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Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry

BACKGROUND: Current treatment guidelines strongly recommend statin therapy for secondary prevention. However, it remains unclear whether patients’ perceptions of cardiovascular risk, beliefs on cholesterol, or the intensity of prescribed statin therapy differs for patients with coronary artery disea...

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Autores principales: Xian, Ying, Navar, Ann Marie, Li, Shuang, Li, Zhuokai, Robinson, Jennifer, Virani, Salim S., Louie, Michael J., Koren, Andrew, Goldberg, Anne, Roger, Veronique L., Wilson, Peter W. F., Peterson, Eric D., Wang, Tracy Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806030/
https://www.ncbi.nlm.nih.gov/pubmed/31554462
http://dx.doi.org/10.1161/JAHA.119.013229
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author Xian, Ying
Navar, Ann Marie
Li, Shuang
Li, Zhuokai
Robinson, Jennifer
Virani, Salim S.
Louie, Michael J.
Koren, Andrew
Goldberg, Anne
Roger, Veronique L.
Wilson, Peter W. F.
Peterson, Eric D.
Wang, Tracy Y.
author_facet Xian, Ying
Navar, Ann Marie
Li, Shuang
Li, Zhuokai
Robinson, Jennifer
Virani, Salim S.
Louie, Michael J.
Koren, Andrew
Goldberg, Anne
Roger, Veronique L.
Wilson, Peter W. F.
Peterson, Eric D.
Wang, Tracy Y.
author_sort Xian, Ying
collection PubMed
description BACKGROUND: Current treatment guidelines strongly recommend statin therapy for secondary prevention. However, it remains unclear whether patients’ perceptions of cardiovascular risk, beliefs on cholesterol, or the intensity of prescribed statin therapy differs for patients with coronary artery disease (CAD) versus cerebrovascular disease (CeVD) versus both CAD and CeVD (CAD&CeVD). METHODS AND RESULTS: The PALM (Patient and Provider Assessment of Lipid Management) registry collected data on statin use, intensity, and core laboratory low‐density lipoprotein cholesterol levels for 3232 secondary prevention patients treated at 133 US clinics. Among individuals with CeVD only (n=403), CAD only (n=2202), and CeVD&CAD (n=627), no significant differences were observed in patient‐perceived cardiovascular disease risk, beliefs on cholesterol lowering, or perceived effectiveness and safety of statin therapy. However, patients with CeVD only were less likely to receive any statin therapy (76.2% versus 86.2%; adjusted odds ratio 0.64, 95% CI 0.45–0.91), or guideline‐recommended statin intensity (34.6% versus 50.4%; adjusted odds ratio 0.60, 95% CI 0.45–0.81) than those with CAD only. Individuals with CeVD only were also less likely to achieve low‐density lipoprotein cholesterol <100 mg/dL (59.2% versus 69.7%; adjusted odds ratio 0.79, 95% CI 0.64–0.99) than individuals with CAD alone. There were no significant differences in the use of any statin therapy or guideline‐recommended statin intensity between individuals with CAD&CeVD and those with CAD only. CONCLUSIONS: Despite lack of significant differences in patient‐perceived cardiovascular risk or statin beliefs, patients with CeVD were significantly less likely to receive higher intensity statin or achieve low‐density lipoprotein cholesterol <100 mg/dL than those with CAD only.
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spelling pubmed-68060302019-10-28 Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry Xian, Ying Navar, Ann Marie Li, Shuang Li, Zhuokai Robinson, Jennifer Virani, Salim S. Louie, Michael J. Koren, Andrew Goldberg, Anne Roger, Veronique L. Wilson, Peter W. F. Peterson, Eric D. Wang, Tracy Y. J Am Heart Assoc Original Research BACKGROUND: Current treatment guidelines strongly recommend statin therapy for secondary prevention. However, it remains unclear whether patients’ perceptions of cardiovascular risk, beliefs on cholesterol, or the intensity of prescribed statin therapy differs for patients with coronary artery disease (CAD) versus cerebrovascular disease (CeVD) versus both CAD and CeVD (CAD&CeVD). METHODS AND RESULTS: The PALM (Patient and Provider Assessment of Lipid Management) registry collected data on statin use, intensity, and core laboratory low‐density lipoprotein cholesterol levels for 3232 secondary prevention patients treated at 133 US clinics. Among individuals with CeVD only (n=403), CAD only (n=2202), and CeVD&CAD (n=627), no significant differences were observed in patient‐perceived cardiovascular disease risk, beliefs on cholesterol lowering, or perceived effectiveness and safety of statin therapy. However, patients with CeVD only were less likely to receive any statin therapy (76.2% versus 86.2%; adjusted odds ratio 0.64, 95% CI 0.45–0.91), or guideline‐recommended statin intensity (34.6% versus 50.4%; adjusted odds ratio 0.60, 95% CI 0.45–0.81) than those with CAD only. Individuals with CeVD only were also less likely to achieve low‐density lipoprotein cholesterol <100 mg/dL (59.2% versus 69.7%; adjusted odds ratio 0.79, 95% CI 0.64–0.99) than individuals with CAD alone. There were no significant differences in the use of any statin therapy or guideline‐recommended statin intensity between individuals with CAD&CeVD and those with CAD only. CONCLUSIONS: Despite lack of significant differences in patient‐perceived cardiovascular risk or statin beliefs, patients with CeVD were significantly less likely to receive higher intensity statin or achieve low‐density lipoprotein cholesterol <100 mg/dL than those with CAD only. John Wiley and Sons Inc. 2019-09-26 /pmc/articles/PMC6806030/ /pubmed/31554462 http://dx.doi.org/10.1161/JAHA.119.013229 Text en © 2019 The Authors and Mayo Clinic. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Xian, Ying
Navar, Ann Marie
Li, Shuang
Li, Zhuokai
Robinson, Jennifer
Virani, Salim S.
Louie, Michael J.
Koren, Andrew
Goldberg, Anne
Roger, Veronique L.
Wilson, Peter W. F.
Peterson, Eric D.
Wang, Tracy Y.
Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
title Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
title_full Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
title_fullStr Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
title_full_unstemmed Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
title_short Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
title_sort intensity of lipid lowering with statin therapy in patients with cerebrovascular disease versus coronary artery disease: insights from the palm registry
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806030/
https://www.ncbi.nlm.nih.gov/pubmed/31554462
http://dx.doi.org/10.1161/JAHA.119.013229
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