The DOI matches its Crossref record; 295 of the 299 references it cites were found in a registry or an index.
Interpretation of the evidence for the efficacy and safety of statin therapy
Open accessAbstract
This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment. Large-scale evidence from randomised trials shows that statin therapy reduces the risk of major vascular events (ie, coronary deaths or myocardial infarctions, strokes, and coronary revascularisation procedures) by about one-quarter for each mmol/L reduction in LDL cholesterol during each year (after the first) that it continues to be taken. The absolute benefits of statin therapy depend on an individual's absolute risk of occlusive vascular events and the absolute reduction in LDL cholesterol that is achieved. For example, lowering LDL cholesterol by 2 mmol/L (77 mg/dL) with an effective low-cost statin regimen (eg, atorvastatin 40 mg daily, costing about £2 per month) for 5 years in 10 000 patients would typically prevent major vascular events from occurring in about 1000 patients (ie, 10% absolute benefit) with pre-existing occlusive vascular disease (secondary prevention) and in 500 patients (ie, 5% absolute benefit) who are at increased risk but have not yet had a vascular event (primary prevention). Statin therapy has been shown to reduce vascular disease risk during each year it continues to be taken, so larger absolute benefits would accrue with more prolonged therapy, and these benefits persist long term. The only serious adverse events that have been shown to be caused by long-term statin therapy-ie, adverse effects of the statin-are myopathy (defined as muscle pain or weakness combined with large increases in blood concentrations of creatine kinase), new-onset diabetes mellitus, and, probably, haemorrhagic stroke. Typically, treatment of 10 000 patients for 5 years with an effective regimen (eg, atorvastatin 40 mg daily) would cause about 5 cases of myopathy (one of which might progress, if the statin therapy is not stopped, to the more severe condition of rhabdomyolysis), 50-100 new cases of diabetes, and 5-10 haemorrhagic strokes. However, any adverse impact of these side-effects on major vascular events has already been taken into account in the estimates of the absolute benefits. Statin therapy may cause symptomatic adverse events (eg, muscle pain or weakness) in up to about 50-100 patients (ie, 0·5-1·0% absolute harm) per 10 000 treated for 5 years. However, placebo-controlled randomised trials have shown definitively that almost all of the symptomatic adverse events that are attributed to statin therapy in routine practice are not actually caused by it (ie, they represent misattribution). The large-scale evidence available from randomised trials also indicates that it is unlikely that large absolute excesses in other serious adverse events still await discovery. Consequently, any further findings that emerge about the effects of statin therapy would not be expected to alter materially the balance of benefits and harms. It is, therefore, of concern that exaggerated claims about side-effect rates with statin therapy may be responsible for its under-use among individuals at increased risk of cardiovascular events. For, whereas the rare cases of myopathy and any muscle-related symptoms that are attributed to statin therapy generally resolve rapidly when treatment is stopped, the heart attacks or strokes that may occur if statin therapy is stopped unnecessarily can be devastating.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Although LDL-lowering drugs have only moderate effects on TG levels, they reduce ASCVD risk in patients with and without HTG.42”
From Clinical review on triglycerides (2020) · cites this paper as [42]
