{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:54:08Z","timestamp":1777312448017,"version":"3.51.4"},"reference-count":98,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"\n Background:<\/jats:bold>\n This umbrella review aims to synthesize evidence from previously conducted meta-analyses and review articles to assess the effects of bempedoic acid on lipid profile and cardiovascular events.\n <\/jats:p>\n \n Methods:<\/jats:bold>\n While adhering to the Preferred Reporting Items for Overviews of Reviews guidelines, PubMed, Google Scholar, Web of Science, and Scopus were searched from the database inception to June 2024 to identify relevant articles. The outcomes were total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL cholesterol, triglyceride (TAG), apolipoprotein B (APOB), high-sensitivity CRP (hs-CRP), major cardiovascular events (MACE), cardiovascular mortality, and myocardial infarction (MI). A corrected covered area (CCA) assessment was performed to determine overlap among reviews. Each included review was assessed for its quality and rigor via the AMSTAR-2 tool.\n <\/jats:p>\n \n Results:<\/jats:bold>\n From 18,297 articles identified during the literature search, 18 meta-analyses were included. A significant overlap was noted across studies with a corrected cover area of 44.4%. Bempedoic acid\u2019s effects on cardiovascular outcomes and lipid levels have been extensively studied. For cardiovascular mortality, the evidence is mixed: Goyal et al.21 reported a risk ratio (RR) of 0.81 (95% CI 0.61\u20131.08) suggesting a potential benefit, while other studies, such as De Filippo et al.26 and Zhang et al.24, indicate no significant association. In terms of MACE, 11 reviews show a consistent trend toward reduced risk, with RRs between 0.75 and 0.88. Bempedoic acid also appears to significantly reduce the risk of MI, with RRs and odds ratios (ORs) around 0.76. Evidence on unstable angina suggests a lower risk, although some studies do not reach statistical significance. For coronary revascularization, the data show a reduced risk, with RRs ranging from 0.74 to 0.82. Studies on coronary non-revascularization also indicate a significant risk reduction with RRs and ORs of 0.41. Regarding lipid levels, bempedoic acid consistently reduces LDL cholesterol (mean differences [MDs] from \u221217.5% to \u221233.91%), total cholesterol (MDs from \u221212.69% to \u221234.41%), and non-HDL cholesterol (MDs from \u221212.3% to \u221223.27%). The effects on HDL cholesterol are less consistent (MDs from \u22121.29% to \u22125.18%), and triglyceride levels show variable results (MDs from \u22128.35% to +5.23%).\n <\/jats:p>\n \n Conclusion:<\/jats:bold>\n Our findings show that bempedoic acid significantly reduces the risk of MACE, nonfatal MI, coronary and noncoronary revascularization, and hospitalizations for unstable angina. While results on cardiovascular mortality are mixed, suggesting a need for further study, bempedoic acid proves to be an effective treatment for improving lipid profiles and reducing cardiovascular events, especially in patients who cannot tolerate statins. It presents a valuable option for cardiovascular risk management, potentially enhancing patient outcomes and quality of life. Further research is needed to assess its long-term benefits and broader applicability.\n <\/jats:p>","DOI":"10.5339\/qmj.2025.51","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T11:30:47Z","timestamp":1752579047000},"source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the effects of bempedoic acid on lipid profiles and cardiovascular risk: An umbrella review of meta-analyses"],"prefix":"10.5339","volume":"2025","author":[{"given":"Ashik","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, SRM Medicak College and Research Center, Chennai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Bhimani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikash Kumar","family":"Karmani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rubaid Azhar","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Riphah International University, Rawalpindi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahzeb","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Charleston Area Medical Center, Charleston, WV, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arman","family":"Amir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Palak","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, New