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Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data
PURPOSE: To estimate the risk of recurrent cardiovascular events in a real-world population of very high-risk Korean patients with prior myocardial infarction (MI), ischemic stroke (IS), or symptomatic peripheral artery disease (sPAD), similar to the Further cardiovascular OUtcomes Research with pro...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834152/ https://www.ncbi.nlm.nih.gov/pubmed/34622354 http://dx.doi.org/10.1007/s10557-021-07255-2 |
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author | Kwon, Osung Na, Wonjun Hur, Jaehee Kim, Ju Hyeon Jun, Tae Joon Kang, Hee Jun Lee, Hojoon Kim, Young-Hak |
author_facet | Kwon, Osung Na, Wonjun Hur, Jaehee Kim, Ju Hyeon Jun, Tae Joon Kang, Hee Jun Lee, Hojoon Kim, Young-Hak |
author_sort | Kwon, Osung |
collection | PubMed |
description | PURPOSE: To estimate the risk of recurrent cardiovascular events in a real-world population of very high-risk Korean patients with prior myocardial infarction (MI), ischemic stroke (IS), or symptomatic peripheral artery disease (sPAD), similar to the Further cardiovascular OUtcomes Research with proprotein convertase subtilisin–kexin type 9 Inhibition in subjects with Elevated Risk (FOURIER) trial population. METHODS: This retrospective study used the Asan Medical Center Heart Registry database built on electronic medical records (EMR) from 2000 to 2016. Patients with a history of clinically evident atherosclerotic cardiovascular disease (ASCVD) with multiple risk factors were followed up for 3 years. The primary endpoint was a composite of MI, stroke, hospitalization for unstable angina, coronary revascularization, and all-cause mortality. RESULTS: Among 15,820 patients, the 3-year cumulative incidence of the composite primary endpoint was 15.3% and the 3-year incidence rate was 5.7 (95% CI 5.5–5.9) per 100 person-years. At individual endpoints, the rates of deaths, MI, and IS were 0.4 (0.3–0.4), 0.9 (0.8–0.9), and 0.8 (0.7–0.9), respectively. The risk of the primary endpoint did not differ significantly between recipients of different intensities of statin therapy. Low-density lipoprotein cholesterol (LDL-C) goals were only achieved in 24.4% of patients during the first year of follow-up. CONCLUSION: By analyzing EMR data representing routine practice in Korea, we found that patients with very high-risk ASCVD were at substantial risk of further cardiovascular events in 3 years. Given the observed risk of recurrent events with suboptimal lipid management by statin, additional treatment to control LDL-C might be necessary to reduce the burden of further cardiovascular events for very high-risk ASCVD patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10557-021-07255-2. |
format | Online Article Text |
id | pubmed-9834152 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-98341522023-01-13 Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data Kwon, Osung Na, Wonjun Hur, Jaehee Kim, Ju Hyeon Jun, Tae Joon Kang, Hee Jun Lee, Hojoon Kim, Young-Hak Cardiovasc Drugs Ther Original Article PURPOSE: To estimate the risk of recurrent cardiovascular events in a real-world population of very high-risk Korean patients with prior myocardial infarction (MI), ischemic stroke (IS), or symptomatic peripheral artery disease (sPAD), similar to the Further cardiovascular OUtcomes Research with proprotein convertase subtilisin–kexin type 9 Inhibition in subjects with Elevated Risk (FOURIER) trial population. METHODS: This retrospective study used the Asan Medical Center Heart Registry database built on electronic medical records (EMR) from 2000 to 2016. Patients with a history of clinically evident atherosclerotic cardiovascular disease (ASCVD) with multiple risk factors were followed up for 3 years. The primary endpoint was a composite of MI, stroke, hospitalization for unstable angina, coronary revascularization, and all-cause mortality. RESULTS: Among 15,820 patients, the 3-year cumulative incidence of the composite primary endpoint was 15.3% and the 3-year incidence rate was 5.7 (95% CI 5.5–5.9) per 100 person-years. At individual endpoints, the rates of deaths, MI, and IS were 0.4 (0.3–0.4), 0.9 (0.8–0.9), and 0.8 (0.7–0.9), respectively. The risk of the primary endpoint did not differ significantly between recipients of different intensities of statin therapy. Low-density lipoprotein cholesterol (LDL-C) goals were only achieved in 24.4% of patients during the first year of follow-up. CONCLUSION: By analyzing EMR data representing routine practice in Korea, we found that patients with very high-risk ASCVD were at substantial risk of further cardiovascular events in 3 years. Given the observed risk of recurrent events with suboptimal lipid management by statin, additional treatment to control LDL-C might be necessary to reduce the burden of further cardiovascular events for very high-risk ASCVD patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10557-021-07255-2. Springer US 2021-10-08 2023 /pmc/articles/PMC9834152/ /pubmed/34622354 http://dx.doi.org/10.1007/s10557-021-07255-2 Text en © The Author(s) 2021, corrected publication October/2021 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Kwon, Osung Na, Wonjun Hur, Jaehee Kim, Ju Hyeon Jun, Tae Joon Kang, Hee Jun Lee, Hojoon Kim, Young-Hak Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data |
title | Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data |
title_full | Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data |
title_fullStr | Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data |
title_full_unstemmed | Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data |
title_short | Cardiovascular Event Rates in Statin-Treated Korean Patients with Cardiovascular Disease: Estimates from a Real-World Population Using Electronic Medical Record Data |
title_sort | cardiovascular event rates in statin-treated korean patients with cardiovascular disease: estimates from a real-world population using electronic medical record data |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9834152/ https://www.ncbi.nlm.nih.gov/pubmed/34622354 http://dx.doi.org/10.1007/s10557-021-07255-2 |
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