Experimental — accuracy not yet measuredIn the citing paper
“Although LDL-lowering drugs have only moderate effects on TG levels, they reduce ASCVD risk in patients with and without HTG.42”
From Clinical review on triglycerides (2020) · cites this paper as [42]
In the citing paper
“Overall, statin therapy produced a 21% relative reduction in major vascular events (relative risk 0.79, 95% CI 0.77-0.81) per 1.0 mmoL/L reduction in LDL-C”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [217]
In the citing paper
“However, since the absolute risk of CAD is higher in older persons, the associated absolute increase in risk for a given increment in TC is larger with increasing age [217].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [217]
In the citing paper
“The relative reduction in major vascular events was similar, irrespective of age, among patients with pre-existing vascular disease, but appeared smaller among older individuals not known to have vascular disease.”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [217]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
1 retracted
Reduced dietary salt for the prevention of cardiovascular disease
Taylor, R. S., Ashton, K. E., Moxham, T., Hooper, L., & Ebrahim, S. B. J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009217.pub2 · Cited by 311
RetractedWriting Group for the Women's Health Initiative Investigators (2002) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.288.3.321 · Cited by 15,889
Sacks, F. M., Pfeffer, M. A., Moye, L. A., Rouleau, J. L., Rutherford, J. D., Cole, T. G., Brown, L., Warnica, J. W., Arnold, J. M. O., Wun, C.-C., et al. (1996) · New England Journal of Medicine · doi:10.1056/nejm199610033351401 · Cited by 7,439
Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437738.63853.7a · Cited by 7,081
(2005) · The Lancet · doi:10.1016/s0140-6736(05)67394-1 · Cited by 6,848
Self-citationRosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein
Ridker, P. M., Danielson, E., Fonseca, F. A. H., Genest, J., Gotto, A. M., Kastelein, J. J. P., Koenig, W., Libby, P., Lorenzatti, A. J., MacFadyen, J. G., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0807646 · Cited by 6,674
Self-citationCholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550
Hulley, S. (1998) · JAMA · doi:10.1001/jama.280.7.605 · Cited by 6,216
The Emerging Risk Factors Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)60484-9 · Cited by 5,125
Research works printed but not linked: 3
- Abramson, 2013, Don't Give More Patients Statins, The New York Times
- 2013, Statins can weaken muscles and joints: cholesterol drug raises risk of problems by up to 20 per cent, MailOnline
- 2016, How Big Pharma greed is killing tens of thousands around the world: Patients are over-medicated and often given profitable drugs with ‘little proven benefits,’ leading doctors warn, MailOnline
Cited by
Sorted by citations
Items 301–400 of 1,000
Zhou, Z., Albarqouni, L., Curtis, A. J., Breslin, M. C., & Nelson, M. R. (2020) · Drugs & Aging · doi:10.1007/s40266-019-00736-y · Cited by 45
Hultstrand, J. N., Gemzell‐Danielsson, K., Kallner, H. K., Lindman, H., Wikman, P., & Poromaa, I. S. (2022) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2022.100470 · Cited by 45
Hopewell, J. C., Offer, A. R., Haynes, R., Bowman, L. J., Li, J., Chen, F., Bulbulia, R. A., Lathrop, M. G., Baigent, C., Landray, M., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehaa574 · Cited by 45
Self-citationStatins and LDL-C in Secondary Prevention—So Much Progress, So Far to Go
Banach, M., & Penson, P. E. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.25675 · Cited by 45
Global prevalence of dyslipidaemia in adult populations: a systematic review protocol
