The decline effect in cardiovascular medicine: Is the effect of cardiovascular medicine and stent on cardiovascular events decline over the years?

The term decline effect is referred to a diminution of scientifically discovered effects over time. Reasons for the decline effect are multi-faceted and include publication bias, selective reporting, outcomes reporting bias, regression to the mean, scientific paradigm shift, over-shadowing and habituation, among others. Such effects can be found in cardiovascular medicines through medications (e.g., aspirin, antithrombotics, proton pump inhibitor, beta-blockers, statins, estrogen/progestin, angiotensin converting enzyme inhibitor etc.), as well as with interventional devices (e.g., angioplasty, percutaneous coronary intervention, stents). The scientific community should understand the various dimensions of the decline effects, and effective steps should be undertaken to prevent or recognize such decline effects in cardiovascular medicines.