Evidence map›Paper›PMID 39982907›Full record

ArticlePloS one2025

Statin use and low-density lipoprotein cholesterol target achievement for primary prevention of atherosclerotic cardiovascular disease in patients with type 2 diabetes mellitus: a multicenter cross-sectional study in Sri Lanka.

P D W D De Zoysa, T P Weerarathna, I L A N Darshana, K G P Wasana, B Piyasekara, M M P T Jayasekara, V Sujanitha, S Silva, C Mettananda, G U Ramadasa and 1 more

Abstract readMulticenter Study
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. 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.

P D W D De ZoysaFaculty of Medicine, University of Ruhuna, Sri Lanka.ORCID https://orcid.org/0000-0002-6209-9806
T P WeerarathnaFaculty of Medicine, University of Ruhuna, Sri Lanka.
I L A N DarshanaFaculty of Medicine, University of Ruhuna, Sri Lanka.
K G P WasanaFaculty of Health Sciences, CINEC Campus, Sri Lanka.
B PiyasekaraDiabetes Center, Co-operative Hospital, Galle, Sri Lanka.
M M P T JayasekaraFaculty of Medicine, General Sir John Kotelawala Defense University, Sri Lanka.
V SujanithaFaculty of Medicine, University of Jaffna, Sri Lanka.
S SilvaFaculty of Medicine, University of Sri Jayewardenepura, Sri Lanka.ORCID https://orcid.org/0000-0002-7348-4830
C MettanandaFaculty of Medicine, University of Kelaniya, Sri Lanka.ORCID https://orcid.org/0000-0002-3328-1553
G U RamadasaFaculty of Medicine, University of Sabaragamuwa, Sri Lanka.ORCID https://orcid.org/0000-0001-9028-3638
L P M M K PathirageFaculty of Medicine, University of Peradeniya, Sri Lanka.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStatin therapy serves a crucial role as a primary preventive strategy against atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes mellitus (T2DM). Even though diabetes poses a significant and growing health concern in Sri Lanka, there is a lack of information regarding the prevalence and intensity of statin prescriptions and the achievement of recommended LDL-C targets in diabetic patients for the primary prevention of ASCVD within the nation. We aimed to assess the prevalence and intensity of statin prescriptions, target LDL-C achievement, and factors associated with target LDL-C achievement for the primary prevention of ASCVD in T2DM patients across several tertiary care facilities in Sri Lanka.

methodsA multi-centered, cross-sectional study was conducted among T2DM patients without clinical ASCVD attending six tertiary care medical clinics in Sri Lanka. Data on ASCVD risk factors and statin prescription were collected using an interviewer-administered questionnaire. ASCVD risk was calculated using the WHO charts. Atorvastatin 20 mg/ rosuvastatin 10 mg was defined as high-intensity statins and target LDL-C was defined as < 70 mg/dL for moderate to high and < 100 mg/dL for low-risk groups of ASCVD according to the NICE guideline. The independent sample t test, one-way ANOVA and chi-square test were used for data analysis as appropriate. Factors linked to achieving LDL-C targets were determined through multiple logistic regression analysis. Level of significance was considered as 0.05.

resultsOf the 2013 participants studied, 46.7% were at moderate-high risk and the rest were at low risk of ASCVD. All were eligible for statin therapy, and 84.1% were prescribed statins. High-intensity statins had been prescribed only for 38.5% of moderate-high-risk patients. Nonetheless, high-intensity statins have also been prescribed for 30.7% of low-risk patients. LDL-C target achievement was studied in a randomly selected subsample of 683 and 65.4% (70.7% in low-risk patients and 60.3% in moderate-high-risk patients) achieved LDL-C targets. Of moderate-high-risk patients, 46.3% had not achieved target LDL-C even with high-intensity statin therapy. Female gender (OR = 1.52, 95% CI 1.03-2.24, p = 0.036), poor adherence to statins (OR = 1.67, 95% CI 1.18-2.37, p = 0.004), poor glycemic control (OR = 2.27, 95% CI 1.41-3.65, p = 0.001), and inadequate physical activity (OR = 1.48, 95% CI 1.04-2.10, p = 0.031) were significantly associated with failing to achieve LDL-C targets.

conclusionOnly about one third of diabetes patients with moderate-high ASCVD risk received high-intensity statins. Even with high-intensity statin therapy, nearly half of the treated patients failed to meet recommended LDL-C targets.

Indexed as

AtherosclerosisCholesterol, LDLDiabetes Mellitus, Type 2Hydroxymethylglutaryl-CoA Reductase InhibitorsAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedPrimary PreventionRisk FactorsSri LankaCholesterol, LDLHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID39982907
PMCPMC11844856

What OpenQuestion holds

Texttitle and abstract
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.