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Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan

OBJECTIVE: Whether a low-density lipoprotein cholesterol (LDL-C) goal is essential in secondary prevention is still being debated. The aim of our study was to investigate whether achieving particular LDL-C level goals is associated with the reduction in the risk of major adverse cardiac events (MACE...

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Autores principales: Yeh, Yen-Ting, Yin, Wei-Hsian, Tseng, Wei-Kung, Lin, Fang-Ju, Yeh, Hung-I, Chen, Jaw-Wen, Wu, Yen-Wen, Wu, Chau-Chung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658082/
https://www.ncbi.nlm.nih.gov/pubmed/29073192
http://dx.doi.org/10.1371/journal.pone.0186861
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author Yeh, Yen-Ting
Yin, Wei-Hsian
Tseng, Wei-Kung
Lin, Fang-Ju
Yeh, Hung-I
Chen, Jaw-Wen
Wu, Yen-Wen
Wu, Chau-Chung
author_facet Yeh, Yen-Ting
Yin, Wei-Hsian
Tseng, Wei-Kung
Lin, Fang-Ju
Yeh, Hung-I
Chen, Jaw-Wen
Wu, Yen-Wen
Wu, Chau-Chung
author_sort Yeh, Yen-Ting
collection PubMed
description OBJECTIVE: Whether a low-density lipoprotein cholesterol (LDL-C) goal is essential in secondary prevention is still being debated. The aim of our study was to investigate whether achieving particular LDL-C level goals is associated with the reduction in the risk of major adverse cardiac events (MACEs) in patients with atherosclerotic cardiovascular diseases (ASCVD) on statin therapy. METHODS AND RESULTS: From January 2010 to August 2014, a total of 4099 patients with ASCVD in the Taiwan Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) registry were analyzed. The risk of a MACE was lower in patients with LDL-C level under control at < 100 mg/dL by statins than in patients with LDL-C level ≥100 mg/dL whether on statin therapy (hazard ratio [HR] 1.66, 95% confidence interval [CI] 1.04‒2.63, p = 0.03) or not (HR 2.04, 95% CI 1.06‒3.94, p = 0.03). In multivariate Cox model analyses, statin intensity had no significant predictive value, and LDL-C ≥ 100 mg/dL was associated with a slight but not significant trend toward increased risk of MACEs (HR 1.41, 95% CI 0.96‒2.07, p = 0.08). CONCLUSIONS: For patients with ASCVD on statin therapy guided by a target-driven strategy, failure to control LDL-C levels to < 100 mg/dL was associated with higher risk of MACEs. Statin intensity alone had no significant impact on the risk of MACEs after multivariate adjustment.
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spelling pubmed-56580822017-11-09 Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan Yeh, Yen-Ting Yin, Wei-Hsian Tseng, Wei-Kung Lin, Fang-Ju Yeh, Hung-I Chen, Jaw-Wen Wu, Yen-Wen Wu, Chau-Chung PLoS One Research Article OBJECTIVE: Whether a low-density lipoprotein cholesterol (LDL-C) goal is essential in secondary prevention is still being debated. The aim of our study was to investigate whether achieving particular LDL-C level goals is associated with the reduction in the risk of major adverse cardiac events (MACEs) in patients with atherosclerotic cardiovascular diseases (ASCVD) on statin therapy. METHODS AND RESULTS: From January 2010 to August 2014, a total of 4099 patients with ASCVD in the Taiwan Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) registry were analyzed. The risk of a MACE was lower in patients with LDL-C level under control at < 100 mg/dL by statins than in patients with LDL-C level ≥100 mg/dL whether on statin therapy (hazard ratio [HR] 1.66, 95% confidence interval [CI] 1.04‒2.63, p = 0.03) or not (HR 2.04, 95% CI 1.06‒3.94, p = 0.03). In multivariate Cox model analyses, statin intensity had no significant predictive value, and LDL-C ≥ 100 mg/dL was associated with a slight but not significant trend toward increased risk of MACEs (HR 1.41, 95% CI 0.96‒2.07, p = 0.08). CONCLUSIONS: For patients with ASCVD on statin therapy guided by a target-driven strategy, failure to control LDL-C levels to < 100 mg/dL was associated with higher risk of MACEs. Statin intensity alone had no significant impact on the risk of MACEs after multivariate adjustment. Public Library of Science 2017-10-26 /pmc/articles/PMC5658082/ /pubmed/29073192 http://dx.doi.org/10.1371/journal.pone.0186861 Text en © 2017 Yeh et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yeh, Yen-Ting
Yin, Wei-Hsian
Tseng, Wei-Kung
Lin, Fang-Ju
Yeh, Hung-I
Chen, Jaw-Wen
Wu, Yen-Wen
Wu, Chau-Chung
Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan
title Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan
title_full Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan
title_fullStr Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan
title_full_unstemmed Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan
title_short Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? ‒ Data from a multicenter registry cohort study in Taiwan
title_sort lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: which matters in the real world? statin intensity or low-density lipoprotein cholesterol level? ‒ data from a multicenter registry cohort study in taiwan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658082/
https://www.ncbi.nlm.nih.gov/pubmed/29073192
http://dx.doi.org/10.1371/journal.pone.0186861
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