Effectiveness of the low-density lipoprotein cholesterol goals in secondary cardiovascular prevention

Abstract

Background: The effectiveness of statin treatment to reduce coronary events and mortality has been hardly examined considering goals of LDL-C. We aimed to analyse such association in secondary cardiovascular prevention. Methods: Retrospective cohort analysis of electronic health records from the SIDIAP database, Catalonia-Spain. Recruitment period was from 2006 to 2017 and study period finished at the end of 2018. We included 54,175 people aged ≥35 years in cardiovascular secondary prevention starting statin treatment. We analysed the association of achieved LDL-C goals after statin initiation with coronary heart disease and all-cause mortality. Results: Mean age was 69 years and 20,146 (37.2%) were women. Coronary heart disease occurred in 5687 (10.5%) participants, and 10,676 (19.7%) persons passed away. Median follow-up lasted 5.7 years (interquartile range, 3.4–8.1). The coronary heart disease HRs (95% CI) for the LDL-C goals of 70–100, <70–55 and <55 mg/dL were.86 (.81–.92),.83 (.76–.9) and.8 (.72–.88), respectively. They were.89 (.83–.96) in the group with 30%–40% reduction and.86 (.8–.93) in the groups with 40%–50% and ≥50% reduction. We observed no association with mortality. We observed no relevant differences by sex or age. Conclusions: This population-level retrospective analysis of real-world data observed that treatment with statins is effective to achieve certain LDL-C goals and CHD reduction. The lack of significant difference between LDL-C goals needs confirmation in additional studies with real-world data. The LDL-C target should consider the magnitude of the decrease in coronary events

Research Funding: RedIAPP, RETICS. Grant Numbers: 0018, RD06; Instituto de Salud Carlos III- FIS grant. Grant Number: PI16/00313; Instituto de Salud Carlos III- RICORS co-funded with; European Union -Next GenerationEU funds. Grant Number: RD21/0016/0001 and Agència de Gestió d'Ajuts Universitaris i de Recerca. Grant Numbers: 2014 SGR 240, 2014 SGR 902

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