The DOI matches its Crossref record; 236 of the 237 references it cites were found in a registry or an index; 3 of the 254 sources its claims cite were checked for support.
ESC/EAS Guidelines for the management of dyslipidaemias
Open accessAbstract
Cardiovascular disease (CVD) due to atherosclerosis of the arterial vessel wall and to thrombosis is the foremost cause of premature mortality and of disability-adjusted life years (DALYs) in Europe, and is also increasingly common in developing countries.1 In the European Union, the economic cost of CVD represents annually E192 billion1 in direct and indirect healthcare costs. The main clinical entities are coronary artery disease (CAD), ischaemic stroke, and peripheral arterial disease (PAD). The causes of these CVDs are multifactorial. Some of these factors relate to lifestyles, such as tobacco smoking, lack of physical activity, and dietary habits, and are thus modifiable. Other risk factors are also modifiable, such as elevated blood pressure, type 2 diabetes, and dyslipidaemias, or non-modifiable, such as age and male gender. These guidelines deal with the management of dyslipidaemias as an essential and integral part of CVD prevention. Prevention and treatment of dyslipidaemias should always be considered within the broader framework of CVD prevention, which is addressed in guidelines of the Joint European Societies’ Task forces on CVD prevention in clinical practice.2 – 5 The latest version of these guidelines was published in 20075; an update will become available in 2012. These Joint ESC/European Atherosclerosis Society (EAS) guidelines on the management of dyslipidaemias are complementary to the guidelines on CVD prevention in clinical practice and address not only physicians [e.g. general practitioners (GPs) and cardiologists] interested in CVD prevention, but also specialists from lipid clinics or metabolic units who are dealing with dyslipidaemias that are more difficult to classify and treat.
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Claims the paper makes
205 Not checked yet · 82 No basis given · 26 Own interpretation · 2 Own method · 1 Supported · 1 Supported so far · 1 Partly supported · accuracy not yet measured
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In the paper
“The most recent Cholesterol Treatment Trialists' Collaboration (CTT) meta-analysis of several trials involving .170000 patients confirmed the dose-dependent reduction in CVD with LDL-C lowering.15”
§ Authors/Task Force Members > 5. Treatment targets
What the sources say
- Partly supportedcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet sourceExperimental — accuracy not yet measured
The Results report a 22% reduction in major vascular events per 1 mmol/L reduction in LDL cholesterol across 26 trials, supporting the dose-dependent finding. But the participant counts given in the Results total 169,138, not more than 170,000; the paper’s title rounds this to 170,000. (LLM, conf=0.87)
plaindirectn = 170,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The MedPed and WHO criteria have been used extensively to identify the HeFH phenotype (Table 19).157 Other commonly used criteria are the Dutch criteria 158 and the criteria from the Simon Broome register.159”
§ Authors/Task Force Members > 10.1.2 Familial hypercholesterolaemia
What the sources say
- Not checked yetcites [157] World Health Organization, Human Genetics Programme, 1999
- Not checked yetcites [158] Defesche, 2004, Advanced method for the identification of patients with inherited hypercholesterolemia, Semin Vasc Med source
- Supportedcites [159] Humphries, 2006, Genetic causes of familial hypercholesterolaemia in patients in the UK: relation to plasma lipid levels and coronary heart disease risk, J Med Genet source
The citation to this paper is attached to the Simon Broome criteria, not the separately cited MedPed/WHO or Dutch criteria. The Patient selection criteria section describes a study of patients with treated heterozygous familial hypercholesterolaemia in the Simon Broome cohort and says diagnostic criteria governed their selection; the paper does not spell out those criteria. (LLM, conf=0.85)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Recent data from a meta-analysis by the Emerging Risk Factor Collaboration 42 indicate that apo B does not provide any benefit beyond non-HDL-C or traditional lipid ratios.”
§ Authors/Task Force Members > Apolipoproteins
What the sources say
- Not checked yetcites [42] The Emerging Risk Factors Collaboration. Major lipids, apolipoproteins, and risk of vascular disease, 2009, JAMA source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In some age categories the vast majority, especially of men, will have estimated CV death risks exceeding the 5-10% level, based on age (and gender) only, even when other CV risk factor levels are relatively low.”
§ Authors/Task Force Members > 3.1 Total cardiovascular risk estimation
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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In the paper
“in another meta-analysis of LDL-C, non-HDL-C, and apo B, the latter was superior as a marker of CV risk.48”
§ Authors/Task Force Members > Apolipoproteins
What the sources say
- Not checked yetcites [48] Sniderman, Meta-analysis of LDL-C, non-HDL-C and apo B as markers of cardiovascular risk, Circulation
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“apo B provided no benefit beyond traditional lipid markers in people with diabetes in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.47”
§ Authors/Task Force Members > Apolipoproteins
What the sources say
- Not checked yetcites [47] Taskinen, 2010, Ability of traditional lipid ratios and apolipoprotein ratios to predict cardiovascular risk in people with type 2 diabetes, Diabetologia source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Every 1.0 mmol/L ( 40 mg/dL) reduction in LDL-C is associated with a corresponding 22% reduction in CVD mortality and morbidity.15”
§ Authors/Task Force Members > 5. Treatment targets
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
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In the paper
“Aerobic physical activity corresponding to a total energy expenditure of between 1500 and 2200 kcal/week, such as 25 -30 km of brisk walking per week (or any equivalent activity) may increase HDL-C levels by 0.08-0.15mmol/L (3.1 -6 mg/dL).77”
§ Authors/Task Force Members > 6.3 The influence of lifestyle on high-density lipoprotein-cholesterol levels
What the sources say
- Not checked yetcites [77] Kraus, 2002, Effects of the amount and intensity of exercise on plasma lipoproteins, N Engl J Med source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Smoking cessation may also contribute to HDL-C elevation.5,81”
§ Authors/Task Force Members > 6.3 The influence of lifestyle on high-density lipoprotein-cholesterol levels
What the sources say
- Not checked yetcites [5] Graham, 2007, European guidelines on cardiovascular disease prevention in clinical practice: Fourth Joint Task Force of the European Society of Cardiology and other societies, Eur J Cardiovasc Prev Rehabil source
- Not checked yetcites [81] Rabkin, 1984, Effect of cigarette smoking cessation on risk factors for coronary atherosclerosis. A control clinical trial, Atherosclerosis source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“At maximal recommended doses the different statins differ in their LDL-C-lowering capacity.”
§ Authors/Task Force Members > Meta-analyses
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 117
- Probably not a substantial claim. 33
Every source the paper cites for this claim was checked and supports it.
In the paper
“The HATS study showed not only a small regression of angiographically measured coronary plaques due to combined nicotinic acid and statin treatment as compared with progression observed on placebo, but also 90% lower risk of CV events, although in a very small number of patients.145”
§ Authors/Task Force Members > 8.5.2 Statins and nicotinic acid
What the sources say
- Supportedcites [145] Brown, 2001, Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease, N Engl J Med source
The Changes in the Severity of Proximal Stenosis section reports slight regression with simvastatin–niacin and progression with placebo. The Discussion reports a 90% lower rate of major clinical events than with placebo and cautions that the small study size produced wide confidence intervals. Page numbers are not available in our copy. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Supported
None of the sources cited for this claim have been checked yet.
In the paper
“The SCORE data indicate that the total CVD event risk is about three times higher than the risk of fatal CVD for men, so that a SCORE risk of 5% translates into a CVD risk of 15% of total (fatal plus non-fatal) hard CVD endpoints; the multiplier is slightly higher in women and lower in older persons.”
§ Authors/Task Force Members > 3.1 Total cardiovascular risk estimation
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The impact of diabetes on risk appears greater than in risk estimation systems based on the Framingham cohort, with relative risks of 5 in women and 3 in men.”
§ Authors/Task Force Members > 3.1 Total cardiovascular risk estimation
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“Information on episodes of increased liver enzymes was not examined in this meta-analysis.”
§ Authors/Task Force Members > Meta-analyses
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In the CTT meta-analyses of individual participant data from .170000 participants in 26 randomized trials of statins, 15 a 10% proportional reduction in all-cause mortality and 20% proportional reduction in CAD death per 1.0 mmol/L ( 40 mg/dL) LDL-C reduction is reported.”
§ Authors/Task Force Members > Meta-analyses
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plaindirectn = 170,000- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The benefits were significant within the first year, but were greater in subsequent years.”
§ Authors/Task Force Members > Meta-analyses
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The daily consumption of 2 g of phytosterols can effectively lower TC and LDL-C by 7-10% in humans, with little or no effect on HDL-C and TG levels when consumed with the main meal.67”
§ Authors/Task Force Members > Phytosterols
What the sources say
- Not checked yetcites [67] Abumweis, 2008, Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials, Food Nutr Res source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“Different commercial preparations of RYR have different concentrations of monacolins, the bioactive ingredients, and lower TC and LDL-C, 71 but the long-term safety of the regular consumption of these products is not fully documented.”
§ Authors/Task Force Members > Dietary fibre
What the sources say
- Not checked yetcites [71] Becker, 2009, Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial, Ann Intern Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“If 1% of the dietary energy derived from SFAs is replaced by monounsaturated fatty acids (MUFAs), LDL-C decreases by 0.041 mmol/L (1.6 mg/dL); if replaced by n-6 polyunsaturated fatty acids (PUFAs) the decrease would be 0.051 mmol/L (2.0 mg/dL); and if replaced by carbohydrate it would be 0.032 mmol/L (1.2 mg/dL).63”
§ Authors/Task Force Members > 6.1 The influence of lifestyle on total cholesterol and low-density lipoprotein-cholesterol levels
What the sources say
- Not checked yetcites [63] Mensink, 2003, Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials, Am J Clin Nutr source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Weight reduction improves insulin sensitivity and decreases TG levels.In many studies the reduction of TG levels due to weight reduction is between 20 and 30%”
§ Authors/Task Force Members > 6.2 The influence of lifestyle on triglyceride levels
What the sources say
- Not checked yetcites [70] Shaw, 2006, Exercise for overweight or obesity, Cochrane Database Syst Rev
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“Alcohol intake has a major negative impact on TG levels.While in individuals with HTG even a small amount of alcohol can induce a further elevation of TG concentrations, in the general population alcohol exerts detrimental effects on TG levels only if the intake exceeds what is considered a moderate consumption (up to 1-2 drinks/day corresponding to 10-30 g/day).74”
§ Authors/Task Force Members > 6.2 The influence of lifestyle on triglyceride levels
What the sources say
- Not checked yetcites [74] Rimm, 1999, Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors, BMJ source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“A high monounsaturated fat diet significantly improves insulin sensitivity compared with a high saturated fat diet.84 This goes in parallel with a reduction in TG levels”
§ Authors/Task Force Members > 6.2 The influence of lifestyle on triglyceride levels
What the sources say
- Not checked yetcites [84] Mattar, 2009, Fish oil and the management of hypertriglyceridemia, Nutr Health source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“The excess risk of rhabdomyolysis with statins was small and not significant.”