York Medical College at Saint Michael\u2019s Medical Center, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anim","family":"Asif","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Harlem Hospital Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umair Abrar","family":"Baig","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Orthopedic Medical and Institute, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheena","family":"Shamoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aatkah","family":"Naseer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Institute of Cardiovascular Disorder, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Owais","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan*Correspondence: Arman Amir Arman.maredia1@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"issue":"(9):","key":"CIT0001","series-title":"Circulation","first-page":"e139\u2013596","article-title":"Heart disease and stroke statistics-2020 update: a report from the American Heart Association","volume":"141","author":"Virani\n \nSS","year":"2020;"},{"issue":"(2):","key":"CIT0002","series-title":"Heart Int","first-page":"27\u201334","article-title":"Bempedoic acid: lipid lowering for cardiovascular disease prevention","volume":"17","author":"Albosta\n \nM","year":"2023"},{"issue":"(1):","key":"CIT0003","series-title":"Eur Heart J","first-page":"111\u201388","article-title":"2019 ESC\/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk [published correction appears in Eur Heart J. 2020 Nov 21;41(44):4255. https:\/\/doi.org\/10.1093\/eurheartj\/ehz826]","volume":"41","author":"Mach\n \nF","year":"2020;"},{"issue":"(25):","key":"CIT0004","series-title":"Circulation","first-page":"e1046\u201381","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA guideline on the management of blood cholesterol: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Circulation. 2019 Jun 18;139(25):e1178\u201381. https:\/\/doi.org\/10.1161\/CIR.0000000000000699]","volume":"139","author":"Grundy\n \nSM","year":"2019;"},{"issue":"(20):","key":"CIT0005","series-title":"West of Scotland Coronary Prevention Study Group. N Engl J Med","first-page":"1301\u20137","article-title":"Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia","volume":"333","author":"Shepherd\n \nJ","year":"1995;"},{"issue":"(20):","key":"CIT0006","series-title":"Air Force\/Texas Coronary Atherosclerosis Prevention Study. JAMA","first-page":"1615\u201322","article-title":"Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS\/TexCAPS","volume":"279","author":"Downs\n \nJR","year":"1998;"},{"issue":"(4):","key":"CIT0007","series-title":"J Clin Lipidol","first-page":"361\u201375","article-title":"NLA scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient","volume":"16","author":"Cheeley\n \nMK","year":"2022;"},{"issue":"(3):","key":"CIT0008","series-title":"JAMA Cardiol","first-page":"206\u201313","article-title":"Association of statin adherence with mortality in patients with atherosclerotic cardiovascular disease","volume":"4","author":"Rodriguez\n \nF","year":"2019;"},{"issue":"(4):","key":"CIT0009","series-title":"Br J Clin Pharmacol","first-page":"684\u201398","article-title":"Impact of statin adherence on cardiovascular disease and mortality 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treatment of hyperlipidaemia","volume":"26","author":"Penson\n \nP","year":"2017;"},{"key":"CIT0014","series-title":"Nat Commun","first-page":"13457","article-title":"Liver-specific ATP-citrate lyase inhibition by bempedoic acid decreases LDL-C and attenuates atherosclerosis","volume":"7","author":"Pinkosky\n \nSL","year":"2016;"},{"issue":"(13):","key":"CIT0015","series-title":"J Am Coll Cardiol","first-page":"1154\u201362","article-title":"Efficacy and safety of a novel dual modulator of adenosine triphosphate-citrate lyase and adenosine monophosphate-activated protein kinase in patients with hypercholesterolemia: results of a multicenter, randomized, double-blind, placebo-controlled, parallel-group trial","volume":"62","author":"Ballantyne\n \nCM","year":"2013;"},{"issue":"(15):","key":"CIT0016","series-title":"N Engl J Med","first-page":"1353\u201364","article-title":"Bempedoic acid and cardiovascular outcomes in statin-intolerant patients","volume":"388","author":"Nissen\n \nSE","year":"2023;"},{"issue":"(1):","key":"CIT0017","series-title":"Syst Rev","first-page":"335","article-title":"Preferred reporting items for overviews of reviews (Prior): a protocol for the development of a reporting guideline for overviews of reviews of healthcare interventions","volume":"8","author":"Pollock\n \nM","year":"2019;"},{"key":"CIT0018","series-title":"BMJ (Clinical Res ed)","first-page":"j4008","article-title":"AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or nonrandomised studies of healthcare interventions, or both","volume":"358","author":"Shea\n \nBJ","year":"2017;"},{"issue":"(4):","key":"CIT0019","series-title":"Clin Epidemiol","first-page":"368\u201375","article-title":"Systematic review finds overlapping reviews were not mentioned in every other overview","volume":"67","author":"Pieper\n \nD","year":"2014;"},{"issue":"(2):","key":"CIT0020","series-title":"Curr Probl Cardiol","first-page":"102191","article-title":"Impact of bempedoic acid on LDL-C reduction and cardiovascular outcomes: a comprehensive meta-analysis of randomized controlled trials","volume":"49","author":"Del Carpio-Tenorio\n \nC","year":"2024"},{"issue":"(2):","key":"CIT0021","series-title":"Curr Probl Cardiol","first-page":"102236","article-title":"Efficacy and outcomes of bempedoic acid versus placebo in patients with statin-intolerance: a pilot systematic review and meta-analysis of randomized controlled trials","volume":"49","author":"Goyal\n \nA","year":"2024"},{"issue":"(1):","key":"CIT0022","series-title":"PLoS One","first-page":"e0297854","article-title":"Safety and efficacy of bempedoic acid among patients with statin intolerance and those without: a meta-analysis and a systematic randomized controlled trial review","volume":"19","author":"Li\n \nY","year":"2024"},{"issue":"(11):","key":"CIT0023","series-title":"Eur J Clin Pharmacol","first-page":"1453\u201363","article-title":"Efficacy and safety of bempedoic acid lipid-lowering therapy: a systematic review and meta-analysis of randomized controlled trials","volume":"79","author":"Venkatraman\n \nS","year":"2023"},{"issue":"(6):","key":"CIT0024","series-title":"Am J Cardiovasc Drugs","first-page":"695\u2013708","article-title":"Bempedoic acid can reduce cardiovascular events in combination with statins or as monotherapy: a systematic review and meta-analysis","volume":"23","author":"Zhang\n \nJ","year":"2023"},{"issue":"(12):","key":"CIT0025","series-title":"Curr Probl Cardiol","first-page":"102003","article-title":"Clinical efficacy and safety of bempedoic acid in high cardiovascular risk patients: a systematic review and meta-analysis of randomized controlled trials","volume":"48","author":"Uddin\n \nN","year":"2023"},{"issue":"(1):","key":"CIT0026","series-title":"Cardiovasc Diabetol","first-page":"324","article-title":"Safety and efficacy of bempedoic acid: a systematic review and meta-analysis of randomised controlled trials","volume":"22","author":"De Filippo\n \nO","year":"2023"},{"issue":"(6):","key":"CIT0027","series-title":"Eur Heart J Cardiovasc Pharmacother","first-page":"583\u201391","article-title":"Cardiovascular events in patients treated with bempedoic acid vs. placebo: systematic review and meta-analysis","volume":"9","author":"Mutschlechner\n \nD","year":"2023"},{"issue":"(2):","key":"CIT0028","series-title":"BMJ Open","first-page":"e048893","article-title":"Clinical efficacy and safety outcomes of bempedoic acid for LDL-C lowering therapy in patients at high cardiovascular risk: a systematic review and meta-analysis","volume":"12","author":"Lin\n \nY","year":"2022"},{"issue":"(3):","key":"CIT0029","series-title":"Clin Investig Arterioscler","first-page":"117\u201326","article-title":"Effect of bempedoic acid on atherogenic lipids and inflammation: a meta-analysis","volume":"33","author":"Masson\n \nW","year":"2021"},{"issue":"(8):","key":"CIT0030","series-title":"Eur J Prev Cardiol","first-page":"825\u201333","article-title":"Efficacy and safety of bempedoic acid in patients with hypercholesterolemia: a systematic review and meta-analysis of randomized controlled trials","volume":"28","author":"Dai\n \nL","year":"2021"},{"issue":"(2):","key":"CIT0031","series-title":"Kardiol Pol","first-page":"207\u201316","article-title":"Safety and efficacy of ETC-1002 in hypercholesterolaemic patients: a meta-analysis of randomised controlled