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Statin dose titrati...
Statin dose titration patterns and subsequent major cardiovascular events in very high-risk patients: estimates from Swedish population-based registry data.
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- Banefelt, Jonas (author)
- Quantify Res, Hantverkargatan 8, S-11221 Stockholm, Sweden.
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- Lindh, Maria (author)
- Quantify Res, Hantverkargatan 8, S-11221 Stockholm, Sweden.
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- Svensson, Maria K. (author)
- Uppsala universitet,Njurmedicin,Amgen AB Sweden, Gustav III S Blvd 54, S-16974 Solna, Sweden
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- Eliasson, Björn, 1959 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Univ Gothenburg, Sahlgrenska Univ Hosp, Dept Med, S-41345 Gothenburg, Sweden.
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- Tai, Ming-Hui (author)
- Amgen Inc, 1 Amgen Ctr Dr, Thousand Oaks, CA 91320 USA.
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Quantify Res, Hantverkargatan 8, S-11221 Stockholm, Sweden Njurmedicin (creator_code:org_t)
- 2020-04-01
- 2020
- English.
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In: European heart journal. Quality of care & clinical outcomes. - : Oxford University Press (OUP). - 2058-1742 .- 2058-1742 .- 2058-5225. ; 6:4, s. 323-331
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https://doi.org/10.1...
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Abstract
Subject headings
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- Clinical studies have demonstrated the efficacy of intensive statin therapy in lowering low-density lipoprotein cholesterol and cardiovascular (CV) events. Our objective was to examine statin titration patterns and the association between titration patterns and subsequent CV events in very high-risk patients.Using Swedish national population-based registry data, we identified 192435 patients with very high risk of atherosclerotic CV disease initiated on moderate-intensity statin therapy between 2006 and 2013. Outcomes of interest were titration to high-intensity therapy and the major adverse cardiovascular events (MACE) composite (myocardial infarction, ischaemic stroke, and CV death) outcome. Cumulative incidence of MACE was assessed by titration status 1-year post-treatment initiation in patients adherent to treatment during the first year, using a 12-week cut-off from initiation to define early, delayed and no up-titration to high-intensity statins. Cox regression analysis was used to estimate adjusted hazard ratios (HRs). In 144498 eligible patients, early titration was associated with significantly lower risk of MACE in the subsequent 2 years compared to no up-titration (HR 0.76, P<0.01]. Delayed up-titration was associated with a smaller reduction (HR 0.88, P=0.08). The majority of patients did not up-titrate.Early up-titration to high-intensity statins was independently associated with lower risk of subsequent CV events compared to no up-titration. Delayed up-titration was not associated with the same benefit. Despite the higher risk associated with no up-titration, few patients at very high CV risk who started treatment on moderate-intensity up-titrated to high intensity, indicating a potential need for more aggressive lipid management of these patients in clinical practice.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Cardiovascular outcomes
- Secondary prevention
- MACE
- ASCVD
- Statin titration
- Cardiovascular outcomes
Publication and Content Type
- ref (subject category)
- art (subject category)
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