ArticleClinical research in cardiology : official journal of the German Cardiac Society2022
Non-statin lipid-lowering therapy over time in very-high-risk patients: effectiveness of fixed-dose statin/ezetimibe compared to separate pill combination on LDL-C.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06526013 (Cholesterol Self-testing in Patients Post Acute Coronary Syndrome), which is not on this map. Cited by 36 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.
Cholesterol Self-testing in Patients Post Acute Coronary Syndrome
Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guideline
- LDL-C Goal Attainment with Fixed-Dose Ezetimibe and Atorvastatin Versus High-Dose Atorvastatin in Chinese Patients: Subgroup Analysis of a Randomized Trial.Advances in therapy · 2026Trial
- LDL-cholesterol distance to target: A practical tool for guiding lipid-lowering treatment decisions.Atherosclerosis plus · 2026Review
- A Comprehensive, Updated Review of Ezetimibe: Evidence-Based Clinical Use for Atherosclerotic Cardiovascular Disease.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Review
- Potential impact on cholesterol goal achievement and predicted cardiovascular risk by the addition of ezetimibe and bempedoic acid on top of statins: a simulation from the SANTORINI study.American journal of preventive cardiology · 2026Article
- Choosing the Right Non-Statin Therapy for the Right Patient - How To Sequence Advanced Lipid-Lowering Therapies.Current atherosclerosis reports · 2026Review
- Prescription of lipid-lowering drugs and their association with hospitalization for ST-elevation myocardial infarction (STEMI) in Germany in 2010-2022.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Treatment pathways of lipid-lowering therapies in Germany 2016-2022.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Chinese expert consensus on the choice of initial cholesterol-lowering strategy.Frontiers in pharmacology · 2026Review
- Article
- 25 years of lipid-lowering therapy: secular trends in therapy of coronary patients.Wiener klinische Wochenschrift · 2025Observational
- WHF Roadmap on Single Pill Combination Therapies.Global heart · 2025Review
- Treatment adherence, persistence, and effectiveness of fixed dose combination versus free combination therapy of rosuvastatin-ezetimibe as a lipid-lowering therapy.Frontiers in cardiovascular medicine · 2025Article
- Evaluating the Efficacy of a Pre-Established Lipid-Lowering Algorithm in Managing Hypercholesterolemia in Patients at Very High Cardiovascular Risk.Journal of personalized medicine · 2024Article
- [Comparison of LDL cholesterol serum concentrations in patients after acute coronary syndrome between 2018 and 2022 in Germany and Europe].Deutsche medizinische Wochenschrift (1946) · 2024Article
- The Hurdle of Access to Emerging Therapies and Potential Solutions in the Management of Dyslipidemias.Journal of clinical medicine · 2024Review
- Rosuvastatin-Based Lipid-Lowering Therapy for the Control of LDL Cholesterol in Patients at High Vascular Risk.Journal of clinical medicine · 2024Review
- Implementation of risk-based lipid-lowering therapies in older (age ≥ 65 years) and very-old adults (age ≥ 75 years) with ischemic heart disease in the greater Salzburg region.Frontiers in pharmacology · 2024Article
- Closing the Gaps in Care of Dyslipidemia: Revolutionizing Management with Digital Health and Innovative Care Models.Reviews in cardiovascular medicine · 2023Review
- Comparative Efficacy and Safety of Statin Monotherapy and Statin plus Ezetimibe Combination in a Real-World Setting.Diseases (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany patients at very-high atherosclerotic cardiovascular disease risk do not reach guideline-recommended targets for LDL-C. There is a lack of data on real-world use of non-statin lipid-lowering therapies (LLT) and little is known on the effectiveness of fixed-dose combinations (FDC). We therefore studied prescription trends in oral non-statin LLT and their effects on LDL-C.
methodsA retrospective analysis was conducted of electronic medical records of outpatients at very-high cardiovascular risk treated by general practitioners (GPs) and cardiologists, and prescribed LLT in Germany between 2013 and 2018.
resultsData from 311,242 patients were analysed. Prescriptions for high-potency statins (atorvastatin and rosuvastatin) increased from 10.4% and 25.8% of patients treated by GPs and cardiologists, respectively, in 2013, to 34.7% and 58.3% in 2018. Prescription for non-statin LLT remained stable throughout the period and low especially for GPs. Ezetimibe was the most prescribed non-statin LLT in 2018 (GPs, 76.1%; cardiologists, 92.8%). Addition of ezetimibe in patients already prescribed a statin reduced LDL-C by an additional 23.8% (32.3 ± 38.4 mg/dL), with a greater reduction with FDC [reduction 28.4% (40.0 ± 39.1 mg/dL)] as compared to separate pills [19.4% (27.5 ± 33.8 mg/dL)]; p < 0.0001. However, only a small proportion of patients reached the recommended LDL-C level of < 70 mg/dL (31.5% with FDC and 21.0% with separate pills).
conclusionsPrescription for high-potency statins increased over time. Non-statin LLT were infrequently prescribed by GPs. The reduction in LDL-C when statin and ezetimibe were prescribed in combination was considerably larger for FDC; however, a large proportion of patients still remained with uncontrolled LDL-C levels.
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Registered trials
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