trials","volume":"77","author":"Wang\n \nX","year":"2019;"},{"issue":"(1):","key":"CIT0032","series-title":"Clin Drug Investig","first-page":"19\u201328","article-title":"Bempedoic acid and ezetimibe for the treatment of hypercholesterolemia: a systematic review and meta-analysis of randomized phase II\/III trials","volume":"41","author":"Bhagavathula\n \nAS","year":"2021"},{"issue":"(1):","key":"CIT0033","series-title":"Cardiovasc Diabetol","first-page":"128","article-title":"Efficacy and safety of bempedoic acid for prevention of cardiovascular events and diabetes: a systematic review and meta-analysis","volume":"19","author":"Wang\n \nX","year":"2020"},{"issue":"(8):","key":"CIT0034","series-title":"Drug Saf","first-page":"727\u201336","article-title":"Effect of bempedoic acid on serum uric acid and related outcomes: a systematic review and meta-analysis of the available phase 2 and phase 3 clinical studies","volume":"43","author":"Cicero\n \nAFG","year":"2020"},{"key":"CIT0035","series-title":"Am J Cardiol","first-page":"130\u20132","article-title":"Meta-analysis of the safety and efficacy of bempedoic acid","volume":"131","author":"Khan\n \nMU","year":"2020"},{"issue":"(7):","key":"CIT0036","series-title":"PLoS Med","first-page":"e1003121","article-title":"Lipid and Blood Pressure Meta-Analysis Collaboration (LBPMC) Group and the International Lipid Expert Panel (ILEP). Efficacy and safety of bempedoic acid for the treatment of hypercholesterolemia: a systematic review and meta-analysis","volume":"17","author":"Cicero\n \nAFG","year":"2020"},{"issue":"(15):","key":"CIT0037","series-title":"J Am Heart Assoc","first-page":"e016262","article-title":"Efficacy and safety of bempedoic acid in patients with hypercholesterolemia: systematic review and meta-analysis of randomized controlled trials","volume":"9","author":"Di Minno\n \nA","year":"2020"},{"issue":"(4):","key":"CIT0038","series-title":"Cardiovasc Drugs Ther","first-page":"853\u201364","article-title":"Role of bempedoic acid in clinical practice","volume":"35","author":"Ballantyne\n \nCM","year":"2021"},{"issue":"(2):","key":"CIT0039","series-title":"JAMA","first-page":"131\u201340","article-title":"Bempedoic acid for primary prevention of cardiovascular events in statin-intolerant patients","volume":"330","author":"Nissen\n \nSE","year":"2023"},{"issue":"(12):","key":"CIT0040","series-title":"N Engl J Med","first-page":"1119\u201331","article-title":"Antiinflammatory therapy with canakinumab for atherosclerotic disease","volume":"377","author":"Ridker\n \nPM","year":"2017"},{"key":"CIT0041","series-title":"Atheroscler Plus","first-page":"20\u20137","article-title":"Estimated cardiovascular benefits of bempedoic acid in patients with established cardiovascular disease","volume":"49","author":"Gunn\n \nLH","year":"2022"},{"issue":"(5):","key":"CIT0042","series-title":"J Clin Lipidol","first-page":"602\u201311","article-title":"The efficacy of intensive lipid-lowering therapies on the reduction of LDLc and of major cardiovascular events","volume":"17","author":"Cordero\n \nA","year":"2023"},{"issue":"(6):","key":"CIT0043","series-title":"Cardiovasc Drugs Ther","first-page":"1415\u20131420","article-title":"The Clinical Efficacy and Safety of Bempedoic Acid in Patients at Elevated Risk of Cardiovascular Disease: A Meta-Analysis of Randomized Clinical Trials","volume":"38","author":"Sayed\n \nA","year":"2024"},{"issue":"(25):","key":"CIT0044","series-title":"N Engl J Med","first-page":"2387\u201397","article-title":"Ezetimibe added to statin therapy after acute coronary syndromes","volume":"372","author":"Cannon\n \nCP","year":"2015"},{"issue":"(18):","key":"CIT0045","series-title":"N Engl J Med","first-page":"1713\u201322","article-title":"Evolocumab and clinical outcomes in patients with cardiovascular disease","volume":"376","author":"Sabatine\n \nMS","year":"2017"},{"issue":"(1):","key":"CIT0046","series-title":"J Cardiovasc Pharmacol","first-page":"35\u201344","article-title":"Extent of low-density lipoprotein cholesterol reduction and all-cause and cardiovascular mortality benefit: a systematic review and meta-analysis","volume":"81","author":"Ennezat\n \nPV","year":"2023"},{"issue":"(5):","key":"CIT0047","series-title":"Lancet Haematol","first-page":"e333\u201345","article-title":"Defibrotide plus best standard of care compared with best standard of care alone for