§ Authors/Task Force Members > Meta-analyses
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a low dose supplementation of a margarine with n-3 PUFAs (400 mg/day) or a-linolenic acid (2 g/day) did not significantly reduce TG levels in an RCT involving 4837 post-MI patients; neither did this supplementation reduce the rate of major CV events.92”
§ Authors/Task Force Members > Dietary fibre
What the sources say
- Not checked yetcites [92] Kromhout, 2010, n-3 Fatty acids and cardiovascular events after myocardial infarction, N Engl J Med source
plainn = 4,837- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“increases in HDL-C predict atherosclerosis regression and low HDL-C is associated with excess events and mortality in CAD patients, even when LDL-C is lower than 1.8 mmol/L or 70 mg/dL.”
§ Authors/Task Force Members > Targets other than low-density lipoprotein-cholesterol
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“Statins are generally well tolerated, and serious adverse events are rare.”
- Also stated in: § Muscle · plain
“Over 129 000 patients have been systematically studied in controlled trials with blinded randomized assignment to statin vs. placebo treatment groups.15”
§ Authors/Task Force Members > Muscle
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Muscle · plain
In the paper
“The risk for major coronary events was reduced by 23% and the risk for stroke was reduced by 17% per mmol/L (40 mg/dL) LDL-C reduction.”
§ Authors/Task Force Members > Meta-analyses
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“dietary fructose contributes to TG elevations; these effects are dose dependent and become clinically relevant when the intake is .10%energy daily-with a habitual fructose consumption between 15 and 20% of the energy intake, plasma TG increases as much as 30 -40%.”
§ Authors/Task Force Members > 6.2 The influence of lifestyle on triglyceride levels
What the sources say
- Not checked yetcites [76] Stanhope, 2009, Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans, J Clin Invest source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“In the FIELD study, small but significant increases in the incidence of pancreatitis (0.8% vs. 0.5%) and of pulmonary embolism (1.1% vs. 0.7%), and a non-significant trend toward an increase in deep vein thrombosis (1.4% vs. 1.0%) were seen in those taking fenofibrate compared with placebo; this is in line with data from other fibrate studies.127”
§ Authors/Task Force Members > Side effects and interactions
What the sources say
- Not checked yetcites [127] Keech, 2005, Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The drug reduces LDL-C and also improves glycated haemoglobin (Hb A1C ) in patients with type 2 diabetes.109,110”
§ Authors/Task Force Members > Efficacy in clinical studies
What the sources say
- Not checked yetcites [109] Levy P, 2010, Review of studies on the effect of bile acid sequestrants in patients with type 2 diabetes mellitus, Metab Syndr Relat Disord source
- Not checked yetcites [110] Fonseca, 2010, Colesevelam lowers glucose and lipid levels in type 2 diabetes: the clinical evidence, Diabetes Obes Metab source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Although the role of TG as a risk factor for CVD has been strongly debated, recent data strongly favour the role of TG-rich lipoproteins as a risk factor for CVD.121”
§ Authors/Task Force Members > 8. Drugs for treatment of hypertriglyceridaemia
What the sources say
- Not checked yetcites [121] Sarwar, 2010, Triglyceride-mediated pathways and coronary disease: collaborative analysis of 101 studies, Lancet source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“At the daily dose of 2 g it reduces TG by 20-40% and LDL-C by 15-18%, and increases HDL-C by 15-35%.130”
§ Authors/Task Force Members > Efficacy in clinical trials
What the sources say
- Not checked yetcites [130] Kamanna, 2008, Mechanism of action of niacin, Am J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“Fibrates are generally well tolerated with mild side effects, gastrointestinal disturbance being reported in 5% of the patients and skin rashes in 2%.128”
§ Authors/Task Force Members > Side effects and interactions
What the sources say
- Not checked yetcites [128] Davidson, 2007, Safety considerations with fibrate therapy, Am J Cardiol source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
In the paper
“The results of the SEAS study in patients with asymptomatic aortic stenosis showed that ezetimibe and simvastatin applied concomitantly reduce the incidence of ischaemic CVD events (up to 46% in the patients with less severe aortic stenosis) but not events related to aortic valve stenosis.38”
§ Authors/Task Force Members > 7.5.2 Statins and cholesterol absorption inhibitors
What the sources say
- Not checked yetcites [38] Rossebø, 2008, Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In clinical trials, bile acid sequestrants have contributed greatly to the original demonstration of the efficacy of LDL-C lowering in reducing CV events in hypercholesterolaemic subjects, with a benefit proportional to the degree of LDL-C lowering.108”
§ Authors/Task Force Members > Efficacy in clinical studies
What the sources say
- Not checked yetcites [108] Tyroler, 1984, Cholesterol and cardiovascular disease. An overview of Lipid Research Clinics (LRC) epidemiologic studies as background for the LRC Coronary Primary Prevention Trial, Am J Cardiol source
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Recent meta-analyses reported that fibrate therapy reduced major CVD events by 13% [95% confidence interval (CI) 7-19], the benefits being most robust in patients with elevated TG levels (.2.3 mmol/L or more than 200 mg/dl).52”
§ Authors/Task Force Members > Efficacy in clinical trials
What the sources say
- Not checked yetcites [52] Jun, 2010, Effects of fibrates on cardiovascular outcomes: a systematic review and meta-analysis, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The burden of HTG as a CVD risk factor is highlighted by the fact that about one-third of adult individuals have TG .1.7 mmol/L (more than 150 mg/dL).122”
§ Authors/Task Force Members > 8. Drugs for treatment of hypertriglyceridaemia
What the sources say
- Not checked yetcites [122] Kotseva, 2009, EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries, Eur J Cardiovasc Prev Rehabil source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Elevations of both CK (.5 times above the ULN) and ALT (.3 times above the ULN) were reported more frequently for patients on fenofibrate than on placebo, but the incidence of these abnormalities remained ,1% in both treatment groups.”
§ Authors/Task Force Members > Side effects and interactions
What the sources say
- Not checked yetcites [127] Keech, 2005, Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial, Lancet source
plaincorrelational- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“Nicotinic acid has broad lipid-modulating action, raising HDL-C in a dose-dependent manner by 25%, and reducing both LDL-C by 15 -18% and TG by 20-40% at the 2 g/day dose.”
§ Authors/Task Force Members > 7.4 Nicotinic acid
What the sources say
- Not checked yetcites [130] Kamanna, 2008, Mechanism of action of niacin, Am J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The data from these trials have shown consistent decreases in the rates of non-fatal MI (although often as a result of post-hoc analyses), the effect being most robust in subjects with elevated TG/low HDL-C levels.”
§ Authors/Task Force Members > Efficacy in clinical trials
What the sources say
- Not checked yetcites [124] Frick, 1987, Helsinki Heart Study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidaemia, N Engl J Med source
- Not checked yetcites [125] Rubins, 1999, Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol, N Engl J Med source
- Not checked yetcites [126] The BIP Study Group, 2000, Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with coronary artery disease. The Bezafibrate Infarction Prevention (BIP) Study, Circulation source
- Not checked yetcites [127] Keech, 2005, Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial, Lancet source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Functional food containing phytosterols as well as plant sterolcontaining tablets additionally reduce LDL-C levels by up to 5-10% in patients taking a stable dose of a statin, and this combination is also well tolerated and safe 67”
§ Authors/Task Force Members > 7.5.3 Other combinations
What the sources say
- Not checked yetcites [67] Abumweis, 2008, Plant sterols/stanols as cholesterol lowering agents: a meta-analysis of randomized controlled trials, Food Nutr Res source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In fact, although there is no evidence that hypolipidaemic treatment in elderly people prolongs life in patients without previous CVD, treatment reduces CV morbidity (stroke, MI) in elderly people in primary prevention.16”
§ Authors/Task Force Members > Primary prevention
What the sources say
- Not checked yetcites [16] Brugts, 2009, The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials, BMJ source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A more recent meta-analysis that included the large female subgroup from the JUPITER trial reported a 12% relative risk reduction (RRR) of total mortality with statin use in high risk subjects without established CVD, with no heterogeneity in treatment effect between men and women.16”
§ Authors/Task Force Members > Primary prevention
What the sources say
- Not checked yetcites [16] Brugts, 2009, The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials, BMJ source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The Cholesterol and Recurrent Events (CARE) trial evaluated the effect of pravastatin on coronary events after MI and showed major coronary events, coronary death, and stroke were reduced by, respectively, 32, 45, and 40% in elderly patients; the number needed to treat (NNT) of older patients for 5 years was 11 in order to prevent one major coronary event and 22 to prevent one coronary death.20”
§ Authors/Task Force Members > Secondary prevention
What the sources say
- Not checked yetcites [20] Lewis, 1998, Effect of pravastatin on cardiovascular events in older patients with myocardial infarction and cholesterol levels in the average range. Results of the Cholesterol and Recurrent Events (CARE) trial, Ann Intern Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Treatment with a combination of 4 g/day n-3 fatty acids and simvastatin caused a stronger reduction of TG concentrations and a small but significant increase in HDL-C when compared with statin alone.146”
§ Authors/Task Force Members > 8.5.3 Statins and n-3 fatty acids
What the sources say
- Not checked yetcites [146] Davidson, 2007, Efficacy and tolerability of adding rescription omega-3 fatty acids 4 g/d to simvastatin 40 mg/d in hypertriglyceridemic patients: an 8-week, randomized, double-blind, placebo-controlled study, Clin Ther source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The results of these trials concordantly showed that lipid-lowering therapy substantially reduces CV events in these patients, although no reduction in total mortality risk could be demonstrated.164”
§ Authors/Task Force Members > Secondary prevention
What the sources say
- Not checked yetcites [164] Walsh, 2004, Drug treatment of hyperlipidaemia in women, JAMA source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It could not reduce total mortality or improve cognitive dysfunction.26”
§ Authors/Task Force Members > Primary prevention
What the sources say
- Not checked yetcites [26] Shepherd, 2002, PROspective Study of Pravastatin in the Elderly at Risk. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial, Lancet source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The CTT meta-analysis showed no significant differences in RRR between younger and older people, 15 and neither did a recent meta-analysis of primary prevention trials.16”
§ Authors/Task Force Members > Primary prevention
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
- Not checked yetcites [16] Brugts, 2009, The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials, BMJ source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Results from an MI registry study in Sweden demonstrate that statin treatment is associated with lower CV mortality in very elderly post-MI patients without increasing the risk of the development of cancer.167”
§ Authors/Task Force Members > Secondary prevention
What the sources say
- Not checked yetcites [167] Gransbo, 2010, Cardiovascular and cancer mortality in very elderly post-myocardial infarction patients receiving statin treatment, J Am Coll Cardiol source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The meta-analysis of Walsh et al. 164 reported, in a cohort of 8272 females with previous CVD mainly treated with statins, a 26% reduction of CV mortality, a 29% reduction of MI, and a 20% reduction of total CAD events.”