Mohamed-Yassin, M.-S., Baharudin, N., Abdul-Razak, S., Ramli, A. S., & Lai, N. M. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049662 · Cited by 44
Statin therapy for the primary prevention of cardiovascular disease: Pros
Razavi, A. C., Mehta, A., & Sperling, L. S. (2022) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2022.07.004 · Cited by 42
Saborowski, M., Dölle, M., Manns, M. P., Leitolf, H., & Zender, S. (2017) · Cardiology Journal · doi:10.5603/cj.a2017.0137 · Cited by 46
Medicine‐related beliefs predict attribution of symptoms to a sham medicine: A prospective study
Webster, R., Weinman, J. A., & Rubin, G. J. (2018) · British Journal of Health Psychology · doi:10.1111/bjhp.12298 · Cited by 42
Vanholder, R. C., Laecke, S. V., Glorieux, G., Verbeke, F., Castillo-Rodríguez, E., & Ortíz, A. (2018) · Toxins · doi:10.3390/toxins10060237 · Cited by 44
Phenome-wide association analysis of LDL-cholesterol lowering genetic variants in PCSK9
Schmidt, A. F., Holmes, M. V., Preiss, D., Swerdlow, D. I., Denaxas, S., Fatemifar, G., Faraway, R., Finan, C., Lumbers, R. T., Henry, A., et al. (2019) · BMC Cardiovascular Disorders · doi:10.1186/s12872-019-1187-z · Cited by 41
Self-citationPCSK9 inhibitors and cardiovascular outcomes
Steffens, D., Bramlage, P., Scheeff, C., Kašner, M., Hassanein, A., Friebel, J., & Rauch‐Kröhnert, U. (2019) · Expert Opinion on Biological Therapy · doi:10.1080/14712598.2020.1677604 · Cited by 46
Development of the novel ACLY inhibitor 326E as a promising treatment for hypercholesterolemia
Xie, Z., Zhang, M., Song, Q., Cheng, L., Zhang, X., Song, G., Sun, X., Gu, M., Zhou, C., Zhang, Y., et al. (2022) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2022.06.011 · Cited by 45
Li, C., Liu, X., Shen, P., Sun, Y., Zhou, T., Chen, W., Chen, Q., Lin, H., Tang, X., & Gao, P. (2023) · European Heart Journal - Digital Health · doi:10.1093/ehjdh/ztad058 · Cited by 57
World Heart Federation Cholesterol Roadmap
Murphy, A., Faria-Neto, J. R., Al-Rasadi, K., Blom, D., Catapano, A., Cuevas, A., Lopez-Jimenez, F., Perel, P., Santos, R., Sniderman, A., et al. (2017) · Global Heart · doi:10.1016/j.gheart.2017.03.002 · Cited by 43
Self-citationSimvastatin inhibits sonic hedgehog signaling and stemness features of pancreatic cancer
Yin, Y., Liu, L., Zhao, Z., Yin, L., Bauer, N., Nwaeburu, C. C., Gladkich, J., Groß, W., Hackert, T., Sticht, C., et al. (2018) · Cancer Letters · doi:10.1016/j.canlet.2018.04.001 · Cited by 43
Statin treatment and the risk of depression
Köhler‐Forsberg, O., Gasse, C., Petersen, L. V., Nierenberg, A. A., Mors, O. N., & Østergaard, S. D. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.12.110 · Cited by 43
Statin-Induced Myopathy: Translational Studies from Preclinical to Clinical Evidence
Camerino, G. M., Tarantino, N., Canfora, I., Bellis, M. D., Musumeci, O., & Pierno, S. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22042070 · Cited by 47
Fu, J., Xu, H., Wu, F., Tu, Q., Dong, X., Xie, H., & Cao, Z. (2022) · International Journal of Cardiology · doi:10.1016/j.ijcard.2022.07.048 · Cited by 43
Critically ill patients with cancer: A clinical perspective
Martos-Benítez, F. D., Soler-Morejón, C. D. D., Lara-Ponce, K. X., Orama-Requejo, V., Aragüez, D. B., Muguercia, H. L., & Lespoir, R. W. (2020) · World Journal of Clinical Oncology · doi:10.5306/wjco.v11.i10.809 · Cited by 45
Statins in Children, an Update
Fiorentino, R., & Chiarelli, F. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24021366 · Cited by 42
Low-Density Lipoprotein Cholesterol-Lowering Drugs: A Narrative Review
Ferri, N., Ruscica, M., Fazio, S., & Corsini, A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13040943 · Cited by 44
