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Relation of Lipid-L...
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Greve, Anders M.
(författare)
Relation of Lipid-Lowering Therapy to Need for Aortic Valve Replacement in Patients With Asymptomatic Mild to Moderate Aortic Stenosis
- Artikel/kapitelEngelska2019
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Elsevier,2019
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LIBRIS-ID:oai:DiVA.org:umu-167068
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-167068URI
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https://doi.org/10.1016/j.amjcard.2019.08.037DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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In this study, we aimed to determine if pretreatment low-density lipoprotein (LDL) levels and aortic stenosis (AS) severity alter the efficacy of lipid-lowering therapy on reducing aortic valve replacement (AVR). We used 1,687 patients with asymptomatic mild-to-moderate AS, who were randomly assigned (1:1) to 40/10 mg simvastatin/ezetimibe combination versus. placebo in the simvastatin and ezetimibe in aortic stenosis (SEAS) trial. Pretreatment LDL levels (>4 mmol/L) and peak aortic jet velocity (3 m/s) were used to partition study participants into 4 groups, which were followed for a primary endpoint of AVR. Cox regression with tests for interaction was used to study the effect of randomized treatment in each subgroup. During a median follow-up of 43 years (IQR 4.2 to 4.7 years; total 7,396 patient-years of follow-up), 478 (28%) patients underwent AVR and 146 (9%) died. A significant risk dependency was detected between simvastatin/ezetimibe combination, LDL levels and mild versus moderate AS on rates of AVR (p = 0.01 for interaction). In stratified analyses, randomized treatment, therefore, reduced the rate of AVR in patients with LDL levels >4 mmol and mild AS at baseline (HR 0.4; 95% CI: 0.2 to 0.9). There was no detectable effect of randomized treatment on the need for AVR in the 3 other participants subgroups. We conclude, that in a secondary analysis from a prospective randomized clinical trial, treatment with simvastatin/ezetimibe combination reduced the need for AVR in a subset of patients with mild AS and high pretreatment LDL levels.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Bang, Casper N.
(författare)
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Boman, KurtUmeå universitet,Avdelningen för medicin(Swepub:umu)kubo0001
(författare)
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Egstrup, Kenneth
(författare)
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Kesaniemi, Y. Antero
(författare)
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Ray, Simon
(författare)
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Pedersen, Terje R.
(författare)
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Wachtell, Kristian
(författare)
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Umeå universitetAvdelningen för medicin
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:American Journal of Cardiology: Elsevier124:11, s. 1736-17400002-91491879-1913
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