§ Authors/Task Force Members > Secondary prevention
What the sources say
- Not checked yetcites [164] Walsh, 2004, Drug treatment of hyperlipidaemia in women, JAMA source
plaindirectn = 8,272- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“There is evidence from carotid ultrasound measurements that increased CIMT compared with siblings who have not inherited HeFH can be detected from the age of 10 years onwards, and that the progression of increasing CIMT can be ameliorated with statin therapy and/or apheresis.161”
§ Authors/Task Force Members > 10.2 Children
What the sources say
- Not checked yetcites [161] Mehta, 2009, Low-density lipoprotein apheresis as a treatment for hyperlipidaemia, Curr Treat Options Cardiovasc Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Among several studies that have evaluated the impact of lipid-lowering therapy on primary and secondary prevention of CAD, only a few have included women, usually in small numbers, and the results have often not been separately reported by gender.162”
§ Authors/Task Force Members > 10.3 Women
What the sources say
- Not checked yetcites [162] Jonsdottir, 2002, Do lipids, blood pressure, diabetes, and smoking confer equal risk of myocardial infarction in women as in men? The Reykjavik Study, J Cardiovasc Risk source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The average reduction of TG is 30% and the benefit seems to be dose dependent, being 45% in subjects with baseline TG values .5.6 mmol/L (496 mg/dL).135”
§ Authors/Task Force Members > Efficacy in clinical trials
What the sources say
- Not checked yetcites [135] Balk, 2006, Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review, Atherosclerosis source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Data from recent meta-analyses indicate that people with MetS have a 2-fold increase in CV outcomes and 1.5-fold increase in all-cause mortality.168”
§ Authors/Task Force Members > 10.5 Metabolic syndrome and diabetes
What the sources say
- Not checked yetcites [168] Mottillo, 2010, The metabolic syndrome and cardiovascular risk. A systematic review and meta-analysis, J Am Coll Cardiol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In one study EPA combined with low dose pravastatin or simvastatin compared with statin therapy alone reduced major coronary events without altering rates of sudden cardiac death.136”
§ Authors/Task Force Members > 8.5.3 Statins and n-3 fatty acids
What the sources say
- Not checked yetcites [136] Yokoyama, 2007, Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised openlabel, blinded endpoint analysis, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Hypertension, dyslipidaemia, and abdominal obesity commonly co-exist with type 2 diabetes and further aggravate the risk that is highest in people with type 2 diabetes and features of MetS.169”
§ Authors/Task Force Members > 10.5 Metabolic syndrome and diabetes
What the sources say
- Not checked yetcites [169] Liu, 2007, Ten-year risk of cardiovascular indidence related to diabetes, prediabetes, and the metabolic syndrome, Am Heart J source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“(1) Those with † known CVD † type 2 diabetes or type 1 diabetes with microalbuminuria † very high levels of individual risk factors † chronic kidney disease (CKD) are automatically at VERY HIGH or HIGH TOTAL CARDIOVASCULAR RISK and need active management of all risk factors.”
§ Authors/Task Force Members > 3.1 Total cardiovascular risk estimation
What the sources say
- Not checked yetcites [5] Graham, 2007, European guidelines on cardiovascular disease prevention in clinical practice: Fourth Joint Task Force of the European Society of Cardiology and other societies, Eur J Cardiovasc Prev Rehabil source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Rests on an assumption: Atherosclerotic cardiovascular disease results from multiple risk factors acting together.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The cut-off points that are used to define high risk are in part arbitrary and based on the risk levels at which benefit is evident in clinical trials.”
§ Authors/Task Force Members > 3.2 Risk levels
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“risk is a continuum and there is no threshold at which, for example, a drug is automatically indicated, and this is true for all continuous risk factors such as plasma cholesterol or systolic blood pressure.”
§ Authors/Task Force Members > 3.1 Total cardiovascular risk estimation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In practice, most risk estimation systems perform rather similarly when applied to populations recognizably similar to that from which the risk estimation system was derived, 6,7 and can be re-calibrated for use in different populations.6”
§ Authors/Task Force Members > 3.1 Total cardiovascular risk estimation
What the sources say
- Not checked yetcites [6] Cooney, 2009, Value and limitations of existing scores for the assessment of cardiovascular risk. A review for clinicians, J Am Coll Cardiol source
- Not checked yetcites [7] Cooney, 2010, Cardiovascular risk estimation systems in primary prevention. Do they differ? Do they make a difference? Can we see the future?, Circulation source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Atherosclerotic cardiovascular disease results from multiple risk factors acting together.
In the paper
“Based on the available evidence, apo B appears to be a risk factor at least as good as LDL-C and a better index of the adequacy of LDL-lowering therapy than LDL-C.46”
§ Authors/Task Force Members > Targets other than low-density lipoprotein-cholesterol
What the sources say
- Not checked yetcites [46] Charlton-Menys, 2009, Targets of statin therapy: LDL cholesterol, non-HDL cholesterol, and apolipoprotein B in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS), Clin Chem source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At any given age, risk estimates are lower for women than for men.This may be misleading since, eventually, at least as many women as men die of CVD.”
§ Authors/Task Force Members > Qualifiers
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Lipoproteins are heterogeneous classes of particles, and a lot of evidence suggests that the different subclasses of LDL and HDL may bear different risks for atherosclerosis.54”
§ Authors/Task Force Members > Lipoprotein particle size
What the sources say
- Not checked yetcites [54] Packard, 2006, Small dense low-density lipoprotein and its role as an independent predictor of cardiovascular disease, Curr Opin Lipidol source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The evidence showing that reducing TC and LDL-C can prevent CVD is strong and compelling, based on results from multiple randomized controlled trials (RCTs).”
- Also stated in: § Lipid and lipoprotein analyses · boosted
“multiple clinical trials have established beyond all reasonable doubt that, at least in high risk subjects, reduction of TC or LDL-C is associated with a statistically and clinically significant reduction in cardiovascular mortality.”
§ Authors/Task Force Members > 2.2 Dyslipidaemias
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Lipid and lipoprotein analyses · boosted
In the paper
“Extrapolating from the available data, an absolute reduction to an LDL-C level ,1.8 mmol/L (less than 70 mg/dL) or at least a 50% relative reduction in LDL-C provides the best benefit in terms of CVD reduction.15”
§ Authors/Task Force Members > 5. Treatment targets
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The ratio between apo B and apo A1 has been used in large prospective studies as an indicator of risk.”
§ Authors/Task Force Members > Apolipoprotein B/apolipoprotein A1 ratio, total cholesterol/high-density lipoprotein-cholesterol ratio, and non-high-density lipoprotein-cholesterol/ high-density lipoprotein-cholesterol ratio
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Current available evidence suggests that the clinical benefit is largely independent of the type of statin but depends on the extent of LDL-C lowering”
§ Authors/Task Force Members > Meta-analyses
What the sources say
- Not checked yetcites [15] Cholesterol Treatment Trialists' (CTT) Collaboration, 2010, Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170000 participants in 26 randomised trials, Lancet source
- Not checked yetcites [100] Catapano, 2009, Perspectives on low-density-lipoprotein cholesterol goal achievement, Curr Med Res Opin source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The specific target for non-HDL-C should be 0.8 mmol/L ( 30 mg/dL) higher than the corresponding LDL-C target; this corresponds to the LDL-C level augmented by the cholesterol fraction which is contained in 1.7 mmol/L ( 150 mg/dL) of TG”
§ Authors/Task Force Members > Targets other than low-density lipoprotein-cholesterol
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Statins reduce synthesis of cholesterol in the liver by competitively inhibiting HMG-CoA reductase activity.The reduction in intracellular cholesterol concentration induces low-density lipoprotein receptor (LDLR) expression on the hepatocyte cell surface, which results in increased extraction of LDL-C from the blood”
§ Authors/Task Force Members > Mechanism of action
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By binding the bile acids, the drugs prevent the entry of bile acid into the blood and thereby remove a large portion of the bile acids from the enterohepatic circulation.”
§ Authors/Task Force Members > Mechanism of action
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Bile acid sequestrants are not absorbed systemically and are not altered by digestive enzymes.
In the paper
“However, the fibrate-induced increase in homocysteine may blunt the increases in both HDL-C and apo A1, and this may contribute to the smaller than estimated benefits of fenofibrate in the outcome parameters.129”
§ Authors/Task Force Members > Side effects and interactions
What the sources say
- Not checked yetcites [129] Taskinen, 2009, Relationships of HDL cholesterol, apoA-I, and ApoA-II with homocysteine and creatinine in patients with type 2 diabetes treated with fenofibrate, Arterioscler Thromb Vasc Biol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“As fenofibrate does not share the same pharmacokinetic pathways as gemfibrozil, the risk of myopathy is much less with the combination therapy.128”
§ Authors/Task Force Members > Side effects and interactions
What the sources say
- Not checked yetcites [128] Davidson, 2007, Safety considerations with fibrate therapy, Am J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By inhibiting cholesterol absorption at the level of the brush border of the intestine (most probably by interacting with the NPC1L1 protein), ezetimibe reduces the amount of lipoprotein cholesterol circulated to the liver.”
§ Authors/Task Force Members > 7.3 Cholesterol absorption inhibitors
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Ezetimibe is the first lipid-lowering drug that inhibits intestinal uptake of dietary and biliary cholesterol without affecting fat-soluble nutrient absorption.
In the paper
“In the recent meta-analysis 146 of several intervention studies in dyslipidaemic patients, elevations in HDL-C varied with dose among the respective statins; such elevations were typically limited to the range of 5-10%.”
§ Authors/Task Force Members > 9.1 Statins
What the sources say
- Not checked yetcites [146] Davidson, 2007, Efficacy and tolerability of adding rescription omega-3 fatty acids 4 g/d to simvastatin 40 mg/d in hypertriglyceridemic patients: an 8-week, randomized, double-blind, placebo-controlled study, Clin Ther source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This was not confirmed in a recent RCT, yet the CAD was significantly reduced.38”
§ Authors/Task Force Members > Valvular disease
What the sources say
- Not checked yetcites [38] Rossebø, 2008, Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis, N Engl J Med source
plaindirectn = 1,873- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but being at higher absolute risk the absolute benefit will be greater resulting in a lower NNT.”
§ Authors/Task Force Members > Evidence for lipid-lowering therapy
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, there are potentially atherogenic changes in the composition of both HDL and LDL particles.”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“In a post-hoc analysis of the FIELD study, fenofibrate reduced CVD events by 27% in those with raised TG (.2.3 mmol/L or more than 204 mg/dL) and reduced HDL-C (NNT ¼ 23).172”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
What the sources say
- Not checked yetcites [172] Scott, 2009, Effects of fenofibrate treatment on cardiovascular disease risk in 9,795 individuals with type 2 diabetes and various components of the metabolic syndrome, Diabetes Care source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although non-controlled observational studies have shown favourable effects among statin users in HF trials, RCT studies do not support this notion.”
