TY - JOUR
T1 - Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases
T2 - Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? – Data from a multicenter registry cohort study in Taiwan
AU - Taiwanese Secondary Prevention for Patients with AtheRosCLErotic Disease (T-SPARCLE) Registry Investigators
AU - Yeh, Yen Ting
AU - Yin, Wei Hsian
AU - Tseng, Wei Kung
AU - Lin, Fang Ju
AU - Yeh, Hung I.
AU - Chen, Jaw Wen
AU - Wu, Yen Wen
AU - Wu, Chau Chung
N1 - Publisher Copyright:
© 2017 Yeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/10
Y1 - 2017/10
N2 - 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.
AB - 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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U2 - 10.1371/journal.pone.0186861
DO - 10.1371/journal.pone.0186861
M3 - Article
C2 - 29073192
AN - SCOPUS:85032505276
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 10
M1 - e0186861
ER -