherence

Identifiers

PMID28673901
PMCPMC5586289
OpenAlexW2732360883

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC
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.