§ Authors/Task Force Members > 10.7 Heart failure and valvular diseases
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Onset of heart failure (HF) increases the risk of mortality and morbidity 3-4 times compared with patients without HF.”
§ Authors/Task Force Members > 10.7 Heart failure and valvular diseases
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Recent data from patients with type 2 diabetes in the FIELD study revealed that traditional lipid ratios (non-HDL-C/HDL-C, TC/ HDL-C) were as strong predictors for CVD risk as the apo B/apo A1 ratio, and captured the impact of both atherogenic and antiatherogenic particles on CVD risk.47”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
What the sources say
- Not checked yetcites [47] Taskinen, 2010, Ability of traditional lipid ratios and apolipoprotein ratios to predict cardiovascular risk in people with type 2 diabetes, Diabetologia source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Patients who have presented recently with an ACS are at high risk of experiencing further CV events.”
§ Authors/Task Force Members > 10.6 Patients with acute coronary syndrome and patients undergoing percutaneous coronary intervention
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In contrast to patients without HF, a low TC portends a poor prognosis in HF.”
§ Authors/Task Force Members > 10.7 Heart failure and valvular diseases
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A post-hoc analysis of patients with low HDL-C ,1 mmol/L (less than 40 mg/dL) and elevated TG .1.80mmol/L (more than 160 mg/dL) in the 4S trial demonstrated a relative risk for major coronary events of 0.48 with simvastatin.The respective relative risk for overall mortality was 0.44.174”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
What the sources say
- Not checked yetcites [174] Ballantyne, 2001, Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S, Circulation source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a meta-analysis of fibrates in the prevention of CVD in 11 590 people with type 2 diabetes showed that fibrates reduced the risk of non-fatal MI significantly by 21%, but had no effect on the risk of overall mortality or coronary mortality.175”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
What the sources say
- Not checked yetcites [175] Saha, 2009, Fibrates in the prevention of cardiovascular disease in patients with type 2 diabetes mellitus—a pooled meta-analysis of randomized placebo-controlled clinical trials, Int J Cardiol source
plaindirectn = 11,590- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The lipid profile in type 1 diabetic subjects with good glycaemic control is 'supernormal' and characterized by subnormal TG and LDL-C, whereas HDL-C is usually within the upper normal range or slightly elevated.”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The consumption of n-3 PUFAs, as either increased (oily) fish intake or a highly purified n-3 acid ethyl ester prescription medication, has in one study been shown to reduce mortality in survivors of MI, 178 but not in another.92”
§ Authors/Task Force Members > Specific lipid management issues in acute coronary syndrome
What the sources say
- Not checked yetcites [178] GISSI-Prevenzione Investigators, 1999, Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-prevenzione trial, Lancet source
- Not checked yetcites [92] Kromhout, 2010, n-3 Fatty acids and cardiovascular events after myocardial infarction, N Engl J Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The impairment of glycaemic control by nicotinic acid is seen at high doses, but at modest doses glycaemic control can in general be maintained by adjustment of diabetes therapy.176”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
What the sources say
- Not checked yetcites [176] Canner, 2005, Benefits of niacin by glycemic status in patients with healed myocardial infarction (from the Coronary Drug Project), Am J Cardiol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Conclusive evidence supports the proposition that hyperglycaemia accelerates atherosclerosis.”
§ Authors/Task Force Members > Triglycerides and high-density lipoprotein-cholesterol
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is an association between aortic stenosis, LDL-C, and Lp(a), and also between aortic stenosis and increased risk for CV events and mortality.”
§ Authors/Task Force Members > Valvular disease
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As fibrates have no effect on creatinine excretion into urine, the estimation of GFR is hampered by the rise of creatinine and is a problem in clinical practice.”
§ Authors/Task Force Members > Safety of lipid management in patients with chronic kidney disease
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The results from AURORA (A study to evaluate the Use of Rosuvastatin in subjects On Regular haemodialysis: an Assessment of survival and cardiovascular events) involving 2776 patients on haemodialysis 40 show that rosuvastatin lowered LDL-C as expected but had no significant effect on the composite CVD endpoint.”
§ Authors/Task Force Members > Lipoprotein profile in chronic kidney disease
What the sources say
- Not checked yetcites [40] Fellström, 2009, Rosuvastatin and cardiovascular events in patients undergoing hemodialysis, N Engl J Med source
plaindirectn = 2,776- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Lipid abnormalities are common in patients who have undergone solid organ transplantation, and predispose to the development of both atherosclerotic disease and transplant arterial vasculopathy, resulting in major vascular events.”
§ Authors/Task Force Members > 10.10 Transplantation patients
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Tacrolimus is also metabolized by CYP3A4 but appears to have less potential for harmful interaction with statins than ciclosporin.”
§ Authors/Task Force Members > 10.10 Transplantation patients
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“Following stroke or TIA, 34 patients are at risk not only of recurrent cerebrovascular events but also of other major CV events including MI.”
§ Authors/Task Force Members > Secondary prevention
What the sources say
- Not checked yetcites [34] Amarenco, 2006, High-dose atorvastatin after stroke or transient ischemic attack, N Engl J Med source
plaincorrelationaln = 34- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“As for cardiac events, a recent systematic review 202 of 18 trials including .10 000 patients, with cholesterol levels from normal to elevated, reported that lipid-lowering therapy in subjects affected by atherosclerosis of the lower limbs is associated with a 20% reduction in total CV events, together with a non-significant 14% reduction of all-cause mortality.”
§ Authors/Task Force Members > 10.11 Peripheral arterial disease
What the sources say
- Not checked yetcites [202] Maxwell, 2007, Lipid lowering for peripheral arterial disease of the lower limb, Cochrane Database Syst Rev
plaincorrelationaln = 10,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Several trials have shown the beneficial effects of lipid-lowering therapy on the progression of CIMT and on the prevention of CV events.”
§ Authors/Task Force Members > Carotid artery disease
plaindirectn = 3,443- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Calcineurin inhibitors increase the activity of hepatic lipase, decrease LPL, and bind the LDLR, resulting in reduced clearance of atherogenic lipoproteins.”
§ Authors/Task Force Members > 10.10 Transplantation patients
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“SHARP reported results in 9500 high risk subjects with CKD.Major atherosclerotic events were reduced by 17% (P ¼ 0.0022) and major vascular events by 15.3% (P ¼ 0.0012) in patients on ezetimibe plus simvastatin as compared with placebo.111”
§ Authors/Task Force Members > Lipoprotein profile in chronic kidney disease
What the sources say
- Not checked yetcites [111] SHARP Collaborative Group, 2010, Study of Heart and Renal Protection (SHARP): randomized trial to assess the effects of lowering low-density lipoprotein cholesterol among 9,438 patients with chronic kidney disease, Am Heart J source
plaindirectn = 9,500 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a meta-analysis of RCTs enrolling .90000 patients, Amarenco et al. reported that statin therapy determines a 21% reduction in the incidence of all strokes in different populations, with a strong correlation between LDL-C reduction and CIMT, pointing to a 0.73% per year reduction of CIMT for each 10% decrease of LDL-C.205”
§ Authors/Task Force Members > Carotid artery disease
What the sources say
- Not checked yetcites [205] Amarenco, 2004, Statins in stroke prevention and carotid atherosclerosis: systematic review and up-to-date meta-analysis, Stroke source
boosteddirectn = 90,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Atherosclerotic changes of retinal arteries correlate with TC, LDL-C, TG, and apo B levels and also with CAD.”
§ Authors/Task Force Members > Retinal artery atherosclerosis
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The diseases are characterized by inflammatory vasculitis and endothelial dysfunction.”
§ Authors/Task Force Members > 10.8 Autoimmune diseases
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In a recent survey in Europe the standardized CV mortality rate was 38 per 1000 person years (95% CI 37.2-39.0)higher in patients starting dialysis than in the general population.190”
§ Authors/Task Force Members > 10.9 Renal disease
What the sources say
- Not checked yetcites [190] de Jager, 2009, Cardiovascular and noncardiovascular mortality among patients starting dialysis, JAMA source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Safety issues and dose adjustment become important in more advanced stages of CKD (stages 3-5), as adverse events are commonly dose related and due to increased blood concentration of the compound.”
§ Authors/Task Force Members > Safety of lipid management in patients with chronic kidney disease
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The relationship between dyslipidaemia and atherothrombotic events including ischaemic stroke and transient ischaemic attack (TIA) is well recognized, while the association of dyslipidaemia with other types of stroke is uncertain.”
§ Authors/Task Force Members > 10.12 Stroke
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Altogether, most patients with stage 3-5 CKD have mixed dyslipidaemia and the lipid profile is highly atherogenic with adverse changes in all lipoproteins.”
§ Authors/Task Force Members > Lipoprotein profile in chronic kidney disease
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Consequently non-HDL-C and apo B levels are clearly increased.”
§ Authors/Task Force Members > Lipoprotein profile in chronic kidney disease
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Several potential drug interactions must also be considered, especially with ciclosporin which is metabolized through CYP3A4 and may increase systemic statin exposure and the risk of myopathy.”
§ Authors/Task Force Members > 10.10 Transplantation patients
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although the presence of abdominal aortic aneurysm represents a risk equivalent condition, there are currently no available clinical trials on CV risk reduction in patients affected by this condition.”
§ Authors/Task Force Members > Retinal artery atherosclerosis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Common general causes of dyslipidaemia in these patients are diabetes, obesity, MetS, and CKD.”
§ Authors/Task Force Members > 10.10 Transplantation patients
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Statins are generally well tolerated at moderate doses in subjects with CKD stages 1-2.”
§ Authors/Task Force Members > Safety of lipid management in patients with chronic kidney disease
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The prevalence of CKD, in particular mild to moderate CKD, is rapidly increasing worldwide.”
§ Authors/Task Force Members > 10.9 Renal disease
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The immune system is believed to be involved in the pathogenesis of atherosclerosis.”
§ Authors/Task Force Members > 10.8 Autoimmune diseases
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Although randomized trial data have shown that statins have the potential to improve outcomes in heart transplant patients 195 -197 and renal transplant patients, 198 the amounts of outcome data are not extensive.”