Elnaem, M. H., Mohamed, M. H. N., Huri, H. Z., Azarisman, S. M., & Elkalmi, R. M. (2017) · Journal of Pharmacy And Bioallied Sciences · doi:10.4103/jpbs.jpbs_30_17 · Cited by 42
Intensity of statin therapy and muscle symptoms: a network meta-analysis of 153 000 patients
Davis, J. W., & Weller, S. C. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-043714 · Cited by 46
Hilton‐Jones, D. (2018) · Practical Neurology · doi:10.1136/practneurol-2017-001738 · Cited by 41
Chen, Y. C., Wang, J., Xu, J., Zhang, J., Xu, S., Zhang, Q., Huang, J., Peng, J., Xu, H., Du, Q., et al. (2023) · ACS Nano · doi:10.1021/acsnano.2c12230 · Cited by 40
ApoB in clinical care: Pro and Con
Sniderman, A. D., & Robinson, J. G. (2018) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2018.11.001 · Cited by 40
Mini-review: medication safety of red yeast rice products
Farkouh, A., & Baumgärtel, C. (2019) · International Journal of General Medicine · doi:10.2147/ijgm.s202446 · Cited by 40
Muscle and statins: from toxicity to the nocebo effect
Pedro‐Botet, J., Climent, E., & Benaiges, D. (2019) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2019.1615053 · Cited by 40
Statins and All‐Cause Mortality in Patients Undergoing Hemodialysis
Jung, J., Bae, G. H., Kang, M., Kim, S. W., & Lee, D. H. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.014840 · Cited by 42
Schooling, C., Zhao, J., Au Yeung, S., & Leung, G. (2020) · eLife · doi:10.7554/elife.58567 · Cited by 39
Drugs and hyperglycemia: A practical guide
Jain, V., Patel, R., Kapadia, Z., Galiveeti, S., Banerji, M., & Hope, L. (2017) · Maturitas · doi:10.1016/j.maturitas.2017.08.006 · Cited by 39
Statin use and knee osteoarthritis progression: Results from a post-hoc analysis of the SEKOIA trial
Eymard, F., Parsons, C. M., Edwards, M. H., Petit-Dop, F., Reginster, J., Bruyère, O., Chevalier, X., Cooper, C. C., & Richette, P. (2017) · Joint Bone Spine · doi:10.1016/j.jbspin.2017.09.014 · Cited by 39
Zhang, M., Wang, X., Shi, J., & Yu, J. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.749113 · Cited by 39
Low-Density Lipoprotein Cholesterol Is Associated With Insulin Secretion
Dannecker, C., Wagner, R. J., Peter, A., Hummel, J., Vosseler, A., Häring, H., Fritsche, A., Birkenfeld, A. L., Stefan, N., & Heni, M. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab147 · Cited by 41
Wieringa, S., Engebretsen, E., Heggen, K. M., & Greenhalgh, T. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.8325 · Cited by 38
Patterns of statin use and long‐term adherence and persistence among older adults with diabetes
Ofori‐Asenso, R., Ilomäki, J., TACEY, M. A., Zomer, E., Curtis, A. J., Bell, J. S., Zoungas, S., & Liew, D. (2018) · Journal of Diabetes · doi:10.1111/1753-0407.12769 · Cited by 38
Cognitive function in patients with coronary artery disease: A literature review
Burkauskas, J., Lang, P., Bunevičius, A., Neverauskas, J., Bučiūtė-Jankauskienė, M., & Mickuvienė, N. (2018) · Journal of International Medical Research · doi:10.1177/0300060517751452 · Cited by 43
Tremoulet, A. H., Jain, S., Jone, P., Best, B. M., Duxbury, E., Franco, A., Printz, B. F., Dominguez, S. R., Heizer, H. R., Anderson, M. S., et al. (2019) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2019.07.064 · Cited by 38
Carter, P., Vithayathil, M. K., Kar, S., Potluri, R., Mason, A. M., Larsson, S. C., & Burgess, S. (2020) · eLife · doi:10.7554/elife.57191 · Cited by 38
Association between statin use and Alzheimer’s disease with dose response relationship
Jeong, S., Shin, D. W., Yoo, T. G., Cho, M. H., Jang, W., Lee, J., & Kim, S. (2021) · Scientific Reports · doi:10.1038/s41598-021-94803-3 · Cited by 38
Redefining cardiovascular risk prediction: is the crystal ball clearer now?
