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Sökning: onr:"swepub:oai:DiVA.org:uu-418944" > 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

White, Harvey D. (författare)
Univ Auckland, Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.
Stewart, Ralph A. H. (författare)
Univ Auckland, Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.
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.
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.
Budaj, Andrzej (författare)
Grochowski Hosp, Postgrad Med Sch, Warsaw, Poland.
Linhart, Ales (författare)
Gen Univ Hosp, Dept Med 2, Dept Cardiovasc Med, Prague, Czech Republic.
Pais, Prem (författare)
St Johns Res Inst, Bangalore, Karnataka, India.
Diaz, Rafael (författare)
Inst Cardiovasc Rosario, Estudios Cordiol Latinoamer, Rosario, Argentina.
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.
Krug-Gourley, Sue (författare)
GlaxoSmithKline, Metab Pathways & Cardiovasc Therapeut Area, King Of Prussia, PA USA.
Granger, Christopher B. (författare)
Duke Clin Res Inst, Duke Med, Durham, NC USA.
Hochman, Judith S. (författare)
NYU, Dept Med, Langone Med Ctr, 550 1St Ave, New York, NY 10016 USA.
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.
Harrington, Robert A. (författare)
Stanford Univ, Stanford Ctr Clin Res, Dept Med, Stanford, CA 94305 USA.
Held, Claes, 1956- (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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.
Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 225, s. 97-107
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
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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