ArticleCirculation. Cardiovascular quality and outcomes2023
Gaps in Guideline-Based Lipid-Lowering Therapy for Secondary Prevention in the United States: A Retrospective Cohort Study of 322 153 Patients.
Article in Circulation. Cardiovascular quality and outcomes, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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.
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
32 citing papers in PubMed, 46 citations in OpenAlex.
- Efficacy and Safety of Bempedoic Acid in Patients Aged ≥75 Years Stratified by Varying Statin Exposure: Results From Phase 3 Studies of Bempedoic Acid.Journal of the American Heart Association · 2026 · on this mapTrial
- Cost-Effectiveness of Bempedoic Acid in High Cardiovascular Risk Patients with Statin Intolerance: An Analysis of the CLEAR Outcomes Trial.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Trial
- Top 10 Concepts in Secondary ASCVD Prevention From the 2026 ACC/AHA Dyslipidemia Guideline: What Is New and Why It Matters.Current atherosclerosis reports · 2026Review
- Electronic Health Record Alerts to Improve Lipid Lowering After a Recent Myocardial Infarction.Journal of the American Heart Association · 2026 · on this mapObservational
- Cardioprotective glucose-lowering drugs, statins, and secondary major adverse cardiovascular events: a nationwide cohort study of individuals with type 2 diabetes and cardiovascular disease.Cardiovascular diabetology · 2026Article
- Cardiovascular disease in women: traditional and sex-specific risk factors.European heart journal · 2026Review
- Clinician-level variation in lipid management for secondary prevention of atherosclerotic cardiovascular disease: Opportunities for practice improvement.American journal of preventive cardiology · 2026Article
- Integrating frailty and cumulative lipid burden for stroke risk stratification: a machine learning-guided Athero-Frailty Score from the CHARLS cohort.Lipids in health and disease · 2026Article
- Epidemiology and cardiometabolic care in adults with ASCVD and high 10-year ASCVD risk: 2021 WHO STEPS study in Iran.Scientific reports · 2026Article
- LDL-C lowering in patients treated with bempedoic acid in a real-world cohort.Atherosclerosis plus · 2026Article
- Choosing the Right Non-Statin Therapy for the Right Patient - How To Sequence Advanced Lipid-Lowering Therapies.Current atherosclerosis reports · 2026Review
- Treatment pathways of lipid-lowering therapies in Germany 2016-2022.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Therapeutic Inertia in Lipid-Lowering Treatment: A Narrative Review.Journal of clinical medicine · 2026Review
- Successful management of the recurrent acute in-stent thrombosis despite optimal medical therapy: a case report and review of the literature.Journal of medical case reports · 2026Review
- Trends in lipid-lowering therapies in acute coronary syndromes after Chinese new insurance policy: a real-world analysis.BMC medicine · 2026Observational
- Highlights of Cardiovascular Disease Prevention Studies Presented at the 2025 American Heart Association Scientific Sessions.Current atherosclerosis reports · 2026Review
- Menopause Hormone Therapy in Women With Cardiovascular Risk Factors or Established Ischemic Heart Disease: A Joint FIGO and WHF Position Paper.Global heart · 2026Review
- A PDCA cycle-based early intensive lipid-lowering strategy improves LDL-C goal achievement and clinical outcomes after PCI in acute coronary syndrome patients.American journal of translational research · 2026Article
- Cholesterol management in US adults with ASCVD in the Family Heart Database® during 2022-23: Current state of care and opportunities for improvement.American journal of preventive cardiology · 2025Article
- A Drug-Drug Interaction Study Evaluating the Pharmacokinetic Consequences of Obicetrapib Therapy on Atorvastatin or Rosuvastatin Levels in Healthy Volunteers.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMany patients with atherosclerotic cardiovascular disease (ASCVD) are not on guideline-recommended statin therapy. We evaluated utilization of statins and other lipid-lowering therapy (LLT), and changes in low-density lipoprotein cholesterol (LDL-C), among patients with ASCVD over a 1-year period.
methodsLLT and LDL-C levels at the first outpatient visit (January 1, 2017-December 31, 2018) and 1-year follow-up were evaluated using data from Cerner Real-World Data, an electronic health record-derived data set from 92 US health systems. Logistic regression was used to evaluate factors associated with high-intensity statin use.
resultsWe identified 322 153 patients with ASCVD (median age 69 years, 58.8% men, 81.8% White). Overall, 76.1% of patients were on statins, with only 39.4% on high-intensity statins. Men were more likely to receive high-intensity statins than women (multivariable-adjusted odds ratio, 1.34 [95% CI, 1.30-1.38]). Increasing age was associated with lower odds of statin use (odds ratio, 0.79 per 5-year increase at 60 years [95% CI, 0.78-0.81]). Patients with peripheral artery disease (odds ratio, 0.40 [95% CI, 0.37-0.42]) and cerebrovascular disease (odds ratio, 0.75 [95% CI, 0.70-0.80]) had lower odds of using high-intensity statins than those with coronary artery disease. At baseline, most patients (61.3%) had elevated LDL-C (≥70 mg/dL), including 59.8% of those on low/moderate-intensity statins and 76.1% on no statin; only 45.3% achieved an LDL-C <70 mg/dL at 1 year. Nonstatin LLT use was low (ezetimibe, 4.4%; proprotein convertase subtilisin/kexin type 9 inhibitors, 0.7%). Among patients on no statin or low/moderate-intensity statin at baseline, 14.8% and 13.4%, respectively, were on high-intensity statins at 1 year.
conclusionsAmong patients with ASCVD in routine care, high-intensity statins are underutilized, and uptitration and use of nonstatin therapy are uncommon. Women, older adults, and individuals with noncardiac ASCVD are particularly undertreated. Concerted efforts are needed to address therapeutic inertia for lipid management in patients with ASCVD.
Indexed as
Identifiers
What OpenQuestion holds
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.