§ Authors/Task Force Members > 10.10 Transplantation patients
What the sources say
- Not checked yetcites [195] Kobashigawa, 1995, Effect of pravastatin on outcomes after cardiac transplantation, N Engl J Med source
- Not checked yetcites [196] Wenke, 1997, Simvastatin reduces graft vessel disease and mortality after heart transplantation: a four-year randomized trial, Circulation source
- Not checked yetcites [197] Page, 2005, Drug therapy in the heart transplant recipient part IV: drug–drug interactions, Circulation source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Patients with PAD are at elevated risk of coronary events, and the presence of peripheral vascular atherosclerosis represents an independent risk factor for MI and CV death.200,201”
§ Authors/Task Force Members > 10.11 Peripheral arterial disease
What the sources say
- Not checked yetcites [200] Mc Dermott, 2003, Knowledge and attitudes regarding cardiovascular disease risk and prevention in patients with coronary or peripheral arterial disease, Arch Intern Med source
- Not checked yetcites [201] Hertzer, 1987, Basic data concerning associated coronary disease in peripheral vascular patients, Ann Vasc Surg source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Dyslipidaemia comprises typically elevations of TG and lowering of HDL-C, whereas the changes of TC and LDL-C are less marked in stage 1 -2 CKD.”
§ Authors/Task Force Members > Lipoprotein profile in chronic kidney disease
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Glucocorticoid therapy causes weight gain and exacerbates insulin resistance, leading to increases in TC, VLDL, and TG, and in the size and density of LDL particles.”
§ Authors/Task Force Members > 10.10 Transplantation patients
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The value of other lipid-lowering therapies in the primary prevention of stroke is uncertain.”
§ Authors/Task Force Members > Primary prevention
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Cholesterol-lowering therapy reduces the risk of ischaemic CV events and worsening of claudication, and improves walking performance.”
§ Authors/Task Force Members > 10.11 Peripheral arterial disease
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Other important patient-related factors may include understanding and acceptance of the disease, perception of the health risk related to the disease, awareness of the costs and benefits of treatment, and active participation in monitoring and decision-making in relation to management of the disease.222”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
What the sources say
- Not checked yetcites [222] Reiner, 2010, Public perceptions of cardiovascular risk factors: the PERCRO survey, Prev Med source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is no predictive value of routine repeat CK testing for rhabdomyolysis since the test can rise with muscle injury or excess muscular exercise.”
§ Authors/Task Force Members > Table 33 Summary of recommendations for monitoring lipids and enzymes in patients on lipid-lowering therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Two of the most important factors contributing to poor adherence are undoubtedly the asymptomatic and lifelong nature of the disease.”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Response to therapy can be assessed at 6-8 weeks from initiation or dose increases for statins, but response to fibrates and lifestyle may take longer.”
§ Authors/Task Force Members > 11. Monitoring of lipids and enzymes in patients on lipid-lowering drug therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Other potential determinants of adherence may be related to: † demographic factors such as age and education † the patient's understanding and perception of dyslipidaemia † the healthcare provider's mode of delivering treatment † the relationships between patients and healthcare professionals † influences from the health systems, and † complex chronic drug regimens.”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Lipoprotein metabolism is influenced to a lesser extent by nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors.”
§ Authors/Task Force Members > 10.13 Human immunodeficiency virus patients
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Dietary changes and regular physical activity as well as switching to another HAART regimen may act favourably on dyslipidaemia, but most patients still need pharmacological therapy to reach the lipid goals.”
§ Authors/Task Force Members > 10.13 Human immunodeficiency virus patients
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Since HAART also increases blood pressure and insulin resistance, this could contribute to the increased CAD risk too.”
§ Authors/Task Force Members > 10.13 Human immunodeficiency virus patients
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, the aetiology of stroke may influence the response to statins, and those patients with evidence of atherothrombosis underlying their cerebrovascular events appear to benefit most, while those with haemorrhagic stroke may not benefit or may even be harmed by statins, particularly if patients do not have evidence of atherosclerotic disease.210”
§ Authors/Task Force Members > Secondary prevention
What the sources say
- Not checked yetcites [210] Amarenco, 2009, Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention, Lancet Neurol source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Secondary prevention therapy with statins reduces the risk of stroke, MI, and vascular death.”
§ Authors/Task Force Members > Secondary prevention
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“A systematic review 218 found that the incidence of drug-induced hepatotoxicity in patients taking lipid-lowering drugs is unknown, with few cases occurring in large-scale randomized trials.”
§ Authors/Task Force Members > Table 33 Summary of recommendations for monitoring lipids and enzymes in patients on lipid-lowering therapy
What the sources say
- Not checked yetcites [218] Law, 2003, Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease and stroke: systematic review and meta-analysis, BMJ source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Highly active antiretroviral treatment (HAART) causes an increase of LDL-C and TG, and predominance of small, dense LDL particles, thus doubling their CAD risk when compared with HIV-negative subjects.212”
§ Authors/Task Force Members > 10.13 Human immunodeficiency virus patients
What the sources say
- Not checked yetcites [212] Glass, 2006, Prevalence of risk factors for cardiovascular disease in HIV-infected patients over time: the Swiss HIV Cohort Study, HIV Med source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“the combination of rosuvastatin with lopinavir/ritonavir should also be used with caution.215”
§ Authors/Task Force Members > 10.13 Human immunodeficiency virus patients
What the sources say
- Not checked yetcites [215] Van der Lee, 2007, Pharmacokinetics and pharmacodynamics of combined use of lopinavir/ritonavir and rosuvastatin in HIV-infected patients, Antivir Ther source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Follow-up is advised at 6 or 12 monthly intervals to monitor potential toxic side effects, but such assessments have a limited scientific basis.”
§ Authors/Task Force Members > Table 33 Summary of recommendations for monitoring lipids and enzymes in patients on lipid-lowering therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No smoking, healthy eating, and being physically active are the foundations of preventive cardiology.”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, in everyday care, statins are usually prescribed at the lowest dose and often not up-titrated to achieve goals.”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These lifestyles are most effectively achieved through formal programmes of preventive care; such programmes are also more appropriate for initiating and up-titrating drug therapies, achieving the treatment goals, and adherence over the long-term which in turn improves eventfree survival.220”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
What the sources say
- Not checked yetcites [220] Rasmussen, 2007, Relationship between adherence to evidence-based pharmacotherapy and long-term mortality after acute myocardial infarction, JAMA source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It is unclear if only the process of monitoring is critical in achieving this, or a combination of education, regular contact, and adherence assessment.”
§ Authors/Task Force Members > 11. Monitoring of lipids and enzymes in patients on lipid-lowering drug therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Evidence for what tests should be carried out to monitor lipids in patients on treatment is limited.Similar limited evidence applies to tests of possible toxicity such as ALT and CK.Recommendations stem from consensus rather than evidence-based guidelines.”
§ Authors/Task Force Members > 11. Monitoring of lipids and enzymes in patients on lipid-lowering drug therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is limited evidence to suggest that some statins have more likelihood of being associated with muscle symptoms (but not CK change), or liver enzyme changes.”
§ Authors/Task Force Members > Table 33 Summary of recommendations for monitoring lipids and enzymes in patients on lipid-lowering therapy
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Standard practice for subsequent follow-up monitoring is 6-12 months, but such monitoring intervals are arbitrary.”
§ Authors/Task Force Members > 11. Monitoring of lipids and enzymes in patients on lipid-lowering drug therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Human immunodeficiency virus (HIV)-infected patients often have low TC and LDL-C as well as low HDL-C and increased TG.”
§ Authors/Task Force Members > 10.13 Human immunodeficiency virus patients
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Poor socioeconomic status, illiteracy, and unemployment are important risk factors for poor adherence.”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Not up-titrating the dose of statin, and poor adherence to this therapy, are the main reasons why over half of all coronary patients, and four out of five of all high risk patients, are not achieving the lipid goals and, as a consequence, are not achieving the maximum benefits of these preventive strategies.221”
§ Authors/Task Force Members > 12. How to improve adherence to lifestyle changes and compliance with drug therapy
What the sources say
- Not checked yetcites [221] Wood, 2008, Nurse-coordinated multidisciplinary, family-based cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster-randomised controlled trial, Lancet source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Epidemiological studies show that non-HDL-C and apo B measurement may correlate modestly better with outcomes, but there are no data on the use in routine clinical settings.”
§ Authors/Task Force Members > 11. Monitoring of lipids and enzymes in patients on lipid-lowering drug therapy
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Where statins are used, safety blood tests are advised by regulators, including ALT and CK at baseline to identify the limited number of patients where treatment is contraindicated.”
§ Authors/Task Force Members > Table 33 Summary of recommendations for monitoring lipids and enzymes in patients on lipid-lowering therapy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The authors state this as an assumption.
The Friedewald formula assumes a constant cholesterol-to-triglyceride ratio in VLDL.
“A constant cholesterol/TG ratio in VLDL is assumed.”
The paper relies on this without support.
Atherosclerotic cardiovascular disease results from multiple risk factors acting together.
“in most people, atherosclerotic CVD is the product of a number of risk factors.”
The paper relies on this without support.
Apolipoprotein B is the main apolipoprotein of VLDL, IDL, and LDL.
“Apo B is the major apolipoprotein of the atherogenic lipoprotein families VLDL, IDL, and LDL.”
The paper relies on this without support.
Apolipoprotein B concentration estimates the number of VLDL, IDL, and LDL particles in plasma.
“The concentration of apo B is a good estimate of the number of these particles in plasma.”
The paper relies on this without support.
Apolipoprotein A1 is the main protein of HDL and estimates HDL concentration.
“Apo A1 is the major protein of HDL and provides a good estimate of HDL concentration.”
The paper relies on this without support.
Plasma apolipoprotein A1 below 120 mg/dL in men and below 140 mg/dL in women corresponds to low HDL-cholesterol.
“Plasma apo A1 of ,120 mg/dL for men and ,140 mg/dL for women approximately correspond to what is considered as low for HDL-C.”
The paper relies on this without support.
Different lipid ratios give similar information.
“The different ratios give similar information.”
The paper relies on this without support.
Plasma lipoprotein(a) level is largely genetically determined.
“The plasma level of Lp(a) is to a major extent genetically determined.”
The paper relies on this without support.
Several genes are associated with cardiovascular disease.
“Several genes have been associated with CVD.”
The paper relies on this without support.
Apolipoprotein E exists in three isoforms: E2, E3, and E4.
“Apo E is present in three isoforms (apo E2, apo E3, and apo E4).”
The paper relies on this without support.
Treatment targets for dyslipidaemia are primarily based on clinical trial results.
“Treatment targets of dyslipidaemia are primarily based on results from clinical trials.”
The paper relies on this without support.
In nearly all lipid-lowering trials, LDL-cholesterol was used as the indicator of response to therapy.
“In nearly all lipid-lowering trials the LDL-C level has been used as an indicator of response to therapy.”
The paper relies on this without support.
In most patients, an LDL-cholesterol target below 1.8 mmol/L or a 50% reduction is achievable with statin monotherapy.
“In the majority of patients, this is achievable with statin monotherapy.”
The paper relies on this without support.
