Evidence map›Paper›PMID 38576462›Full record

ArticleAmerican journal of preventive cardiology2024

The importance of LDL-C lowering in atherosclerotic cardiovascular disease prevention: Lower for longer is better.

Omar Mhaimeed, Zain A Burney, Stacey L Schott, Payal Kohli, Francoise A Marvel, Seth S Martin

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of preventive cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 2 pooled it
51.0field-weighted citation impact, top 1% 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

69 citing papers in PubMed, 2 syntheses or guidelines pooled it, 89 citations in OpenAlex.

  1. Pooled it
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  3. Trial
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  7. Identification of a peptide inhibitor disrupting the PCSK9-LDLR interactionJournal of enzyme inhibition and medicinal chemistry · 2026
    Article
  8. Review
  9. Article
  10. Bempedoic Acid: From Guidelines to the Real World.Journal of lipid and atherosclerosis · 2026
    Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. A Comprehensive, Updated Review of Ezetimibe: Evidence-Based Clinical Use for Atherosclerotic Cardiovascular Disease.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026
    Review
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article

9 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

6 authors at 4 institutions in 3 countries.

Omar MhaimeedDepartment of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States.
Zain A BurneyDepartment of Medicine, Cleveland Clinic, Cleveland, OH, United States.
Stacey L SchottDepartment of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States.
Payal KohliDepartment of Cardiology, University of Colorado Anschutz, Aurora, CO, United States.
Francoise A MarvelDepartment of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States.
Seth S MartinDepartment of Medicine, Johns Hopkins Hospital, Baltimore, MD, United States.
Johns Hopkins University · USCleveland Clinic · USJohns Hopkins Hospital · USVeterans Health Administration · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cumulative exposure to low-density lipoprotein cholesterol (LDL-C) is a key driver of atherosclerotic cardiovascular disease (ASCVD) risk. An armamentarium of therapies to achieve robust and sustained reduction in LDL-C can reduce ASCVD risk. The gold standard for LDL-C assessment is ultracentrifugation but in routine clinical practice LDL-C is usually calculated and the most accurate calculation is the Martin/Hopkins equation. For primary prevention, consideration of estimated ASCVD risk frames decision making regarding use of statins and other therapies, and tools such as risk enhancing factors and coronary artery calcium enable tailoring of risk assessment and decision making. In patients with diabetes, lipid lowering therapy is recommended in most patients to reduce ASCVD risk with an opportunity to tailor therapy based on other risk factors. Patients with primary hypercholesterolemia and familial hypercholesterolemia (FH) with baseline LDL-C greater than or equal to 190 mg/dL are at elevated risk, and LDL-C lowering with high-intensity statin therapy is often combined with non-statin therapies to prevent ASCVD. Secondary prevention of ASCVD, including in patients with prior myocardial infarction or stroke, requires intensive lipid lowering therapy and lifestyle modification approaches. There is no established LDL-C level below which benefit ceases or safety concerns arise. When further LDL-C lowering is required beyond lifestyle modifications and statin therapy, additional medications include oral ezetimibe and bempedoic acid, or injectables such as PCSK9 monoclonal antibodies or siRNA therapy. A novel agent that acts independently of hepatic LDL receptors is evinacumab, which is approved for patients with homozygous FH. Other emerging agents are targeted at Lp(a) and CETP. In light of the expanding lipid treatment landscape, this manuscript reviews the importance of early, intensive, and sustained LDL-C-lowering for primary and secondary prevention of ASCVD.

Indexed as

Atherosclerotic cardiovascular diseaseLDL cholesterolLipid loweringNon-statinPrimary preventionSecondary preventionStatins

Identifiers

PMID38576462
PMCPMC10992711
OpenAlexW4392906909

What OpenQuestion holds

Textmetadata
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.