Evidence map›Paper›PMID 31358978›Full record

ReviewNature reviews. Cardiology2020

The myth of 'stable' coronary artery disease.

Keith A A Fox, Marco Metra, João Morais, Dan Atar

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01776424 (A Randomized Controlled Trial of Rivaroxaban for the Prevention of Major Cardiovascular Events in Patients With Coronary or Peripheral Artery Disease), which is not on this map. Cited by 83 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 8 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.

NCT01776424 phase3completednot on this map

A Randomized Controlled Trial of Rivaroxaban for the Prevention of Major Cardiovascular Events in Patients With Coronary or Peripheral Artery Disease (COMPASS - Cardiovascular OutcoMes for People Using Anticoagulation StrategieS).

TypeinterventionalSponsorBayerRan2013 to 2021Enrolled27,395ConditionsPrevention & ControlArmsRivaroxaban (Xarelto, BAY59-7939), Aspirin, Aspirin placebo, Rivaroxaban placebo, Pantoprazole
3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
  2. Vascular medicine (London, England) · 2025
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  7. Metabolic Syndrome and Coronary Artery Disease Risk: A Meta-Analysis of Observational Studies.International journal of environmental research and public health · 2021
    Pooled it
  8. Pooled it
  9. Review
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23 more citing papers are in PubMed but not listed here.

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

4 authors.

Keith A A FoxBritish Heart Foundation Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK. k.a.a.fox@ed.ac.uk.ORCID http://orcid.org/0000-0002-0140-2752
Marco MetraUniversity of Brescia, Brescia, Italy.
João MoraisLeiria Hospital Centre, Leiria, Portugal.ORCID http://orcid.org/0000-0003-3406-2878
Dan AtarDepartment of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with known cardiovascular disease who have not had a recent acute event are often referred to as having stable coronary artery disease (CAD). The concept of 'stable' CAD is misleading for two important reasons: the continuing risks of cardiovascular events over the longer term and the diverse spectrum of powerful risk characteristics. The risks of cardiovascular events are frequently underestimated and continue to exist, despite current standards of care for secondary prevention, including lifestyle changes, optimal medical therapy, myocardial revascularization and the use of antiplatelet agents to limit thrombosis. In dispelling the myth of 'stable' CAD, we explore the pathophysiology of the disease and the relative contribution of plaque and systemic factors to cardiovascular events. A broader concept of the vulnerable patient, not just the vulnerable plaque, takes into account the diversity and future risks of atherothrombotic events. We also evaluate new and ongoing research into medical therapies aimed at further reducing the risks of cardiovascular events in patients with chronic - but not stable - atherothrombotic disease.

Indexed as

Terminology as TopicCoronary Artery DiseaseDisease ProgressionHumansProgression-Free SurvivalRisk AssessmentRisk FactorsTime Factors

Identifiers

PMID31358978

What OpenQuestion holds

Textmetadata
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.