Apolipoprotein B determination has less laboratory error than LDL-cholesterol determination, particularly in patients with hypertriglyceridaemia.
“there now appears to be less laboratory error in the determination of apo B than of LDL-C, particularly in patients with HTG.”
The paper relies on this without support.
Apolipoprotein B is not presently measured in all clinical laboratories.
“However, apo B is not presently being measured in all clinical laboratories.”
The paper relies on this without support.
No specific targets for HDL-cholesterol or triglycerides have been determined in clinical trials.
“To date, no specific targets for HDL-C or TG levels have been determined in clinical trials”
The paper relies on this without support.
Clinical trial evidence is lacking on whether intervening on HDL-cholesterol or triglycerides reduces cardiovascular risk further.
“clinical trial evidence is lacking on the effectiveness of intervening on these variables to reduce CV risk further”
The paper relies on this without support.
Advanced age, small body size, female sex, renal or hepatic dysfunction, perioperative periods, hypothyroidism, multisystem disease, and alcohol abuse raise the chance of statin side effects.
“Factors such as advanced age, small body size, female gender, renal and hepatic dysfunction, perioperative periods, hypothyroidism, multisystem disease, and alcohol abuse increase the likelihood of side effects with statins.”
The paper relies on this without support.
The most serious adverse effect of statins is myopathy, which can progress to rhabdomyolysis and then to renal failure and death.
“The most serious adverse effect associated with statin therapy is myopathy, which may progress to rhabdomyolysis, and that, in turn, can lead to renal failure and death.”
The paper relies on this without support.
An increase in creatine phosphokinase is the best, though not definitive, indicator of statin-induced myopathy.
“An elevation of CK is the best indicator, although not unequivocal, of statin-induced Table 13 Examples of causes of secondary hypercholesterolaemia myopathy.”
The paper relies on this without support.
In clinical trials, myopathy occurs in fewer than 1 per 1000 treated patients, and the excess risk versus placebo is less than 1 per 10 000 treated patients.
“The incidence of myopathy is low (,1/1000 patients treated) and the excess risk in comparison with placebotreated patients has been ,1/10 000 patients treated in clinical trials.”
The paper relies on this without support.
Myopathy is most likely in people with complex medical problems, those taking multiple medications, and elderly individuals, especially women.
“Myopathy is most likely to occur in persons with complex medical problems and/or who are taking multiple medications, or in elderly persons, especially women.”
The paper relies on this without support.
Myalgia without creatine phosphokinase elevation occurs in 5–10% of patients in clinical practice.
“Myalgia (without CK elevation) occurs in 5-10% of patients in clinical practice.”
The paper relies on this without support.
Elevated hepatic transaminases occur in 0.5–2.0% of statin-treated patients and are dose dependent.
“Elevated hepatic transaminases occur in 0.5 -2.0% of statin-treated patients and are dose dependent.”
The paper relies on this without support.
Progression to liver failure is exceedingly rare.
“Progression to liver failure is exceedingly rare.”
The paper relies on this without support.
Transaminase elevation often reverses when the dose is reduced.
“Reversal of transaminase elevation is frequently noted with reduction of dose;”
The paper relies on this without support.
Several important drug interactions with statins can raise the risk of side effects.
“A number of important drug interactions with statins have been described that may increase the risk of side effects.”
The paper relies on this without support.
All currently available statins except pravastatin, rosuvastatin, and pitavastatin undergo major hepatic metabolism through cytochrome P450 enzymes.
“All currently available statins, except pravastatin, rosuvastatin, and pitavastatin, undergo major hepatic metabolism via the CYPs.”
The paper relies on this without support.
Bile acid sequestrants are not absorbed systemically and are not altered by digestive enzymes.
“The bile acid sequestrants are not systemically absorbed or altered by digestive enzymes.”
The paper relies on this without support.
Bile acid sequestrants also lower glucose levels in hyperglycaemic patients, though the mechanism is not fully clear.
“These agents also reduce glucose levels in hyperglycaemic patients; however, the mechanism behind this reduction is not completely clear.”
The paper relies on this without support.
At maximum doses—24 g cholestyramine, 20 g colestipol, or 4.5 g colestagel—LDL-C falls by 18–25%.
“At the top dose of 24 g of cholestyramine, 20 g of colestipol, or 4.5 g of cholestagel, a reduction in LDL-C of 18-25% has been observed.”
The paper relies on this without support.
Bile acid sequestrants have no major effect on HDL-C, but triglycerides may rise in some predisposed patients.
“No major effect on HDL-C has been reported, while TG may increase in some predisposed patients.”
The paper relies on this without support.
Gastrointestinal side effects—most often flatulence, constipation, dyspepsia, and nausea—are common with bile acid sequestrants even at low doses and limit their practical use.
“Gastrointestinal adverse effects (most commonly flatulence, constipation, dyspepsia and nausea) are often present with these drugs even at low doses, which limit their practical use.”
The paper relies on this without support.
Reduced absorption of fat-soluble vitamins has been reported with bile acid sequestrants.
“Reduced absorption of fat-soluble vitamins has been reported.”
The paper relies on this without support.
Bile acid sequestrants may raise triglycerides in some patients.
“Furthermore, these drugs may increase TG in certain patients.”
The paper relies on this without support.
Bile acid sequestrants have important interactions with many commonly prescribed drugs.
“Bile acid sequestrants have important drug interactions with many commonly prescribed drugs and should therefore be administered either 4 h before or 1 h after other drugs.”
The paper relies on this without support.
Colesevelam is a newer bile acid sequestrant that may be better tolerated than cholestyramine.
“Colesevelam represents a newer formulation of the bile acid sequestrant, which may be better tolerated than cholestyramine.”
The paper relies on this without support.
Colesevelam has fewer interactions with other drugs and can be taken with statins.
“Colesevelam has fewer interactions with other drugs and can be taken together with statins.”
The paper relies on this without support.
Ezetimibe is the first lipid-lowering drug that inhibits intestinal uptake of dietary and biliary cholesterol without affecting fat-soluble nutrient absorption.
“Ezetimibe is the first lipid-lowering drug that inhibits intestinal uptake of dietary and biliary cholesterol without affecting the absorption of fat-soluble nutrients.”
The paper relies on this without support.
In clinical studies, ezetimibe monotherapy lowers LDL-C by 15–22% in hypercholesterolaemic patients.
“In clinical studies ezetimibe in monotherapy reduces LDL-C in hypercholesterolaemic patients by 15-22%.”
The paper relies on this without support.
Adding ezetimibe to a statin gives an additional LDL-C reduction of 15–20%.
“Combined therapy with ezetimibe and a statin provides an incremental reduction in LDL-C levels of 15 -20%.”
The paper relies on this without support.
Ezetimibe is rapidly absorbed and extensively metabolized to the active ezetimibe glucuronide.
“Ezetimibe is rapidly absorbed and extensively metabolized to the pharmacologically active ezetimibe glucuronide.”
The paper relies on this without support.
Age, sex, and race have no clinically significant effect on ezetimibe pharmacokinetics, and no dose adjustment is needed for mild hepatic impairment or mild to severe renal insufficiency.
“There are no clinically significant effects of age, sex, or race on ezetimibe pharmacokinetics, and no dosage adjustment is necessary in patients with mild hepatic impairment or mild to severe renal insufficiency.”
The paper relies on this without support.
Ezetimibe can be co-administered with any dose of any statin.
“Ezetimibe can be co-administered with any dose of any statin.”
The paper relies on this without support.
No major side effects have been reported for ezetimibe; the most frequent are moderate liver enzyme elevations and muscle pain.
“No major side effects have been reported; the most frequent side effects are moderate elevations of liver enzymes, and muscle pain.”
The paper relies on this without support.
Adding a bile acid sequestrant to a statin lowers LDL-C by an additional 10–20% on average.
“On average the addition of a bile acid sequestrant to a statin reduces LDL-C further by 10 -20%.”
The paper relies on this without support.
Adding ezetimibe to a bile acid sequestrant (colesevelam, colestipol, or cholestyramine) further lowers LDL-C without extra adverse effects compared with the sequestrant alone.
“Co-administration of ezetimibe and bile acid sequestrants (colesevelam, colestipol, or cholestyramine) resulted in an additional reduction of LDL-C levels without any additional adverse effects when compared with the stable bile acid sequestrant regimen alone.”
The paper relies on this without support.
Adding ezetimibe to nicotinic acid further lowers LDL-C and does not affect the HDL-C increase caused by nicotinic acid.
“Adding ezetimibe to nicotinic acid further reduces LDL-C and does not affect nicotinic acid-induced HDL-C increase.”
The paper relies on this without support.
Triple therapy with a bile acid sequestrant, a statin, and either ezetimibe or nicotinic acid further lowers LDL-C.
“Also triple therapy (bile acid sequestrant, statin, and ezetimibe or nicotinic acid) will further reduce LDL-C.”
The paper relies on this without support.
Acute pancreatitis is one of the major clinical risks of markedly elevated triglycerides.
“One of the major clinical risks of dramatically elevated TG is acute pancreatitis.”
The paper relies on this without support.
The risk of pancreatitis becomes clinically significant when triglycerides exceed 10 mmol/L (880 mg/dL).
“The risk of pancreatitis is clinically significant if TG exceed 10 mmol/L (more than 880 mg/dL) and actions to prevent acute pancreatitis are mandatory.”
The paper relies on this without support.
Hypertriglyceridaemia causes 10% of all pancreatitis cases.
“Notably HTG is the cause of 10% of all cases with pancreatitis,”
The paper relies on this without support.
Pancreatitis can occur even when triglyceride levels are between 5 and 10 mmol/L (440–880 mg/dL).
“and patients can develop pancreatitis even when their TG concentration is between 5 and 10 mmol/L ( 440 -880 mg/dL).”
The paper relies on this without support.
In general, triglyceride levels fall sharply within 2–5 days.
“In general a sharp decrease of TG values is seen within 2-5 days.”
The paper relies on this without support.
The effect of lifestyle management on triglyceride levels is well documented.
“The influence of lifestyle management on TG levels is well documented.”
The paper relies on this without support.
Weight reduction plus regular moderate-intensity physical activity can lower triglycerides by 20–30%.
“Weight reduction together with a regular physical activity programme of moderate intensity can reduce TG between 20 and 30%,”
The paper relies on this without support.
Statins have significant effects on mortality and most cardiovascular outcome parameters.
“As statins have significant effects on mortality as well as most CVD outcome parameters, these drugs are the first choice to reduce both total CVD risk and moderately elevated TG levels.”
The paper relies on this without support.
More potent statins—atorvastatin, rosuvastatin, and pitavastatin—robustly lower triglycerides, especially at high doses and in patients with elevated triglycerides.
“More potent statins (atorvastatin, rosuvastatin, and pitavastatin) demonstrate a robust lowering of TG levels, especially at high doses and in patients with elevated TG.”