Tokgözoğlu, L. S., & Torp-Pedersen, C. T. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab310 · Cited by 41
Patient preferences for cardiovascular preventive medication: a systematic review
Albarqouni, L., Doust, J. A., & Glasziou, P. (2017) · Heart · doi:10.1136/heartjnl-2017-311244 · Cited by 36
Prevalence and Management of Symptoms Associated With Statin Therapy in Community Practice
Návar, A. M., Peterson, E. D., Li, S., Robinson, J. G., Roger, V. L., Goldberg, A. C., Virani, S. S., Wilson, P. W. F., Nanna, M. G., Lee, L. V., et al. (2018) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.117.004249 · Cited by 37
An update on efflux and uptake transporters as determinants of statin response
Rocha, K. C. E., Pereira, B. M. V., & Rodrigues, A. C. (2018) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2018.1482276 · Cited by 38
Nocebo effects in health psychology
Faasse, K. (2019) · Australian Psychologist · doi:10.1111/ap.12392 · Cited by 42
Use of Statins After Ischemic Stroke in Young Adults and Its Association With Long-Term Outcome
van Dongen, M. M. E., Aarnio, K., Martinez‐Majander, N., Pirinen, J., Sinisalo, J. P., Lehto, M., Kaste, M., Tatlisumak, T., de Leeuw, F., & Jukka Putaala, A. (2019) · Stroke · doi:10.1161/strokeaha.119.026992 · Cited by 38
Statins in a Distorted Mirror of Media
Nelson, A. J., Puri, R., & Nissen, S. E. (2020) · Current Atherosclerosis Reports · doi:10.1007/s11883-020-00853-9 · Cited by 38
Bempedoic acid for the treatment of dyslipidemia
Marrs, J. C., & Anderson, S. L. (2020) · Drugs in Context · doi:10.7573/dic.2020-6-5 · Cited by 36
Xue, H., & Pan, W. (2020) · PLoS Genetics · doi:10.1371/journal.pgen.1009105 · Cited by 37
Peters, F., Kuchenbecker, J., Kreutzburg, T., Marschall, U., Debus, E. S., & Behrendt, C. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.120.018338 · Cited by 38
Li, X., Ploner, A., Wang, Y., Zhan, Y., Pedersen, N. L., Magnusson, P. K. E., Jylhävä, J., & Hägg, S. (2021) · EBioMedicine · doi:10.1016/j.ebiom.2021.103318 · Cited by 37
Hyperglycaemic disorders associated with PCSK9 inhibitors: a real-world, pharmacovigilance study
Goldman, A., Raschi, E., Cukierman‐Yaffe, T., Dankner, R. S., Shouval, R., Shechter, M., Ben‐Zvi, I., Gerstein, H. C., & Maor, E. (2021) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwab209 · Cited by 38
Chasing LDL cholesterol to the bottom — PCSK9 in perspective
Libby, P., & Tokgözoğlu, L. S. (2022) · Nature Cardiovascular Research · doi:10.1038/s44161-022-00085-x · Cited by 41
Statin wars: have we been misled about the evidence? A narrative review
Demasi, M. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098497 · Cited by 36
Association of change in total cholesterol level with mortality: A population-based study
Jeong, S., Choi, S., Kim, K., Kim, S., Lee, G., Son, J. S., Yun, J., & Park, S. M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0196030 · Cited by 36
Schwaab, B., Zeymer, U., Jannowitz, C., Pittrow, D., & Gitt, A. K. (2018) · European Journal of Preventive Cardiology · doi:10.1177/2047487318817082 · Cited by 36
Cianflone, E., Cappetta, D., Mancuso, T., Sabatino, J., Marino, F., Scalise, M., Albanese, M., Salatino, A., Parrotta, E. I., Cuda, G., et al. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21217927 · Cited by 36
Schiele, F., Quignot, N., Khachatryan, A., Gusto, G., Villa, G., Kahangire, D. A., Chauny, J.-V., Ricci, L., & Désaméricq, G. (2021) · International Journal of Cardiology · doi:10.1016/j.ijcard.2021.03.007 · Cited by 36
Foryciarz, A., Pfohl, S. R., Patel, B., & Shah, N. H. (2022) · BMJ Health & Care Informatics · doi:10.1136/bmjhci-2021-100460 · Cited by 36
Tian, L., Liu, R., Zhou, Z., Xu, X., Feng, S., Kushmaro, A., Marks, R. S., Wang, D., & Sun, Q. (2022) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-021-09886-1 · Cited by 35
Takada, K., Shimokawa, M., Takamori, S., Shimamatsu, S., Hirai, F., Tagawa, T., Okamoto, T., Hamatake, M., Tsuchiya‐Kawano, Y., Otsubo, K., et al. (2022) · BMC Cancer · doi:10.1186/s12885-022-09385-8 · Cited by 34
Re-thinking Alzheimer's disease therapeutic targets using gene-based tests
Kwok, M. K., Lin, S. L., & Schooling, C. M. (2018) · EBioMedicine · doi:10.1016/j.ebiom.2018.10.001 · Cited by 35
Sponsorship bias in clinical trials: growing menace or dawning realisation?
