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Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline
BACKGROUND: The effects on cardiovascular disease (CVD) by treatment recommendations on prevention of atherosclerotic CVD remain to be evaluated. The objectives were to assess treatment gap for low density lipoprotein cholesterol (LDL-C) according to guidelines, potential impact on CVD outcomes, and...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559790/ https://www.ncbi.nlm.nih.gov/pubmed/28814290 http://dx.doi.org/10.1186/s12872-017-0659-2 |
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author | Journath, Gunilla Hambraeus, Kristina Hagström, Emil Pettersson, Billie Löthgren, Mickael |
author_facet | Journath, Gunilla Hambraeus, Kristina Hagström, Emil Pettersson, Billie Löthgren, Mickael |
author_sort | Journath, Gunilla |
collection | PubMed |
description | BACKGROUND: The effects on cardiovascular disease (CVD) by treatment recommendations on prevention of atherosclerotic CVD remain to be evaluated. The objectives were to assess treatment gap for low density lipoprotein cholesterol (LDL-C) according to guidelines, potential impact on CVD outcomes, and possible avoided economic costs, in post myocardial infarction (MI) patients, if target LDL-C levels of ≤1.8 mmol/L would be achieved. METHODS: All patients registered in the Swedish Secondary Prevention after Heart Intensive care Admission register, with one-year post-MI follow-up during 2013 were selected. The REACH risk prediction and a calibrated model for recurrent cardiovascular events and death were used to estimate unadjusted risk prediction based on the REACH equation henceforth called base case, and calibrated CVD outcomes based on gender-specific risk factors. The predicted impact of the LDL-C reduction on the risk of CVD was based on the Cholesterol Treatment Trialists´ Collaboration findings. RESULTS: A sample of n = 5904 patients (74% men) with a mean age of 64 years were included. Around 70% did not reach LDL-C target ≤1.8 mmol/L. Over a 10-year period, 820–2262 events were predicted to occur in those who did not reach target corresponding to 20% – 55% risk of CVD events. To achieve LDL-C target, the mean LDL-C had to be reduced by 0.73 mmol/L (29%). If this LDL-C reduction was achieved, 195–544 life years, 132–343 CVD events, and 7.9–20.9 million Swedish crowns (MSEK) of direct costs, and 19.3(−)51.0 MSEK of total costs would be avoided. CONCLUSION: Lowering of LDL cholesterol to achieve target levels according to guidelines for post-MI patients may lead to fewer cardiovascular events and avoidance of event costs. |
format | Online Article Text |
id | pubmed-5559790 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-55597902017-08-18 Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline Journath, Gunilla Hambraeus, Kristina Hagström, Emil Pettersson, Billie Löthgren, Mickael BMC Cardiovasc Disord Research Article BACKGROUND: The effects on cardiovascular disease (CVD) by treatment recommendations on prevention of atherosclerotic CVD remain to be evaluated. The objectives were to assess treatment gap for low density lipoprotein cholesterol (LDL-C) according to guidelines, potential impact on CVD outcomes, and possible avoided economic costs, in post myocardial infarction (MI) patients, if target LDL-C levels of ≤1.8 mmol/L would be achieved. METHODS: All patients registered in the Swedish Secondary Prevention after Heart Intensive care Admission register, with one-year post-MI follow-up during 2013 were selected. The REACH risk prediction and a calibrated model for recurrent cardiovascular events and death were used to estimate unadjusted risk prediction based on the REACH equation henceforth called base case, and calibrated CVD outcomes based on gender-specific risk factors. The predicted impact of the LDL-C reduction on the risk of CVD was based on the Cholesterol Treatment Trialists´ Collaboration findings. RESULTS: A sample of n = 5904 patients (74% men) with a mean age of 64 years were included. Around 70% did not reach LDL-C target ≤1.8 mmol/L. Over a 10-year period, 820–2262 events were predicted to occur in those who did not reach target corresponding to 20% – 55% risk of CVD events. To achieve LDL-C target, the mean LDL-C had to be reduced by 0.73 mmol/L (29%). If this LDL-C reduction was achieved, 195–544 life years, 132–343 CVD events, and 7.9–20.9 million Swedish crowns (MSEK) of direct costs, and 19.3(−)51.0 MSEK of total costs would be avoided. CONCLUSION: Lowering of LDL cholesterol to achieve target levels according to guidelines for post-MI patients may lead to fewer cardiovascular events and avoidance of event costs. BioMed Central 2017-08-16 /pmc/articles/PMC5559790/ /pubmed/28814290 http://dx.doi.org/10.1186/s12872-017-0659-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Journath, Gunilla Hambraeus, Kristina Hagström, Emil Pettersson, Billie Löthgren, Mickael Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline |
title | Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline |
title_full | Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline |
title_fullStr | Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline |
title_full_unstemmed | Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline |
title_short | Predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of Swedish atherosclerotic cardiovascular disease guideline |
title_sort | predicted impact of lipid lowering therapy on cardiovascular and economic outcomes of swedish atherosclerotic cardiovascular disease guideline |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559790/ https://www.ncbi.nlm.nih.gov/pubmed/28814290 http://dx.doi.org/10.1186/s12872-017-0659-2 |
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