The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease
Open accessAbstract
BACKGROUND: Previous trials have shown that the use of statins to lower cholesterol reduces the risk of cardiovascular events among persons without cardiovascular disease. Those trials have involved persons with elevated lipid levels or inflammatory markers and involved mainly white persons. It is unclear whether the benefits of statins can be extended to an intermediate-risk, ethnically diverse population without cardiovascular disease. METHODS: In one comparison from a 2-by-2 factorial trial, we randomly assigned 12,705 participants in 21 countries who did not have cardiovascular disease and were at intermediate risk to receive rosuvastatin at a dose of 10 mg per day or placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included revascularization, heart failure, and resuscitated cardiac arrest. The median follow-up was 5.6 years. RESULTS: The overall mean low-density lipoprotein cholesterol level was 26.5% lower in the rosuvastatin group than in the placebo group. The first coprimary outcome occurred in 235 participants (3.7%) in the rosuvastatin group and in 304 participants (4.8%) in the placebo group (hazard ratio, 0.76; 95% confidence interval [CI], 0.64 to 0.91; P=0.002). The results for the second coprimary outcome were consistent with the results for the first (occurring in 277 participants [4.4%] in the rosuvastatin group and in 363 participants [5.7%] in the placebo group; hazard ratio, 0.75; 95% CI, 0.64 to 0.88; P<0.001). The results were also consistent in subgroups defined according to cardiovascular risk at baseline, lipid level, C-reactive protein level, blood pressure, and race or ethnic group. In the rosuvastatin group, there was no excess of diabetes or cancers, but there was an excess of cataract surgery (in 3.8% of the participants, vs. 3.1% in the placebo group; P=0.02) and muscle symptoms (in 5.8% of the participants, vs. 4.7% in the placebo group; P=0.005). CONCLUSIONS: Treatment with rosuvastatin at a dose of 10 mg per day resulted in a significantly lower risk of cardiovascular events than placebo in an intermediate-risk, ethnically diverse population without cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; HOPE-3 ClinicalTrials.gov number, NCT00468923.).
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
“First, there are three large, randomized trials of statin versus placebo where specific cognitive tests were performed, and no differences were seen between statin and placebo (166-169).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [169]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“First, there are three large, randomized trials of statin versus placebo where specific cognitive tests were performed, and no differences were seen between statin and placebo (160–163).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [163]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The Heart Outcomes Prevention Evaluation 3 (HOPE-3), published in 2016, showed that low-dose statin therapy reduced the composite cardiovascular outcome by 24% but had no significant effect on mortality.19”
From Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients (2023) · cites this paper as [19]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The effectiveness of statins for preventing the first occurrence and recurrence of stroke in Japanese populations was confirmed in a sub-analysis of the MEGA study620, 621) and in the JELIS study622).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [621]
Experimental — accuracy not yet measured
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
Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17018-9 · Cited by 12,026
Self-citationForouzanfar, M. H., Afshin, A., Alexander, L. T., Anderson, H. R., Bhutta, Z. A., Biryukov, S., Brauer, M., Burnett, R., Cercy, K., Charlson, F. J., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31679-8 · Cited by 7,698
Rosuvastatin 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
Cholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550
Proportional hazards tests and diagnostics based on weighted residuals
GRAMBSCH, P. M., & THERNEAU, T. M. (1994) · Biometrika · doi:10.1093/biomet/81.3.515 · Cited by 5,885