Jefferson, T. (2020) · Journal of the Royal Society of Medicine · doi:10.1177/0141076820914242 · Cited by 37
Colchicine and Cardiovascular Outcomes: a Critical Appraisal of Recent Studies
Banach, M., & Penson, P. E. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00932-5 · Cited by 35
PCSK9 as a Target for Development of a New Generation of Hypolipidemic Drugs
Kuzmich, N. N., Andresyuk, E., Porozov, Y. B., Tarasov, V. V., MIu, S., Preferanskaya, N., Veselov, V. V., & Alyautdin, R. N. (2022) · Molecules · doi:10.3390/molecules27020434 · Cited by 35
Ji, C., Bai, J., Zhou, J., Zou, Y., & Yu, M. (2022) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.15460 · Cited by 35
Hosseini, A. A., Simpson, R., Altaf, N., Bath, P. M., MacSweeney, S. T. R., & Auer, D. P. (2017) · Stroke · doi:10.1161/strokeaha.116.015504 · Cited by 35
Effect of atorvastatin on behavioral alterations and neuroinflammation during epileptogenesis
de Oliveira, C. V., Grigoletto, J., Canzian, J., Duarte, M. M. M. F., Duarte, T., Furian, A. F., & Oliveira, M. S. (2017) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2017.10.021 · Cited by 35
Lipid-Lowering Drug Therapy: Critical Approach for Implementation in Clinical Practice
Rossi, M., Fabris, E., Barbisan, D., Massa, L., & Sinagra, G. (2021) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-021-00497-3 · Cited by 35
Compensated liver cirrhosis: Natural course and disease-modifying strategies
Kumar, R. K., Kumar, S., & Prakash, S. S. (2023) · World Journal of Methodology · doi:10.5662/wjm.v13.i4.179 · Cited by 40
Wang, Y., Pan, Y., Hou, M., Luo, R., He, J., Lin, F., Xia, X., Li, P., He, C., He, P., et al. (2023) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2023.115736 · Cited by 34
Fang, F., Wang, E., Yang, H., Zhao, T., Wang, Q., Zhang, Z., Song, Y., & Liu, X. (2025) · Nature Communications · doi:10.1038/s41467-025-64201-8 · Cited by 34
Liao, Y. J., Ouyang, L., Ci, L., Chen, B., Lv, D., Li, Q., Sun, Y., Fei, J., Bao, S., Liu, X., et al. (2019) · Biomaterials · doi:10.1016/j.biomaterials.2019.02.027 · Cited by 34
Fear-Based Medical Misinformation and Disease Prevention
Návar, A. M. (2019) · JAMA Cardiology · doi:10.1001/jamacardio.2019.1972 · Cited by 34
Interaction potential between clarithromycin and individual statins—A systematic review
Christensen, M. M. H., Haastrup, M. B., Øhlenschlæger, T., Esbech, P. S., Pedersen, S. A., Dunvald, A. D., Stage, T. B., Henriksen, D. P., & Pedersen, A. J. T. (2019) · Basic & Clinical Pharmacology & Toxicology · doi:10.1111/bcpt.13343 · Cited by 34
Sprügel, M. I., Kuramatsu, J. B., Volbers, B., Saam, J. I., Sembill, J. A., Gerner, S. T., Balk, S., Hamer, H. M., Lücking, H., Hoelter, P., et al. (2021) · Stroke · doi:10.1161/strokeaha.120.029345 · Cited by 34
Aging biomarkers and the measurement of health and risk
Green, S., & Hillersdal, L. (2021) · History & Philosophy of the Life Sciences · doi:10.1007/s40656-021-00367-w · Cited by 39
Groner, J., Göpferich, A. M., & Breunig, M. (2021) · Journal of Controlled Release · doi:10.1016/j.jconrel.2021.03.034 · Cited by 34
Harper, C., Mafham, M. M., Herrington, W. G., Staplin, N., Stevens, W., Wallendszus, K., Haynes, R., Landray, M., Parish, S., Bowman, L. J., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.39748 · Cited by 34
