ArticleHeart (British Cardiac Society)2019
Sub-optimal cholesterol response to initiation of statins and future risk of cardiovascular disease.
Article in Heart (British Cardiac Society), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.
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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.
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.
Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it, 115 citations in OpenAlex.
- Time Gained to Cardiovascular Disease by Intensive Lipid-Lowering Therapy: Results of Individual Placebo-Controlled Trials and Pooled Effects.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024Pooled it
- Artichoke and Bergamot Phytosome Alliance: A Randomized Double Blind Clinical Trial in Mild Hypercholesterolemia.Nutrients · 2021Trial
- Trial
- Apolipoprotein E Mimetic Peptide-Mediated Modulation of Lipid Homeostasis.Biomolecules · 2026Review
- Observational
- Enzyme-Assisted Synthesis and In Vitro Characterization of Bifunctional PCSK9 Inhibitors.Chembiochem : a European journal of chemical biology · 2026Article
- Efficient Synthesis of Enlicitide Chloride through Convergent Solution-Phase and Hybrid Solution-Solid-Phase Strategies.Precision chemistry · 2026Article
- Statin therapy and stroke risk in patients with hypercholesterolaemia: a population-based longitudinal study using electronic health records in South London.BMC medicine · 2026Article
- Beyond Cholesterol Lowering: Clinical Caution, Personalization, and Nutritional Integration in Statin Therapy.Nutrients · 2026Review
- Is Targeting LDL-C Levels Below 70 mg/dL Beneficial for Cardiovascular and Overall Health? A Critical Examination of the Evidence.Journal of clinical medicine · 2025Review
- Opportunities and challenges for identifying undiagnosed Rare Disease patients through analysis of primary care records: long QT syndrome as a test case.Journal of community genetics · 2024Article
- Statins in the Cause and Prevention of Cancer: Confounding by Indication and Mediation by Rhabdomyolysis and Phosphate Toxicity.Journal of cardiovascular development and disease · 2024Review
- Advances in targeting LDL cholesterol: PCSK9 inhibitors and beyond.American journal of preventive cardiology · 2024Article
- Trends and Prospects of Low-Density Lipoprotein Cholesterol in Stroke: A Bibliometric Analysis.Cureus · 2024Review
- [Effectiveness of the CNIC polypill in secondary cardiovascular prevention in the subgroup of patients of the NEPTUNO study using atorvastatin doses of 20 mg].Archivos de cardiologia de Mexico · 2024Observational
- Harnessing RNA Interference for Cholesterol Lowering: The Bench-to-Bedside Story of Inclisiran.Journal of the American Heart Association · 2024Review
- Article
- The role of structured inpatient lipid protocols in optimizing non-statin lipid lowering therapy: a review and single-center experience.Frontiers in cardiovascular medicine · 2024Review
- Adherence to the 2018 AHA cholesterol management guideline in hyperlipidemia treatment among adults in an outpatient setting.Frontiers in cardiovascular medicine · 2024Article
- Relationship Between Diet Quality and Statin Use Among Adults With Metabolic Syndrome From the CARTaGENE Cohort.CJC open · 2024Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess low-density lipoprotein cholesterol (LDL-C) response in patients after initiation of statins, and future risk of cardiovascular disease (CVD).
methodsProspective cohort study of 165 411 primary care patients, from the UK Clinical Practice Research Datalink, who were free of CVD before statin initiation, and had at least one pre-treatment LDL-C within 12 months before, and one post-treatment LDL-C within 24 months after, statin initiation. Based on current national guidelines, <40% reduction in baseline LDL-C within 24 months was classified as a sub-optimal statin response. Cox proportional regression and competing-risks survival regression models were used to determine adjusted hazard ratios (HRs) and sub-HRs for incident CVD outcomes for LDL-C response to statins.
results84 609 (51.2%) patients had a sub-optimal LDL-C response to initiated statin therapy within 24 months. During 1 077 299 person-years of follow-up (median follow-up 6.2 years), there were 22 798 CVD events (12 142 in sub-optimal responders and 10 656 in optimal responders). In sub-optimal responders, compared with optimal responders, the HR for incident CVD was 1.17 (95% CI 1.13 to 1.20) and 1.22 (95% CI 1.19 to 1.25) after adjusting for age and baseline untreated LDL-C. Considering competing risks resulted in lower but similar sub-HRs for both unadjusted (1.13, 95% CI 1.10 to 1.16) and adjusted (1.19, 95% CI 1.16 to 1.23) cumulative incidence function of CVD.
conclusionsOptimal lowering of LDL-C is not achieved within 2 years in over half of patients in the general population initiated on statin therapy, and these patients will experience significantly increased risk of future CVD.
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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.