{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:02:30Z","timestamp":1789592550198,"version":"build-2803163510"},"reference-count":45,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":380,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1016\/j.jacc.2025.07.013","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T16:19:26Z","timestamp":1757348366000},"page":"797-809","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Safety and Effectiveness of Statins for Primary Prevention in Adults With Type 1 Diabetes"],"prefix":"10.1016","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7895-198X","authenticated-orcid":false,"given":"Joseph Edgar","family":"Blais","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Ka Chun","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7602-9470","authenticated-orcid":false,"given":"Esther Wai Yin","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian Chi Kei","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Yuk Fai","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacc.2025.07.013_bib1","doi-asserted-by":"crossref","first-page":"798","DOI":"10.2337\/diacare.29.04.06.dc05-1433","article-title":"High risk of cardiovascular disease in patients with type 1 diabetes in the U.K.: a cohort study using the general practice research database","volume":"29","author":"Soedamah-Muthu","year":"2006","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001321","article-title":"Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study","volume":"9","author":"Livingstone","year":"2012","journal-title":"PLoS Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib3","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S0140-6736(18)31506-X","article-title":"Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study","volume":"392","author":"Rawshani","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.jacc.2025.07.013_bib4","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.2337\/dc10-1170","article-title":"All-cause mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes: the Allegheny County Type 1 Diabetes Registry","volume":"33","author":"Secrest","year":"2010","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib5","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.2337\/dc15-2399","article-title":"Diabetes Control Complications Trial\/Epidemiology of Diabetes Interventions Complications Study Research Group. Mortality in type 1 diabetes in the DCCT\/EDIC versus the general population","volume":"39","year":"2016","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib6","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s11892-013-0380-1","article-title":"Is the risk and nature of CVD the same in type 1 and type 2 diabetes?","volume":"13","author":"Duca","year":"2013","journal-title":"Curr Diab Rep"},{"key":"10.1016\/j.jacc.2025.07.013_bib7","doi-asserted-by":"crossref","DOI":"10.1016\/j.atherosclerosis.2023.06.005","article-title":"Cardiovascular disease in type 1 diabetes, an underestimated danger: epidemiological and pathophysiological data","volume":"394","author":"Verges","year":"2024","journal-title":"Atherosclerosis"},{"key":"10.1016\/j.jacc.2025.07.013_bib8","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/MED.0000000000000551","article-title":"Lipid management for cardiovascular risk reduction in type 1 diabetes","volume":"27","author":"Tell","year":"2020","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"10.1016\/j.jacc.2025.07.013_bib9","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1056\/NEJMra2311526","article-title":"Prevention of cardiovascular disease in type 1 diabetes","volume":"390","author":"Manrique-Acevedo","year":"2024","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib10","article-title":"Cardiovascular disease: risk assessment and reduction, including lipid modification","year":"2014","journal-title":"Clinical guideline CG181"},{"key":"10.1016\/j.jacc.2025.07.013_bib11","doi-asserted-by":"crossref","first-page":"e285","DOI":"10.1016\/j.jacc.2018.11.003","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA guideline on the management of blood cholesterol","volume":"73","author":"Grundy","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2025.07.013_bib12","doi-asserted-by":"crossref","first-page":"S179","DOI":"10.2337\/dc24-S010","article-title":"10. Cardiovascular disease and risk management: standards of care in diabetes\u20142024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib13","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)","volume":"41","author":"Mach","year":"2020","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2025.07.013_bib14","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jacc.2025.07.013_bib15","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S0140-6736(08)60104-X","article-title":"Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis","volume":"371","author":"Cholesterol Treatment Trialists\u2019 Collaborators","year":"2008","journal-title":"Lancet"},{"key":"10.1016\/j.jacc.2025.07.013_bib16","doi-asserted-by":"crossref","first-page":"996","DOI":"10.2337\/dc15-2450","article-title":"Association between use of lipid-lowering therapy and cardiovascular diseases and death in individuals with type 1 diabetes","volume":"39","author":"Hero","year":"2016","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib17","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1186\/s12967-023-04691-6","article-title":"Impact of statin treatment on cardiovascular risk in patients with type 1 diabetes: a population-based cohort study","volume":"21","author":"Yoo","year":"2023","journal-title":"J Transl Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib18","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/aje\/kwv254","article-title":"Using big data to emulate a target trial when a randomized trial is not available","volume":"183","author":"Hern\u00e1n","year":"2016","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.jacc.2025.07.013_bib19","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1002\/pds.1335","article-title":"Validation studies of the Health Improvement Network (THIN) database for pharmacoepidemiology research","volume":"16","author":"Lewis","year":"2007","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"10.1016\/j.jacc.2025.07.013_bib20","first-page":"251","article-title":"Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates","volume":"19","author":"Blak","year":"2011","journal-title":"Inform Prim Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib21","first-page":"75","article-title":"A language of health in action: Read codes, classifications and groupings","author":"Stuart-Buttle","year":"1996","journal-title":"Proc AMIA Annu Fall Symp"},{"key":"10.1016\/j.jacc.2025.07.013_bib22","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1056\/NEJMp2113319","article-title":"Methods of public health research\u2014strengthening causal inference from observational data","volume":"385","author":"Hern\u00e1n","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib23","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1177\/0962280211403603","article-title":"Observational data for comparative effectiveness research: an emulation of randomised trials of statins and primary prevention of coronary heart disease","volume":"22","author":"Danaei","year":"2013","journal-title":"Stat Methods Med