Evidence map›Paper›PMID 38730371›Full record

ArticleBMC cardiovascular disorders2024

Potential impact of blood cholesterol guidelines on statin treatment in the U.S. population using interrupted time series analysis.

Pui Ying Yew, Matt Loth, Terrence J Adam, Julian Wolfson, Yue Liang, Peter J Tonellato, Chih-Lin Chi

Abstract read
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In one paragraph

Article in BMC cardiovascular disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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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

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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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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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

7 authors.

Pui Ying YewInstitute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
Matt LothInstitute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
Terrence J AdamInstitute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
Julian WolfsonDivision of Biostatistics, University of Minnesota, Minneapolis, MN, USA.
Yue LiangInstitute for Health Informatics, University of Minnesota, Minneapolis, MN, USA.
Peter J TonellatoDepartment of Health Management and Informatics, University of Missouri School of Medicine, Columbia, MO, USA.
Chih-Lin ChiInstitute for Health Informatics, University of Minnesota, Minneapolis, MN, USA. cchi@umn.edu.

Funding

Personalized Statin Treatment Plan to Optimize Clinical Outcomes Using Big DataR01HL143390 · NHLBI · UNIVERSITY OF MINNESOTA · PI CHI, CHIH-LIN · 2019 to 2022
$3.0M
NHLBI NIH HHS 1R01HL143390-01A1NHLBI NIH HHS R01 HL143390
6 · The paper itself

Abstract

backgroundThe 2013 ACC/AHA Guideline was a paradigm shift in lipid management and identified the four statin-benefit groups. Many have studied the guideline's potential impact, but few have investigated its potential long-term impact on MACE. Furthermore, most studies also ignored the confounding effect from the earlier release of generic atorvastatin in Dec 2011.

methodsTo evaluate the potential (long-term) impact of the 2013 ACC/AHA Guideline release in Nov 2013 in the U.S., we investigated the association of the 2013 ACC/AHA Guideline with the trend changes in 5-Year MACE survival and three other statin-related outcomes (statin use, optimal statin use, and statin adherence) while controlling for generic atorvastatin availability using interrupted time series analysis, called the Chow's test. Specifically, we conducted a retrospective study using U.S. nationwide de-identified claims and electronic health records from Optum Labs Database Warehouse (OLDW) to follow the trends of 5-Year MACE survival and statin-related outcomes among four statin-benefit groups that were identified in the 2013 ACC/AHA Guideline. Then, Chow's test was used to discern trend changes between generic atorvastatin availability and guideline potential impact.

results197,021 patients were included (ASCVD: 19,060; High-LDL: 33,907; Diabetes: 138,159; High-ASCVD-Risk: 5,895). After the guideline release, the long-term trend (slope) of 5-Year MACE Survival for the Diabetes group improved significantly (P = 0.002). Optimal statin use for the ASCVD group also showed immediate improvement (intercept) and long-term positive changes (slope) after the release (P < 0.001). Statin uses did not have significant trend changes and statin adherence remained unchanged in all statin-benefit groups. Although no other statistically significant trend changes were found, overall positive trend change or no changes were observed after the 2013 ACC/AHA Guideline release.

conclusionsThe 2013 ACA/AHA Guideline release is associated with trend improvements in the long-term MACE Survival for Diabetes group and optimal statin use for ASCVD group. These significant associations might indicate a potential positive long-term impact of the 2013 ACA/AHA Guideline on better health outcomes for primary prevention groups and an immediate potential impact on statin prescribing behaviors in higher-at-risk groups. However, further investigation is required to confirm the causal effect of the 2013 ACA/AHA Guideline.

Indexed as

Guideline AdherenceHydroxymethylglutaryl-CoA Reductase InhibitorsInterrupted Time Series AnalysisPractice Guidelines as TopicAgedAtorvastatinBiomarkersCardiovascular DiseasesCholesterolDatabases, FactualDrugs, GenericDyslipidemiasFemaleHumansMaleMedication AdherenceAtorvastatinBiomarkersCholesterolDrugs, GenericHydroxymethylglutaryl-CoA Reductase InhibitorsCardiovascular diseaseDiabetesGeneric atorvastatinGuideline implementationInterrupted time series analysisLong-term effectMACEPolicy effect

Identifiers

PMID38730371
PMCPMC11088177

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Texttitle and abstract
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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.