the prevention of sinusoidal obstruction syndrome (HARMONY): a randomised, multicentre, phase 3 trial","volume":"10","author":"Grupp\n \nSA","year":"2023"},{"key":"CIT0048","series-title":"Health Sci Rev","first-page":"100116","article-title":"Clinical efficacy and safety outcomes of bempedoic acid: an updated systematic review and meta-analysis after CLEAR outcomes trial","volume":"9","author":"Bhandari\n \nA","year":"2023"},{"issue":"(6):","key":"CIT0049","series-title":"Eur J Prevent Cardiol","first-page":"593\u2013603","article-title":"Bempedoic acid plus ezetimibe fixed-dose combination in patients with hypercholesterolemia and high CVD risk treated with maximally tolerated statin therapy","volume":"27","author":"Ballantyne\n \nCM","year":"2020"},{"issue":"(9):","key":"CIT0001","series-title":"Circulation","first-page":"e139\u2013596","article-title":"Heart disease and stroke statistics-2020 update: a report from the American Heart 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Association Task Force on Clinical Practice Guidelines [published correction appears in Circulation. 2019 Jun 18;139(25):e1178\u201381. https:\/\/doi.org\/10.1161\/CIR.0000000000000699]","volume":"139","author":"Grundy\n \nSM","year":"2019;"},{"issue":"(20):","key":"CIT0005","series-title":"West of Scotland Coronary Prevention Study Group. 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JAMA","first-page":"1615\u201322","article-title":"Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS\/TexCAPS","volume":"279","author":"Downs\n \nJR","year":"1998;"},{"issue":"(4):","key":"CIT0007","series-title":"J Clin Lipidol","first-page":"361\u201375","article-title":"NLA scientific statement on statin intolerance: a new definition and key considerations for ASCVD risk reduction in the statin intolerant patient","volume":"16","author":"Cheeley\n \nMK","year":"2022;"},{"issue":"(3):","key":"CIT0008","series-title":"JAMA Cardiol","first-page":"206\u201313","article-title":"Association of statin adherence with mortality in patients with atherosclerotic cardiovascular disease","volume":"4","author":"Rodriguez\n \nF","year":"2019;"},{"issue":"(4):","key":"CIT0009","series-title":"Br J Clin Pharmacol","first-page":"684\u201398","article-title":"Impact of statin adherence on cardiovascular disease and mortality outcomes: a systematic review","volume":"78","author":"De Vera\n \nMA","year":"2014;"},{"key":"CIT0010","series-title":"Atherosclerosis","doi-asserted-by":"publisher","first-page":"86\u20138","DOI":"10.1016\/j.atherosclerosis.2021.01.009","article-title":"Lipid-lowering therapies: better together","volume":"320","author":"Banach\n \nM","year":"2021;"},{"issue":"(3):","key":"CIT0011","series-title":"Cardiovasc Res","first-page":"e26\u201331","article-title":"What have we learned about lipids and cardiovascular risk from PCSK9 inhibitor outcome trials: ODYSSEY and FOURIER?","volume":"115","author":"Banach\n \nM","year":"2019;"},{"issue":"(11):","key":"CIT0012","series-title":"Curr Atheroscler Rep","first-page":"69","article-title":"RNA silencing in the management of dyslipidemias","volume":"23","author":"Henney\n \nNC","year":"2021;"},{"issue":"(2):","key":"CIT0013","series-title":"Expert Opin Investig Drugs","first-page":"251\u20139","article-title":"Evaluating bempedoic acid for the 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\nSE","year":"2023;"},{"issue":"(1):","key":"CIT0017","series-title":"Syst Rev","first-page":"335","article-title":"Preferred reporting items for overviews of reviews (Prior): a protocol for the development of a reporting guideline for overviews of reviews of healthcare interventions","volume":"8","author":"Pollock\n \nM","year":"2019;"},{"key":"CIT0018","series-title":"BMJ (Clinical Res ed)","first-page":"j4008","article-title":"AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or nonrandomised studies of healthcare interventions, or both","volume":"358","author":"Shea\n \nBJ","year":"2017;"},{"issue":"(4):","key":"CIT0019","series-title":"Clin Epidemiol","first-page":"368\u201375","article-title":"Systematic review finds overlapping reviews were not mentioned in every other overview","volume":"67","author":"Pieper\n \nD","year":"2014;"},{"issue":"(2):","key":"CIT0020","series-title":"Curr Probl Cardiol","first-page":"102191","article-title":"Impact of 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