The Impact of Low-density lipoprotein cholesterol Goal Attainments on Cardiovascular Outcomes: A Retrospective Cohort Study in Chinese Acute Coronary Syndrome Patients
Refereed conference paper presented and published in conference proceedings


摘要OBJECTIVES: This study aimed to assess the effect of low-density lipoprotein cholesterol(LDL-C) goal attainments (of < 2.6mmol/L, <1.8mmol/L, and <50%reduction) on first major adverse cardiovascular events (MACEs) for acute coronary syndrome (ACS )patients who underwent percutaneous coronary intervention (PCI).
METHODS: A retrospective cohort study was conducted using case reviews of post PCI ACS patients at an acute public hospital in Hong Kong between January 2009 and August 2015. Patients were followed from the date of PCI procedure until the first event of MACE (including all-cause death, myocardial infarction, heart failure, documented unstable angina, revascularization, and stroke) or to the end of the first year. Kaplan-Meier estimates were used to evaluate the impact of LDL-C goal attainment prior to the event on event-free time (time from the latest lipid goal attainment to the first occurrence of MACE).
RESULTS: A total of 1684 patients were identified. Mean age was 68.7years(78.8%males). At one-year endpoint, 658(39.1%) attained the LDL-C goal of < 1.8mmol/L, 727(43.2%) had LDL-C between 1.8mmol/L and 2.6mmol/L, and 299(17.8%) had LDL-C > 2.6mmol/L. About 10% experienced a MACE within one year. The attainment of LDL-C level < 2.6mmol/L was significantly associated with lower rates of MACEs during the one-year follow-up, and a further lowering of LDL-C level to 1.8mmol/L did not lead to any incremental clinical benefits.Statin therapy was highly associated with LDL-C goal attainments but high-intensity statin therapy itself was not associated with a reduced rate of MACEs. Obtaining a <50% reduction in LDL-C was associated with a significant reduction in MACEs.
CONCLUSIONS: The clinical benefits of achieving an LDL-C goal of <2.6mmol/L or obtaining a <50% reduction were reconfirmed, whereas achieving a <1.8mmol/L goal was not.
著者Lee VWY, Wang Y, Yan BPY, Nichol MB, Tomlinson B
會議名稱ISPOR 22nd Annual International Meeting
會議論文集題名Value in Health
頁次A262 - A262

上次更新時間 2021-14-09 於 00:54