The paper relies on this without support.
Fibrates are PPAR-α agonists that act through transcription factors regulating lipid and lipoprotein metabolism.
“Fibrates are agonists of peroxisome proliferator-activated receptor-a (PPAR-a), acting via transcription factors regulating various steps in lipid and lipoprotein metabolism.”
The paper relies on this without support.
Myopathy risk is higher in patients with chronic kidney disease and varies with the fibrate and statin used in combination.
“The risk of myopathy is greater in patients with CKD, and it varies with different fibrates and statins used in combination.”
The paper relies on this without support.
Gemfibrozil inhibits statin metabolism through glucuronidation, greatly increasing statin plasma concentrations.
“Gemfibrozil inhibits the metabolism of statins via the glucuronidation pathway that leads to highly increased plasma concentrations of statins.”
The paper relies on this without support.
Fibrates as a class have been reported to raise serum creatinine and homocysteine in short- and long-term studies, but the effect appears fibrate-specific.
“As a class, fibrates have been reported to raise both serum creatinine and homocysteine in both short-term and long-term studies, but the effect seems to be fibrate specific.”
The paper relies on this without support.
The homocysteine increase caused by fibrates has been considered relatively innocent for cardiovascular risk.
“The increase in homocysteine by fibrates has been considered to be relatively innocent with respect to CVD risk.”
The paper relies on this without support.
Nicotinic acid has been reported to reduce fatty acid influx to the liver and hepatic VLDL secretion, partly through effects on hormone-sensitive lipase in adipose tissue.
“Nicotinic acid has been reported to decrease fatty acid influx to the liver and the secretion of VLDL by the liver; this effect appears to be mediated in part by the effects on hormone-sensitive lipase in the adipose tissue.”
The paper relies on this without support.
In clinical practice, flushing is the most frequent and troublesome side effect of nicotinic acid and its derivatives, often preventing dose titration to maximal efficacy even with aspirin.
“In clinical practice, skin reactions (flushing) are the most frequent and troublesome side effect of nicotinic acid and its derivatives, often preventing titration of the dose to maximal efficacy, even using aspirin as a modulator of flushing.”
The paper relies on this without support.
Other side effects of nicotinic acid include hyperuricaemia, liver toxicity, and acanthosis nigricans.
“Other side effects of nicotinic acid include hyperuricaemia, liver toxicity, and acanthosis nigricans.”
The paper relies on this without support.
The mediator is prostaglandin D2 released from arachidonic acid.
“The mediator is prostaglandin D2 released from arachidonic acid.”
The paper relies on this without support.
A recent survey found that fewer than 15% of new users of extended-release nicotinic acid were still taking it after 1 year.
“A recent survey revealed that ,15% of new users of ER nicotinic acid were still using the drug after 1 year.”
The paper relies on this without support.
Liver enzyme elevation with extended-release nicotinic acid is less common (<1%) than with older nicotinic acid compounds.
“Elevation of liver enzymes in users of ER nicotinic acid is less common (,1%) than with previous nicotinic acid compounds.”
The paper relies on this without support.
Nicotinic acid may interfere with glycaemic control by raising blood glucose, which is a concern in diabetes.
“The issue that nicotinic acid may interfere with glycaemic control by increasing blood glucose levels is of concern in treating people with diabetes.”
The paper relies on this without support.
At pharmacological doses above 2 g/day, n-3 fatty acids affect serum lipids and lipoproteins, especially VLDL concentration.
“n-3 fatty acids at pharmacological doses (.2 g/day) affect serum lipids and lipoproteins, in particular VLDL concentration.”
The paper relies on this without support.
Fish oil lowers triglycerides by 30%, but its effects on other lipoproteins are trivial.
“Fish oil reduces TG by 30%, but the effects on other lipoproteins are trivial in their magnitude.”
The paper relies on this without support.
n-3 fatty acid administration appears safe and free of clinically significant interactions.
“The administration of n-3 fatty acids appears to be safe and devoid of clinically significant interactions.”
The paper relies on this without support.
The antithrombotic effects of n-3 fatty acids may increase bleeding tendency, especially when added to aspirin or clopidogrel.
“However, the antithrombotic effects may increase the propensity to bleed, especially when given in addition to aspirin/clopidogrel.”
The paper relies on this without support.
Patients taking nicotinic acid with a statin—mostly simvastatin or atorvastatin—report similar all-cause adverse event rates, and flushing incidence is similar with and without statin treatment.
“Patients taking concomitant statin therapy, mostly simvastatin or atorvastatin, with nicotinic acid report a similar incidence of all-cause adverse events, and the incidence of flushing is similar in patients with and without statin treatment.”
The paper relies on this without support.
Adding n-3 fatty acids to pravastatin and fenofibrate further lowered triglycerides and homocysteine in patients with diabetic dyslipidaemia.
“Adding n-3 fatty acids to pravastatin and fenofibrate in a triple combination further decreased TG concentrations and homocysteine as well in patients with diabetic dyslipidaemia.”
The paper relies on this without support.
No significant interactions of any drug with n-3 fatty acids have been described.
“No significant interactions of any drug with n-3 fatty acids have been described.”
The paper relies on this without support.
Therapeutic lifestyle changes (weight reduction, exercise, smoking cessation, and moderate alcohol consumption) can increase HDL-C levels by up to 10%.
“While HDL-C levels may be increased by up to 10% by implementing therapeutic lifestyle changes, including weight reduction, exercise, smoking cessation, and moderate alcohol consumption”
The paper relies on this without support.
Fibrates lower TG levels by up to 50% and raise HDL-C by up to 10-15% in short-term studies.
“As a class, fibrates differ in their potential to modulate the atherogenic lipid profile by concomitantly lowering TG levels (up to 50%) and by raising those of HDL-C (up to 10 -15% in short-term studies).”
The paper relies on this without support.
CETP inhibition by small molecule inhibitors is the most efficacious pharmacological approach to elevating low HDL-C levels.
“To date, the most efficacious pharmacological approach to elevation of low HDL-C levels has involved direct inhibition of cholesteryl ester transfer protein (CETP) by small molecule inhibitors”
The paper relies on this without support.
The deleterious effects of torcetrapib arose primarily from off-target toxicity related to activation of the renin-angiotensin-aldosterone system (RAAS).
“Retrospectively, it appears that the deleterious effects of torcetrapib arose primarily from off-target toxicity related to activation of the renin-angiotensin -aldosterone system (RAAS).”
The paper relies on this without support.
HeFH affects 1 in 500 people of European descent.
“Heterozygous familial hypercholesterolaemia (HeFH) affects 1 in 500 people of European descent.”
The paper relies on this without support.
FCH is a common genetic dyslipidaemia (1:100) and a major cause of premature CAD.
“FCH is a highly prevalent genetic dyslipidaemia (1:100) and an important cause of premature CAD.”
The paper relies on this without support.
Elevated LDL-C is more dangerous when HTG coexists.
“It emphasizes both the importance of considering family history in deciding how rigorously to treat dyslipidaemia, and that raised LDL-C levels are riskier when HTG is also present.”
The paper relies on this without support.
Statins lower CV risk by the same relative amount in people with and without HTG.
“Statin treatment has been shown to decrease CV risk by the same relative amount in people with HTG as in those without.”
The paper relies on this without support.
Without treatment, most HeFH patients develop symptomatic coronary disease by age 60, and half of men and 15% of women die.
“Untreated, the majority of affected men and women will have symptomatic coronary disease by 60 years and half of the men and 15% of the women will have died.”
The paper relies on this without support.
Tendon xanthomata are virtually diagnostic of HeFH.
“The presence of tendon xanthomata is, however, virtually diagnostic of HeFH.”
The paper relies on this without support.
In HeFH, TC levels are elevated from birth.
“High TC levels are present from birth in HeFH.”
The paper relies on this without support.
HoFH is rare in Europeans (about 1 in 10^6 births) except with founder effects or consanguinity.
“HoFH is rare in European populations ( 1 in 10 6 births) unless there is a founder gene effect or consanguinity”
The paper relies on this without support.
Without treatment, HoFH usually causes death in adolescence or early adulthood from myocardial ischaemia or aortic stenosis.
“Regardless of this, HoFH is always an extremely serious disease, which untreated leads to death typically in adolescence or early adulthood due to myocardial ischaemia or aortic stenosis.”
The paper relies on this without support.
Familial dysbetalipoproteinaemia is uncommon and usually follows autosomal recessive inheritance with variable penetrance.
“Familial dysbetalipoproteinaemia (syn.type III hyperlipoproteinaemia; remnant removal disease) is rare and is generally inherited as an autosomal recessive disorder with variable penetrance.”
The paper relies on this without support.
CAD risk is very high in familial dysbetalipoproteinaemia.
“The risk of CAD is very high, and accelerated atherosclerosis of the femoral and tibial arteries is also prevalent.”
The paper relies on this without support.
Familial LPL deficiency is an uncommon cause of severe HTG.
“Familial LPL deficiency is a rare cause of severe HTG which may cause severe disorders of the pancreas.”
The paper relies on this without support.
The most common genetic hypolipidaemia is hypobetalipoproteinaemia.
“The most common genetic hypolipidaemia is hypobetalipoproteinaemia which is dominantly inherited and often due to truncation of apo B.”
The paper relies on this without support.
Very high levels of HDL-C in CETP deficiency are not associated with disease.
“This is not associated with disease.”
The paper relies on this without support.
Low-dose third-generation oral contraceptives do not seem to raise adverse coronary event risk.
“Currently used third-generation low oestrogen-progestin dose oral contraceptives do not appear to increase adverse coronary events”
The paper relies on this without support.
Older adults are less likely to be prescribed lipid-lowering drugs or to adhere to statins.
“Elderly individuals are less likely to receive lipid-lowering medications or adhere to statin therapy.”
The paper relies on this without support.
Chronic kidney disease is a coronary artery disease risk equivalent.
“CKD is acknowledged as a CAD risk equivalent.”
The authors state this as an assumption.
Most problems related to adherence to lifestyle changes are similar to those related to compliance with lipid-lowering drug therapy.
“Most of the problems related to adherence to lifestyles are currently assumed to be similar to those related to compliance with lipid-lowering drug therapy.”
The paper relies on this without support.
Health system issues play an important role in promoting adherence.
“Issues related to health systems also play an important role in the promotion of adherence.”
The paper relies on this without support.
In most low-income countries, medication supplies are limited and often must be purchased out-of-pocket.
“In most low income countries, supplies of medications are limited and they often have to be bought out-of-pocket.”
The paper relies on this without support.
Strategies that improve access to drugs, such as sustainable financing, affordable prices, and reliable supply systems, have an important influence on patient adherence.
“Strategies for improving access to drugs such as sustainable financing, affordable prices, and reliable supply systems have an important influence on patient adherence.”
The paper relies on this without support.
