Evidence map›Paper›PMID 34855879›Full record

ArticlePloS one2021

Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease.

Stephen Franklin Weng, Ralph Kwame Akyea, Kenneth Kc Man, Wallis C Y Lau, Barbara Iyen, Joseph Edgar Blais, Esther W Chan, Chung Wah Siu, Nadeem Qureshi, Ian C K Wong and 1 more

Open access · goldFull text read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 22% 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

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. 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

11 authors at 3 institutions in 2 countries.

Stephen Franklin WengPrimary Care Stratified Medicine (PRISM), Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
Ralph Kwame AkyeaPrimary Care Stratified Medicine (PRISM), Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.ORCID 0000-0003-4529-8237
Kenneth Kc ManCentre for Medicine Optimisation Research and Education (CMORE), Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom.ORCID 0000-0001-8645-1942
Wallis C Y LauCentre for Medicine Optimisation Research and Education (CMORE), Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom.
Barbara IyenPrimary Care Stratified Medicine (PRISM), Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.ORCID 0000-0001-9720-1180
Joseph Edgar BlaisCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.ORCID 0000-0001-7895-198X
Esther W ChanCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
Chung Wah SiuCardiology Division, Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
Nadeem QureshiPrimary Care Stratified Medicine (PRISM), Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
Ian C K WongCentre for Medicine Optimisation Research and Education (CMORE), Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom.
Joe KaiPrimary Care Stratified Medicine (PRISM), Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
University of Nottingham · GBUniversity College London · GBUniversity of Hong Kong · HK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVariability in low-density lipoprotein cholesterol (LDL-C) response to statins is underappreciated. We characterised patients by their statin response (SR), baseline risk of cardiovascular disease (CVD) and 10-year CVD outcomes. METHODS AND

resultsA multivariable model was developed using 183,213 United Kingdom (UK) patients without CVD to predict probability of sub-optimal SR, defined by guidelines as <40% reduction in LDL-C. We externally validated the model in a Hong Kong (HK) cohort (n = 170,904). Patients were stratified into four groups by predicted SR and 10-year CVD risk score: [SR1] optimal SR & low risk; [SR2] sub-optimal SR & low risk; [SR3] optimal SR & high risk; [SR4] sub-optimal SR & high risk; and 10-year hazard ratios (HR) determined for first major adverse cardiovascular event (MACE). Our SR model included 12 characteristics, with an area under the curve of 0.70 (95% confidence interval [CI] 0.70-0.71; UK) and 0.68 (95% CI 0.67-0.68; HK). HRs for MACE in predicted sub-optimal SR with low CVD risk groups (SR2 to SR1) were 1.39 (95% CI 1.35-1.43, p<0.001; UK) and 1.14 (95% CI 1.11-1.17, p<0.001; HK). In both cohorts, patients with predicted sub-optimal SR with high CVD risk (SR4 to SR3) had elevated risk of MACE (UK HR 1.36, 95% CI 1.32-1.40, p<0.001: HK HR 1.25, 95% CI 1.21-1.28, p<0.001).

conclusionsPatients with sub-optimal response to statins experienced significantly more MACE, regardless of baseline CVD risk. To enhance cholesterol management for primary prevention, statin response should be considered alongside risk assessment.

Indexed as

AgedCardiovascular DiseasesCholesterol, LDLFemaleHong KongHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedRisk AssessmentUnited KingdomCholesterol, LDLHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID34855879
PMCPMC8638964
OpenAlexW3217604012

What OpenQuestion holds

Textfull text, public
LicenceCC BY
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.