Evidence map›Paper›PMID 29223956›Full record

Trial reportJournal of the American Heart Association2017

Residual Risk of Atherosclerotic Cardiovascular Events in Relation to Reductions in Very-Low-Density Lipoproteins.

Patrick R Lawler, Akintunde O Akinkuolie, Paulo Harada, Robert J Glynn, Daniel I Chasman, Paul M Ridker, Samia Mora

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report 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. It is linked to trial NCT00239681 (A Randomized, Double-Blind, Placebo Controlled, Multicenter, Phase 3 Study of Rosuvastatin), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 1 pooled it
9.2field-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.

NCT00239681 phase3terminatednot on this map

A Randomized, Double-Blind, Placebo Controlled, Multicenter, Phase 3 Study of Rosuvastatin (CRESTOR®) 20 mg in the Prevention of Cardiovascular Events Among Subjects With Low Levels of Low Density Lipoprotein(LDL) Cholesterol & Elevated Levels of C-Reactive Protein

TypeinterventionalSponsorAstraZenecaRan2003 to 2008Enrolled17,802ConditionsElevated High-sensitivity C-Reactive Protein (hsCRP)ArmsRosuvastatin, Placebo
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.

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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

7 authors at 2 institutions in 2 countries.

Patrick R LawlerPeter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
Akintunde O AkinkuolieCenter for Lipid Metabolomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Paulo HaradaCenter for Lipid Metabolomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Robert J GlynnPreventive Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Daniel I ChasmanPreventive Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Paul M RidkerCardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Samia MoraCenter for Lipid Metabolomics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA smora@partners.org.
Harvard University · USBrigham and Women's Hospital · US

Funding

Training Program in the Epidemiology of CVDT32HL007575 · NHLBI · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI BURING, JULIE E., RIDKER, PAUL M. · 1985 to 2019
$5.0M
Total plasma and IgG glycomes, statin therapy and ASCVD eventsR01HL117861 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MORA, SAMIA · 2013 to 2022
$3.8M
Reducing Inflammation for the Prevention of CVD: A Focus on Eicosanoid PathwaysR01HL134811 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MORA, SAMIA · 2017 to 2020
$3.0M
NHLBI NIH HHS R01 HL117861NHLBI NIH HHS R01 HL134811NHLBI NIH HHS T32 HL007575
6 · The paper itself

Abstract

backgroundIt is uncertain whether pharmacological reductions in very-low-density lipoproteins (VLDLs), and their component triglyceride and cholesterol could reduce residual risk of atherosclerotic cardiovascular disease (ASCVD) events among individuals in whom low-density lipoprotein cholesterol (LDL-C) has been adequately lowered. We examined whether individuals with greater on-statin reductions in VLDL-related measures-beyond reductions in LDL-C-were at further reduced risk of ASCVD. METHODS AND

resultsIn 9423 participants in the JUPITER (Justification for the Use of Statins in Prevention) trial (NCT00239681), at baseline and on statin we measured standard lipids, 400-MHz proton nuclear magnetic resonance spectroscopy-measured VLDL particle subclasses (small, medium, and large VLDL lipoprotein particle concentration), and total VLDL cholesterol mass. Compared with individuals allocated to placebo, we examined risk of incident ASCVD (N=211) among statin-allocated participants who achieved minimal (<median) or greater (≥median) marker reductions using adjusted Cox models. On-statin changes in VLDL-related markers were only modestly correlated (Spearman

conclusionsPharmacological reduction in small, cholesterol-enriched, triglyceride-depleted VLDL was associated with reduction in ASCVD risk. Chemically measured triglycerides may not sufficiently capture risk related to VLDL pathways. These findings also support broader profiling of lipid and lipoprotein changes in response to statins as prognostic markers of individual benefit, supporting more precision-medicine, individualized approaches to cardiovascular risk reduction. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT00239681.

Indexed as

AgedAtherosclerosisBiomarkersFemaleHumansLipoproteins, VLDLMagnetic Resonance SpectroscopyMaleMassachusettsMiddle AgedMorbidityPrimary PreventionRisk AssessmentRisk FactorsRosuvastatin CalciumSurvival RateBiomarkersLipoproteins, VLDLRosuvastatin Calciumarteriosclerosislipidslipoproteinsmetabolomicspersonalized medicineprimary preventionstatin

Identifiers

PMID29223956
PMCPMC5779048
OpenAlexW2772281339

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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.