Self-citationSrinivasan, N., Thangavelu, K., & Uthandi, S. (2022) · Microbial Cell Factories · doi:10.1186/s12934-022-01751-2 · Cited by 34
FILIPPO, O. D., Russo, C., Manai, R., Borzillo, I., Savoca, F., Gallone, G., Bruno, F., Ahmad, M., Ferrari, G. M. D., & D’Ascenzo, F. (2022) · International Journal of Cardiology · doi:10.1016/j.ijcard.2022.08.034 · Cited by 34
Thalmann, I., Preiss, D., Schlackow, I., Gray, A. M., & Mihaylova, B. (2022) · Heart · doi:10.1136/heartjnl-2022-321452 · Cited by 36
Self-citationCardiovascular risk reduction with icosapent ethyl
Patel, P. N., Patel, S. M., & Bhatt, D. L. (2019) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000678 · Cited by 33
Zheng, Q., Li, X., Huang, N., Li, F., Ge, J., Wang, D., Sun, R., & Liu, R. (2022) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2022.116110 · Cited by 33
Does Googling lead to statin intolerance?
Khan, S. H., Holbrook, A. M., & Shah, B. R. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.02.085 · Cited by 33
Ofori‐Asenso, R., Ilomäki, J., Zomer, E., Curtis, A. J., Zoungas, S., & Liew, D. (2018) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-018-6794-x · Cited by 34
Joharatnam‐Hogan, N., Alexandre, L., Yarmolinsky, J., Lake, B., Capps, N. E., Martin, R. M., Ring, A. E., Cafferty, F. H., & Langley, R. E. (2021) · Current Oncology Reports · doi:10.1007/s11912-021-01023-z · Cited by 34
Lipid-lowering therapies: Better together
Banach, M., & Penson, P. E. (2021) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2021.01.009 · Cited by 33
Afroz, R., Cao, Y., Rostam, M. A., Ta, H. T., Xu, S., Zheng, W., Osman, N., Kamato, D., & Little, P. J. (2018) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2018.02.005 · Cited by 33
Variations in time to benefit among clinical trials of cholesterol-lowering drugs
Barter, P. J., & Waters, D. D. (2018) · Journal of clinical lipidology · doi:10.1016/j.jacl.2018.04.006 · Cited by 33
Trust the Blinded Randomized Evidence That Statin Therapy Rarely Causes Symptomatic Side Effects
Peto, R., & Collins, R. (2018) · Circulation · doi:10.1161/circulationaha.118.036846 · Cited by 33
Self-citationMatrix metalloproteinase‑9 in hemorrhagic transformation after acute ischemic stroke (Review)
Guo, P., Li, H., Zhang, X., Liu, Y., Xue, S., Yong, V. W., & Xue, M. (2025) · Molecular Medicine Reports · doi:10.3892/mmr.2025.13590 · Cited by 32
Pagan, E., Chatenoud, L., Rodriguez, T., Bosetti, C., Levi, F., Malvezzi, M., Vecchia, C. L., Negri, E., & Bertuccio, P. (2016) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.11.040 · Cited by 32
Bakar, N. S., Neely, D., Avery, P. J., Brown, C., Daly, A. K., & Kamali, F. (2017) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.887 · Cited by 32
Statin use and risk for type 2 diabetes: what clinicians should know
Maki, K. C., Diwadkar‐Navsariwala, V., & Kramer, M. W. (2017) · Postgraduate Medicine · doi:10.1080/00325481.2018.1402658 · Cited by 32
Wang, C., Li, F., Guo, J., Li, C., Xu, D., & Wang, B. (2017) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2017.5584 · Cited by 32
Jarmul, J. A., Pletcher, M. J., Lich, K. H., Wheeler, S. B., Weinberger, M., Avery, C. L., Jonas, D. E., Earnshaw, S., & Pignone, M. P. (2018) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.117.004171 · Cited by 32
RNA Silencing in the Management of Dyslipidemias
Henney, N. C., Banach, M., & Penson, P. E. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00968-7 · Cited by 32
