Evidence map›Paper›PMID 40399054›Full record

ArticleJournal of atherosclerosis and thrombosis2025

Impact of a Physician-led Strike Early-Strike Strong Lipid-Lowering Protocol Incorporating PCSK9 Inhibitors for Patients with Acute Myocardial Infarction.

Riku Arai, Yuta Hotsubo, Yuki Nakajima, Ran Sumida, Saki Mizobuchi, Shohei Migita, Yudai Tanaka, Koichiro Hori, Katsunori Fukumoto, Yasunari Ebuchi and 3 more

Abstract read
In one paragraph

Article in Journal of atherosclerosis and thrombosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

13 authors.

Riku AraiDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Yuta HotsuboDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Yuki NakajimaDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Ran SumidaDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Saki MizobuchiDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Shohei MigitaDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Yudai TanakaDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Koichiro HoriDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Katsunori FukumotoDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Yasunari EbuchiDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Keisuke KojimaDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Mitsumasa SudoDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.
Yasuo OkumuraDivision of Cardiology, Department of Medicine, Nihon University School of Medicine.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsIntensive lipid-lowering therapy is recommended for secondary prevention of cardiovascular events after acute myocardial infarction (AMI). However, the prescription rate of PCSK9 inhibitors (PCSK9is) remains low among patients not achieving low-density lipoprotein (LDL) cholesterol target levels.

methodsA retrospective analysis was conducted on 194 patients with AMI who were discharged alive and followed up as outpatients at our institution between October 2022 and October 2024. In October 2023, we implemented the Physician-led Strike Early-Strike Strong Lipid-Lowering Protocol (Physician-led Protocol) to enhance lipid management. Patients were divided into two groups: pre-protocol (October 2022-September 2023) and post-protocol (October 2023-October 2024). Patient background characteristics, lipid-lowering therapies, and LDL cholesterol levels in the chronic phase were compared between the two groups. The outcomes included post-discharge PCSK9i initiation rates and chronic-phase LDL levels.

resultsWhile the prescription rates of strong statins and ezetimibe were similar between the groups, PCSK9i use was significantly higher in the post-protocol group than in the pre-protocol group (15.3% vs. 2.8%, p = 0.002). Furthermore, the chronic LDL levels were significantly lower in the post-protocol group than in the pre-protocol group (51.0 vs. 58.0 mg/dL, p = 0.007). Multivariate logistic regression showed that initial LDL levels and PCSK9i use were associated with achieving chronic LDL levels <55 mg/dL. Among eligible patients in the post-protocol group, 36.4% received PCSK9is.

conclusionsThe physician-led protocol increased PCSK9i prescriptions, achieving a median chronic LDL level of 51 mg/dL.

Indexed as

Anticholesteremic AgentsMyocardial InfarctionPCSK9 InhibitorsAgedCholesterol, LDLEzetimibeFemaleFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedProprotein Convertase 9Retrospective StudiesSecondary PreventionAnticholesteremic AgentsCholesterol, LDLEzetimibeHydroxymethylglutaryl-CoA Reductase InhibitorsPCSK9 InhibitorsPCSK9 protein, humanProprotein Convertase 9AMILDL-CPCSK9iPhysician-led Protocol

Identifiers

PMID40399054
PMCPMC12597475

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Registered trials

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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.