ArticlePloS one2023
Long-term statin therapy is associated with severe coronary artery calcification.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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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.
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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.
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Who cites it
18 citing papers in PubMed, 23 citations in OpenAlex.
- Statin Use and Arterial Calcification in the General Population: A Longitudinal Analysis and a Negative Control Population.Clinical drug investigation · 2026Article
- Incidental Detection of Coronary Artery Calcification in Women Undergoing Cancer Screening or Treatment.Current atherosclerosis reports · 2026Review
- Atherosclerosis Progression Evaluation in Coronary Arteries by Computed Tomography Compared to Peripheral Vessels Using 3D Ultrasonography.Journal of clinical medicine · 2026Article
- Pleiotropic Effects of Statins: Focus on Endothelial Function, Plaque Stability and Thrombosis (Part II).Current atherosclerosis reports · 2026Review
- Decoding Vascular Senescence: Cellular Insights and Therapeutic Strategies.International journal of biological sciences · 2026Review
- Undiagnosed Coronary Artery Disease in Hemodialysis-Initiating Patients.Journal of atherosclerosis and thrombosis · 2025Article
- Article
- Cardiovascular risk assessment enhanced by automated machine learning in a multi-phase study.Scientific reports · 2025Article
- Prevalence of CAC Scoring in Patients With Known Coronary Artery Disease: A Cohort Study on Choosing Wisely.Journal of evaluation in clinical practice · 2025Article
- Antiatherogenic and plaque stabilizing effects of saffron ethanolic extract in atherosclerotic rabbits.BMC complementary medicine and therapies · 2025Article
- Rosuvastatin Is Associated With Incidental Dermal Calcification.The American Journal of dermatopathology · 2025Article
- Association of Smoking and Alcohol with Abdominal Aortic Calcification in the General Middle-Aged and Elderly Populations.Reviews in cardiovascular medicine · 2025Article
- Statin Use in Children and Adolescents - Dos, Don'ts and Practical Tips.Current atherosclerosis reports · 2024Review
- Molecular Aspects of Cardiovascular Risk Factors.Biomolecules · 2024Article
- Management of Chronic Heart Failure in Dialysis Patients: A Challenging but Rewarding Path.Reviews in cardiovascular medicine · 2024Review
- Reversion of the Inflammatory Markers in Patients With Chronic Limb-Threatening Ischemia.Journal of the American Heart Association · 2024Observational
- Comparative Analysis of High-Intensity versus Low-to-Moderate Intensity Statin Therapy in Patients Undergoing Rotational Atherectomy for Calcified Coronary Artery Disease.Life (Basel, Switzerland) · 2023Article
- The Role of Imaging in Cardiovascular Prevention: A Comprehensive Review.Journal of cardiovascular echographyReview
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAtherosclerosis and consequent risk of cardiovascular events or mortality can be accurately assessed by quantifying coronary artery calcium score (CACS) derived from computed tomography. HMG-CoA-reductase inhibitors (statins) are the primary pharmacotherapy used to reduce cardiovascular events, yet there is growing data that support statin use may increase coronary calcification. We set out to determine the likelihood of severe CACS in the context of chronic statin therapy.
methodsWe established a retrospective, case-control study of 1,181 U.S. veterans without coronary artery disease (CAD) from a single site, the Providence VA Medical Center. Duration of statin therapy for primary prevention was divided into 5-year categorical increments. The primary outcome was CACS derived from low-dose lung cancer screening computed tomography (LCSCT), stratified by CACs severity (none = 0; mild = 1-99; moderate = 100-399; and severe ≥400 AU). Statin duration of zero served as the referent control. Ordinal logistic regression analysis determined the association between duration of statin use and CACS categories. Proportional odds assumption was tested using likelihood ratio test. Atherosclerotic cardiovascular disease (ASCVD) risk score, body mass index, and CKD (glomerular filtration rate of <60 ml/min/1.73 m2) were included in the adjustment models.
resultsThe mean age of the study population was 64.7±7.2 years, and 706 (60%) patients were prescribed a statin at baseline. Duration of statin therapy was associated with greater odds of having increased CACS (>0-5 years, OR: 1.71 [CI: 1.34-2.18], p<0.001; >5-10 years, OR: 2.80 [CI: 2.01-3.90], p<0.001; >10 years, OR: 5.30 [CI: 3.23-8.70], p<0.001), and the relationship between statin duration and CACS remained significant after multivariate adjustment (>0-5 years, OR: 1.49 [CI: 1.16-1.92], p = 0.002; >5-10 years, OR: 2.38 [CI: 1.7-3.35], p<0.001; >10 years, OR: 4.48 [CI: 2.7-7.43], p<0.001).
conclusionsLong-term use of statins is associated with increased likelihood of severe CACS in patients with significant smoking history. The use of CACS to interpret cardiovascular event risk may require adjustment in the context of chronic statin therapy.
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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.