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In patients with st...
In patients with stable coronary heart disease, low-density lipoprotein-cholesterol levels < 70 mg/dL and glycosylated hemoglobin A1c < 7% are associated with lower major cardiovascular events
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- White, Harvey D. (författare)
- Univ Auckland, Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.
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- Stewart, Ralph A. H. (författare)
- Univ Auckland, Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.
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- Dolby, Anthony J. (författare)
- Milpk Hosp, Johannesburg, South Africa.
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- Stebbins, Amanda (författare)
- Duke Clin Res Inst, Duke Med, Durham, NC USA.
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- Cannon, Christopher P. (författare)
- Brigham & Womens Hosp, Cardiovasc Div, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Harvard Clin Res Inst, Boston, MA 02115 USA.
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- Budaj, Andrzej (författare)
- Grochowski Hosp, Postgrad Med Sch, Warsaw, Poland.
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- Linhart, Ales (författare)
- Gen Univ Hosp, Dept Med 2, Dept Cardiovasc Med, Prague, Czech Republic.
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- Pais, Prem (författare)
- St Johns Res Inst, Bangalore, Karnataka, India.
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- Diaz, Rafael (författare)
- Inst Cardiovasc Rosario, Estudios Cordiol Latinoamer, Rosario, Argentina.
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- Steg, Philippe Gabriel (författare)
- Hop Bichat Claude Bernard, AP HP, Paris, France.;Paris Univ, FACT French Alliance Cardiovasc Trials, INSERM, Paris, France.;Imperial Coll, Natl Heart & Lung Inst, Royal Brampton Hosp, London, England.
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- Krug-Gourley, Sue (författare)
- GlaxoSmithKline, Metab Pathways & Cardiovasc Therapeut Area, King Of Prussia, PA USA.
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- Granger, Christopher B. (författare)
- Duke Clin Res Inst, Duke Med, Durham, NC USA.
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- Hochman, Judith S. (författare)
- NYU, Dept Med, Langone Med Ctr, 550 1St Ave, New York, NY 10016 USA.
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- Koenig, Wolfgang (författare)
- Univ Ulm, Inst Epidemiol & Med Biometry, Ulm, Germany.;Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany.;German Ctr Cardiovasc Res, Heart Alliance, Partner Site Munich, Munich, Germany.
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- Harrington, Robert A. (författare)
- Stanford Univ, Stanford Ctr Clin Res, Dept Med, Stanford, CA 94305 USA.
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- Held, Claes, 1956- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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Univ Auckland, Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand Milpk Hosp, Johannesburg, South Africa. (creator_code:org_t)
- Elsevier BV, 2020
- 2020
- Engelska.
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 225, s. 97-107
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- BackgroundIn patients with stable coronary heart disease, it is not known whether achievement of standard of care (SOC) targets in addition to evidence-based medicine (EBM) is associated with lower major adverse cardiovascular events (MACE): cardiovascular death, myocardial infarction, and stroke.MethodsEBM use was recommended in the STabilisation of Atherosclerotic plaque By Initiation of darapLadIb TherapY trial. SOC targets were blood pressure (BP) <140/90 mm Hg and low-density lipoprotein-cholesterol (LDL-C) <100 mg/dL and <70 mg/dL. In patients with diabetes, glycosylated hemoglobin A1c (HbA1c) < 7% and BP of <130/80 mm Hg were recommended. Feedback to investigators about rates of EBM and SOC was provided regularly.ResultsIn 13,623 patients, 1-year landmark analysis assessed the association between EBM, SOC targets, and MACE during follow-up of 2.7 years (median) after adjustment in a Cox proportional hazards model.At 1 year, aspirin was prescribed in 92.5% of patients, statins in 97.2%, β-blockers in 79.0%, and angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers in 76.9%. MACE was lower with LDL-C < 100 mg/dL (70-99 mg/dL) compared with LDL-C ≥ 100 mg/dL (hazard ratio [HR] 0.694, 95% CI 0.594-0.811) and lower with LDL-C < 70 mg/dL compared with LDL-C < 100 mg/dL (70-99 mg/dL) (HR 0.834, 95% CI 0.708-0.983). MACE was lower with HbA1c < 7% compared with HbA1c ≥ 7% (HR 0.705, 95% CI 0.573-0.866). There was no effect of BP targets on MACE.ConclusionsMACE was lower with LDL-C < 100 mg/dL (70-99 mg/dL) and even lower with LDL-C < 70 mg/dL. MACE in patients with diabetes was lower with HbA1c < 7%. Achievement of targets is associated with improved patient outcomes.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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White, Harvey D.
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Stewart, Ralph A ...
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Dolby, Anthony J ...
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Stebbins, Amanda
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Cannon, Christop ...
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Budaj, Andrzej
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Linhart, Ales
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Pais, Prem
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Diaz, Rafael
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Steg, Philippe G ...
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Krug-Gourley, Su ...
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Granger, Christo ...
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Hochman, Judith ...
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Koenig, Wolfgang
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Harrington, Robe ...
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Held, Claes, 195 ...
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Wallentin, Lars, ...
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