Res"},{"key":"10.1016\/j.jacc.2025.07.013_bib24","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1056\/NEJMoa2101765","article-title":"BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting","volume":"384","author":"Dagan","year":"2021","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib25","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1007\/s11606-021-06651-6","article-title":"The risk of muscular events among new users of hydrophilic and lipophilic statins: an observational cohort study","volume":"36","author":"Mueller","year":"2021","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib26","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/pds.1919","article-title":"Validation of ischemic cerebrovascular diagnoses in The Health Improvement Network (THIN)","volume":"19","author":"Ruigomez","year":"2010","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"10.1016\/j.jacc.2025.07.013_bib27","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1093\/jamia\/ocy094","article-title":"Identification of validated case definitions for medical conditions used in primary care electronic medical record databases: a systematic review","volume":"25","author":"McBrien","year":"2018","journal-title":"J Am Med Inform Assoc"},{"key":"10.1016\/j.jacc.2025.07.013_bib28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1136\/hrt.2007.134890","article-title":"Performance of the QRISK cardiovascular risk prediction algorithm in an independent UK sample of patients from general practice: a validation study","volume":"94","author":"Hippisley-Cox","year":"2008","journal-title":"Heart"},{"key":"10.1016\/j.jacc.2025.07.013_bib29","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.b2584","article-title":"An independent external validation and evaluation of QRISK cardiovascular risk prediction: a prospective open cohort study","volume":"339","author":"Collins","year":"2009","journal-title":"BMJ"},{"key":"10.1016\/j.jacc.2025.07.013_bib30","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1001\/jamapsychiatry.2014.2133","article-title":"Cardiovascular risk prediction models for people with severe mental illness: results from the Prediction and Management of Cardiovascular Risk in People With Severe Mental Illnesses (PRIMROSE) research program","volume":"72","author":"Osborn","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"10.1016\/j.jacc.2025.07.013_bib31","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1007\/s12072-021-10144-3","article-title":"Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines","volume":"15","author":"Devarbhavi","year":"2021","journal-title":"Hepatol Int"},{"key":"10.1016\/j.jacc.2025.07.013_bib32","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.jhep.2019.02.014","article-title":"EASL clinical practice guidelines: drug-induced liver injury","volume":"70","year":"2019","journal-title":"J Hepatol"},{"key":"10.1016\/j.jacc.2025.07.013_bib33","doi-asserted-by":"crossref","first-page":"463","DOI":"10.2307\/2529360","article-title":"On the treatment of grouped observations in life studies","volume":"33","author":"Thompson","year":"1977","journal-title":"Biometrics"},{"key":"10.1016\/j.jacc.2025.07.013_bib34","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1097\/00001648-200009000-00011","article-title":"Marginal structural models and causal inference in epidemiology","volume":"11","author":"Robins","year":"2000","journal-title":"Epidemiology"},{"key":"10.1016\/j.jacc.2025.07.013_bib35","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1056\/NEJMsm1605385","article-title":"Per-protocol analyses of pragmatic trials","volume":"377","author":"Hern\u00e1n","year":"2017","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib36","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1038\/s41591-019-0597-x","article-title":"Avoidable flaws in observational analyses: an application to statins and cancer","volume":"25","author":"Dickerman","year":"2019","journal-title":"Nat Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib37","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1161\/circ.106.25.3143","article-title":"Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report","volume":"106","year":"2002","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2025.07.013_bib38","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.2337\/dc12-1756","article-title":"Statins and risk of diabetes: an analysis of electronic medical records to evaluate possible bias due to differential survival","volume":"36","author":"Danaei","year":"2013","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib39","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1046\/j.1464-5491.2002.00643.x","article-title":"Design of the Collaborative Atorvastatin Diabetes Study (CARDS) in patients with type 2 diabetes","volume":"19","author":"Colhoun","year":"2002","journal-title":"Diabet Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib40","doi-asserted-by":"crossref","first-page":"268","DOI":"10.7326\/M16-2607","article-title":"Sensitivity analysis in observational research: introducing the E-value","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib41","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1056\/NEJMoa0900241","article-title":"A randomized trial of rosuvastatin in the prevention of venous thromboembolism","volume":"360","author":"Glynn","year":"2009","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1741-7015-12-51","article-title":"Unintended effects of statins from observational studies in the general population: systematic review and meta-analysis","volume":"12","author":"Macedo","year":"2014","journal-title":"BMC Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib43","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1056\/NEJMoa050461","article-title":"Intensive lipid lowering with atorvastatin in patients with stable coronary disease","volume":"352","author":"LaRosa","year":"2005","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2025.07.013_bib44","doi-asserted-by":"crossref","first-page":"S258","DOI":"10.2337\/dc24-S014","article-title":"14. Children and adolescents: standards of care in diabetes\u20142024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"10.1016\/j.jacc.2025.07.013_bib45","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/S2213-8587(14)70248-7","article-title":"Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis","volume":"3","author":"Huxley","year":"2015","journal-title":"Lancet Diabetes Endocrinol"}],"container-title":["JACC"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735109725071219?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735109725071219?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:03:52Z","timestamp":1789589032000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0735109725071219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":45,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["S0735109725071219"],"URL":"https:\/\/doi.org\/10.1016\/j.jacc.2025.07.013","relation":{},"ISSN":["0735-1097"],"issn-type":[{"value":"0735-1097","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Safety and Effectiveness of Statins for Primary Prevention in Adults With Type 1 Diabetes","name":"articletitle","label":"Article Title"},{"value":"JACC","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacc.2025.07.013","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 by the American College of Cardiology Foundation. Published by Elsevier.","name":"copyright","label":"Copyright"}]}}