Xiong, A., Hu, Z., Zhou, S., Qiang, Y., Song, Z., Chen, H., Xiang, Q., Zhang, Y., Cao, Y., Cui, H., et al. (2021) · Lara D. Veeken · doi:10.1093/rheumatology/keab851 · Cited by 32
Etiology and Management of Dyslipidemia in Patients With Cancer
de Jesus, M., Mohammed, T. J., Singh, M., Tiu, J. G., & Kim, A. S. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.892335 · Cited by 32
Metadata
- Authors
- Collins, R., Reith, C., Emberson, J., Armitage, J., Baigent, C., Blackwell, L., Blumenthal, R., Danesh, J., Smith, G. D., DeMets, D., Evans, S., Law, M., MacMahon, S., Martin, S., Neal, B., Poulter, N., Preiss, D., Ridker, P., Roberts, I., Rodgers, A., Sandercock, P., Schulz, K., Sever, P., Simes, J., Smeeth, L., Wald, N., Yusuf, S., & Peto, R.
- Affiliations
- University of Oxford (GB)
- Johns Hopkins University (US)
- University of Cambridge (GB)
- University of Bristol (GB)
- University of Wisconsin–Madison (US)
- University of London (GB)
- The University of Sydney (AU)
- Imperial College London (GB)
- Brigham and Women's Hospital (US)
- University of Edinburgh (GB)
- University of North Carolina at Chapel Hill (US)
- Population Health Research Institute (CA)
- Corresponding author
- Collins, Rory
- ORCID
- Collins, Rory
- Reith, Christina
- Emberson, Jonathan
- Armitage, Jane
- Baigent, Colin
- Blumenthal, Roger
- Danesh, John
- Smith, George Davey
- DeMets, David
- Evans, Stephen
- MacMahon, Stephen
- Martin, Seth
- Neal, Bruce
- Poulter, Neil
- Preiss, David
- Ridker, Paul
- Roberts, Ian
- Rodgers, Anthony
- Sandercock, Peter
- Schulz, Kenneth
- Smeeth, Liam
- Wald, Nicholas
- Yusuf, Salim
- Peto, Richard
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2016-11
- Volume
- 388
- Issue
- 10059
- Pages
- 2532-2561
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2519634482
- Cited by
- 1,857
- References
- 299
- Citations by year
- 2026: 136 · 2025: 136 · 2024: 150 · 2023: 166 · 2022: 187 · 2021: 229 · 2020: 192 · 2019: 218 · 2018: 206 · 2017: 202 · 2016: 31
- FWCI
- 43.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion, other-oa)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc-nd)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion, other-oa)
- Spiral (Imperial College London) (submittedVersion, cc-by-nc-nd)
- Funders
- Cancer Research UK (16896)
- National Institute for Health and Care Research (NF-SI-0611-10057, HTA/14/49/159, 14/49/159, NF-SI-0513-10059)
- British Heart Foundation (SP/08/010/25939, SP/14/3/31114, RG/13/13/30194)
- Medical Research Council (MR/K006584/1, MR/L003120/1)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- statin therapy, LDL cholesterol lowering, cardiovascular disease prevention, secondary prevention, primary prevention, absolute risk reduction, statin adverse effects, myopathy, rhabdomyolysis, new-onset diabetes, hemorrhagic stroke, atorvastatin, long-term treatment, evidence evaluation, cardiovascular risk assessment, cost-effectiveness, randomized controlled trials, meta-analysis
- MeSH terms
- Anticholesteremic Agents, Clinical Trials as Topic, Coronary Disease, Humans, Cholesterol, LDL, Myocardial Infarction, Safety, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Simvastatin, Stroke, Drug-Related Side Effects and Adverse Reactions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