Determinants of adherence to hypolipidaemic therapy include drug tolerability, regimen complexity, drug costs, and treatment duration.
“Some of the better recognized determinants of adherence to hypolipidaemic therapy are related to aspects of the drug treatment itself, and include drug tolerability, regimen complexity, drug costs, and treatment duration.”
The paper relies on this without support.
Regimen complexity is a treatment-related factor identified as a possible cause of poor adherence.
“The complexity of the regimen is, for instance, a treatmentrelated factor that has been identified as a possible cause of poor adherence.”
The paper relies on this without support.
Frequency of dosing, number of concurrent medications, and changes in medications contribute to regimen complexity.
“Frequency of dosing, number of concurrent medications, and changes in medications are some of the factors that contribute to the complexity of a regimen, and these have been investigated in many observational studies.”
The paper relies on this without support.
Fewer daily doses, monotherapies, and fewer changes in medications are associated with better adherence.
“Fewer daily doses of drugs, monotherapies, and fewer changes in medications have all been associated with better adherence.”
The paper relies on this without support.
The listed adherence interventions have tended to be used alone.
“While many interventions (e.g.education in self-management; pharmacy management programmes; nurse, pharmacist, and other non-medical health professional intervention protocols; counselling; behavioural interventions; follow-up; and reminders) have been shown to be effective in significantly improving adherence rates, 224 they have tended to be used alone.”
The paper relies on this without support.
Several programmes have demonstrated good results using multilevel team approaches.
“Several programmes have demonstrated good results using multilevel team approaches.”
The paper relies on this without support.
Patients with dyslipidaemia have low rates of adherence.
“Healthcare providers need to be made aware of the low rates of adherence of patients with dyslipidaemia.”
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 cited source says what the claim attributes to it.
In the citing paper
“The evidence that reducing plasma LDL cholesterol reduces CVD risk is unequivocal”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [42]
In the citing paper
“Measurement of Lp(a) has been shown to provide clinically significant improved risk reclassification under certain conditions”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [112]
In the citing paper
“Familial hypercholesterolaemia is a dominantly inherited condition affecting 1 in 500 people of European descent (heterozygous) most commonly caused by a mutation of the LDL receptor, and is characterized by very high levels of LDL cholesterol (usually 5-10 mmol/L or 200-400 mg/dL).42”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [42]
In the citing paper
“CKD (stages 2 -5, i.e.GFR ,90 mL/min/1.73m 2 ) is acknowledged as a CHD risk-equivalent, and the LDL cholesterol target in these patients has been adapted to the degree of renal failure (see page 1653).42”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [42]
In the citing paper
“In both the 2011 EAS/ESC guidelines for the management of dyslipidaemias 125 and the American Heart Association/American College of Cardiology (AHA/ACC) guidelines on the treatment of blood cholesterol to reduce atherosclerotic CV risk in adults, 71 the importance of LDL-C lowering to prevent CVD is strongly emphasized.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [125]
In the citing paper
“In both the 2011 EAS/ESC guidelines for the management of dyslipidaemias 125 and the American Heart Association/American College of Cardiology (AHA/ACC) guidelines on the treatment of blood cholesterol to reduce atherosclerotic CV risk in adults, 71 the importance of LDL-C lowering to prevent CVD is strongly emphasized.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [125]
In the citing paper
“Of course, drugs are also effective [14], such as fibrates, fish oil and niacin [15].”
From Effects of aerobic exercise on lipids and lipoproteins (2017) · cites this paper as [14]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Authors/Task Force Members > 9.1 Statins
“In the recent meta-analysis 146 of several intervention studies in dyslipidaemic patients, elevations in HDL-C varied with dose among the respective statins; such elevations were typically limited to the range of 5-10%.”
§ Authors/Task Force Members > References
“146. Davidson MH, Stein EA, Bays HE, Maki KC, Doyle RT, Shalwitz RA, Ballantyne CM, Ginsberg HN; COMBination of prescription Omega-3 with Sim- vastatin (COMBOS) Investigators. Efficacy and tolerability of adding rescription omega-3 fatty acids 4 g/d to simvastatin 40 mg/d in hypertriglyceridemic patients: an 8-week, randomized, double-blind, placebo-controlled study.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Authors/Task Force Members > Secondary prevention
“A recent meta-analysis suggests that nicotinic acid alone or in combination with statin may add further benefit in stroke prevention.133”
§ Authors/Task Force Members > References
“133. Lee JM, Robson MD, Yu LM, Shirodaria CC, Cunnington C, Kylintireas I, Digby JE, Bannister T, Handa A, Wiesmannn F, Durrington PN, Channon KM, Neubauer S, Choudhury RP. Effects of high-dose modified-release nicotinic acid on atherosclerosis and vascular function: a randomized, placebo-controlled, magnetic resonance imaging study.”
Citations
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Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
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European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490
Self-citationOLSSON, A. G., McMurray, J. J. V., Thorgeirsson, G., Spaulding, C. M., Slattery, J., Pyörälà, K., Færgeman, O., Wright, R. S., Berg, K. M., Wilhelmsen, L., et al. (1994) · The Lancet · Cited by 8,467
Self-citationGeneral Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study
D’Agostino, R. B., Vasan, R. S., Pencina, M. J., Wolf, P. A., Cobain, M., Massaro, J. M., & Kannel, W. B. (2008) · Circulation · doi:10.1161/circulationaha.107.699579 · Cited by 7,491
Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia
Shepherd, J., Cobbe, S. M., Ford, I., Isles, C. G., Lorimer, A. R., Macfarlane, P. W., McKillop, J. H., & Packard, C. J. (1995) · New England Journal of Medicine · doi:10.1056/nejm199511163332001 · Cited by 7,449
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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
Research works printed but not linked: 5
- Sniderman, Meta-analysis of LDL-C, non-HDL-C and apo B as markers of cardiovascular risk, Circulation
- The European Atherosclerosis Society Consensus Panel, 2011, Triglyceride-rich lipoprotein and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management, Eur Heart J
- Poulter, 1999, The impact of micronized fenofibrate on lipid subfractions and on reaching HDL-target levels in 7,098 patients with dyslipidaemia, Br J Cardiol, 6, 682
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Cited by
Sorted by citations
McDonagh, T. A., Metra, M., Adamo, M., Gardner, R. S., Baumbach, A., Böhm, M., Burri, H., Butler, J., Čelutkienė, J., Chioncel, O. D., et al. (2021) · PubMed · doi:10.1093/eurheartj/ehab670 · Cited by 20,604
Self-citation2013 ESH/ESC Guidelines for the management of arterial hypertension
Authors Task Force Members, Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., Christiaens, T., Cífková, R., Backer, G. D., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht151 · Cited by 13,739
Self-citation2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., Falk, V., González-Juanatey, J. R., Harjola, V.-P., Jankowska, E. A., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw128 · Cited by 11,429
Self-citationMach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz455 · Cited by 8,961
Self-citationEuropean Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490
Self-citation
Metadata
- Authors
- Reiner, Ž., Catapano, A. L., De Backer, G., Graham, I., Taskinen, M.-R., Wiklund, O., Agewall, S., Alegria, E., Chapman, M. J., Durrington, P., Erdine, S., Halcox, J., Hobbs, R., Kjekshus, J., Filardi, P. P., Riccardi, G., Storey, R. F., Wood, D., Bax, J., Vahanian, A., Auricchio, A., Baumgartner, H., Ceconi, C., Dean, V., Deaton, C., Fagard, R., Filippatos, G., Funck-Brentano, C., Hasdai, D., Hobbs, R., Hoes, A., Kearney, P., Knuuti, J., Kolh, P., McDonagh, T., Moulin, C., Poldermans, D., Popescu, B. A., Reiner, Ž., Sechtem, U., Sirnes, P. A., Tendera, M., Torbicki, A., Vardas, P., Widimsky, P., Windecker, S., Reviewers:, D., Funck-Brentano, C., Poldermans, D., Berkenboom, G., De Graaf, J., Descamps, O., Gotcheva, N., Griffith, K., Guida, G. F., Gulec, S., Henkin, Y., Huber, K., Kesaniemi, Y. A., Lekakis, J., Manolis, A. J., Marques-Vidal, P., Masana, L., McMurray, J., Mendes, M., Pagava, Z., Pedersen, T., Prescott, E., Rato, Q., Rosano, G., Sans, S., Stalenhoef, A., Tokgozoglu, L., Viigimaa, M., Wittekoek, M. E., & Zamorano, J. L.
- Affiliations
- University of Milan (IT)
- The disclosure forms of the authors and reviewers are available on the ESC website www.escardio.org/guidelines
- ORCID
- Catapano, Alberico L.
- Taskinen, Marja-Riitta
- Wiklund, Olov
- Agewall, Stefan
- Chapman, M. John
- Durrington, Paul
- Erdine, Serap
- Halcox, Julian
- Filardi, Pasquale Perrone
- Storey, Robert F.
- Bax, Jeroen
- Vahanian, Alec
- Auricchio, Angelo
- Ceconi, Claudio
- Deaton, Christi
- Hoes, Arno
- Knuuti, Juhani
- Kolh, Philippe
- Sirnes, Per Anton
- Torbicki, Adam
- Vardas, Panos
- Windecker, Stephan
- Manolis, Athanasios J.
- Marques-Vidal, Pedro
- Masana, Luis
- McMurray, John
- Pagava, Zurab
- Pedersen, Terje
- Prescott, Eva
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-01-01
- Volume
- 32
- Issue
- 14
- Pages
- 1769-1818
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W1972661406
- Cited by
- 3,549
- References
- 236
- Citations by year
- 2026: 31 · 2025: 69 · 2024: 71 · 2023: 88 · 2022: 108 · 2021: 128 · 2020: 167 · 2019: 165 · 2018: 212 · 2017: 312 · 2016: 490 · 2015: 504 · 2014: 492 · 2013: 383 · 2012: 271
- FWCI
- 390.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- IRIS (submittedVersion)
- Open Repository and Bibliography (University of Liège) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- European Atherosclerosis Society
- European Society of Cardiology
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- dyslipidemia, dyslipidemia management, cardiovascular disease prevention, atherosclerosis, cardiovascular risk factors, lipid-lowering therapy, coronary artery disease, ischemic stroke, peripheral arterial disease, cardiovascular risk assessment
- MeSH terms
- Adult, Hypolipidemic Agents, Energy Intake, Cardiovascular Diseases, Child, Diet, Dietary Fats, Female, Humans, Kidney Failure, Chronic, Life Style, Male, Patient Compliance, Primary Prevention, Risk Factors, Specimen Handling, Transplantation, Weight Loss, Exercise, Risk Assessment, Dietary Supplements, Early Diagnosis, Dyslipidemias, Lipid Metabolism, Secondary Prevention
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.
A language model drew the claims from the paper on 2026-10-04, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-04 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
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 ›
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