Rosuvastatin to Prevent Vascular Events in Men and Women With Elevated C-Reactive Protein
Ridker, P. M., Danielson, E., Fonseca, F. A. H., Genest, J. J., Gotto, A. M., Kastelein, J. J. P., Köenig, W., Libby, P., Lorenzatti, A. J., MacFadyen, J. G., et al. (2009) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000344393.60303.0a · Cited by 3,641
O'Donnell, M. J., Xavier, D., Liu, L., Zhang, H., Chin, S. L., Rao-Melacini, P., Rangarajan, S., Islam, S., Pais, P., McQueen, M. J., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60834-3 · Cited by 3,448
Self-citationCollaborators, C. T. T. (. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60367-5 · Cited by 2,833
Forouzanfar, M. H., Alexander, L., Anderson, H. R., Bachman, V. F., Biryukov, S., Brauer, M., Burnett, R., Casey, D., Coates, M. M., Cohen, A., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00128-2 · Cited by 2,701
Semiparametric regression for the mean and rate functions of recurrent events
Lin, D. Y., Wei, L. J., Yang, I., & Ying, Z. (2000) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/1467-9868.00259 · Cited by 969
Research works printed but not linked: 1
- Sackett DL, 2000, CMAJ, 162, 1311
Cited by
Sorted by citations
2018 ESC/ESH Guidelines for the management of arterial hypertension
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy339 · Cited by 10,286
Self-citationForouzanfar, M. H., Afshin, A., Alexander, L. T., Anderson, H. R., Bhutta, Z. A., Biryukov, S., Brauer, M., Burnett, R., Cercy, K., Charlson, F. J., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31679-8 · Cited by 7,698
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000625 · Cited by 6,185
Stanaway, J. D., Afshin, A., Gakidou, E., Lim, S. S., Abate, D., Abate, K. H., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32225-6 · Cited by 4,943
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000678 · Cited by 4,536
Metadata
- Authors
- Yusuf, S., Bosch, J., Dagenais, G., Zhu, J., Xavier, D., Liu, L., Pais, P., López-Jaramillo, P., Leiter, L. A., Dans, A., Avezum, A., Piegas, L. S., Parkhomenko, A., Keltai, K., Keltai, M., Sliwa, K., Peters, R. J. G., Held, C., Chazova, I., Yusoff, K., Lewis, B. S., Jansky, P., Khunti, K., Toff, W. D., Reid, C. M., Varigos, J., Sanchez-Vallejo, G., McKelvie, R., Pogue, J., Jung, H., Gao, P., Diaz, R., & Lonn, E.
- Affiliations
- St. Michael's Hospital (CA)
- Semmelweis University (HU)
- Uppsala University (SE)
- ORCID
- Yusuf, Salim
- Bosch, Jackie
- Dagenais, Gilles
- Zhu, Jun
- Xavier, Denis
- Liu, Lisheng
- Pais, Prem
- López-Jaramillo, Patricio
- Leiter, Lawrence A.
- Piegas, Leopoldo S.
- Parkhomenko, Alexander
- Keltai, Katalin
- Sliwa, Karen
- Peters, Ron J.G.
- Held, Claes
- Chazova, Irina
- Yusoff, Khalid
- Lewis, Basil S.
- Khunti, Kamlesh
- Toff, William D.
- Reid, Christopher M.
- McKelvie, Robert
- Jung, Hyejung
- Lonn, Eva
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2016-05-26
- Volume
- 374
- Issue
- 21
- Pages
- 2021-2031
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2313998826
- Cited by
- 848
- References
- 23
- Citations by year
- 2026: 32 · 2025: 52 · 2024: 61 · 2023: 66 · 2022: 84 · 2021: 90 · 2020: 75 · 2019: 109 · 2018: 101 · 2017: 97 · 2016: 78
- FWCI
- 142.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-nd)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, other-oa)
- Funders
- AstraZeneca
- Canadian Institutes of Health Research (IR2-91038))
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- rosuvastatin, statins, cholesterol lowering, intermediate cardiovascular risk, primary prevention, cardiovascular events, LDL cholesterol, ethnic diversity, C-reactive protein, cataract surgery, statin adverse effects, muscle symptoms, diabetes risk, cardiovascular mortality, myocardial infarction, stroke, heart failure, revascularization, cardiac arrest, cardiovascular risk stratification, lipid-lowering therapy
- MeSH terms
- Rosuvastatin Calcium, Aged, Cardiovascular Diseases, Double-Blind Method, Female, Humans, Hypercholesterolemia, Cholesterol, LDL, Male, Middle Aged, Risk Factors, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Medication Adherence
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
