- Title
- Reduction in total recurrent cardiovascular events in acute coronary syndrome patients with low-density lipoprotein cholesterol goal < 70 mg/dL: a real-life cohort in a developing country
- Creator
- Chinwong, Surarong; Patumanond, Jayanton; Chinwong, Dujrudee; Hall, John Joseph; Phrommintikul, Arintaya
- Relation
- Therapeutics and Clinical Risk Management Vol. 12, p. 353-360
- Publisher Link
- http://dx.doi.org/10.2147/TCRM.S96016
- Publisher
- Dove Medical Press
- Resource Type
- journal article
- Date
- 2016
- Description
- Background: For investigations into cardiovascular disease, the first problematic event (ie, nonfatal acute coronary syndrome (ACS), nonfatal stroke, or all-cause mortality) generally was considered as the primary end point; however, ACS patients often experience subsequent events, which are rarely considered. This study reports an investigation into whether achieving a low-density lipoprotein cholesterol (LDL-C) goal of <70 mg/dL (1.8 mmol/L) is associated with a reduction in total recurrent cardiovascular events in a cohort of ACS patients hospitalized in northern Thailand. Methods: The medical charts and the electronic hospital database of ACS patients treated with statins at a tertiary hospital in Thailand between 2009 and 2012 were reviewed. Patients were checked for their LDL-C goal attainment, and then were followed for subsequent events until the last follow-up date, or to December 31, 2012. The Wei–Lin–Weissfeld method was used for multiple time-to-events data to investigate the association between achieving an LDL-C goal of <70 mg/dL and total recurrent cardiovascular events. Results: Of 405 eligible patients, 110 patients attained an LDL-C goal of <70 mg/dL. During a median follow-up of 1.94 years, the majority of patients (88.6%) had no subsequent cardiovascular events, while 46 patients experienced at least one recurrent cardiovascular event: 36 with one event, six with two events, two with three events, one with four events, and one with seven events. Compared to patients with an LDL-C ≥100 mg/dL, patients achieving an LDL-C of <70 mg/dL were significantly less likely to experience total cardiovascular events (adjusted hazard ratio =0.29; 95% confidence interval =0.09–0.87; P-value =0.028); the result was similar to patients with an LDL-C of 70–100 mg/dL, but it was not significant (adjusted hazard ratio =0.53; 95% confidence interval =0.23–1.26; P-value =0.154). Conclusion: ACS patients receiving statins who attained an LDL-C <70 mg/dL experienced a reduction in total recurrent cardiovascular events compared to those with LDL-C ≥100 mg/dL.
- Subject
- LDL-C goal; statins; recurrent events; multiple events; subsequent events; WLW method; multiple time-to-events
- Identifier
- http://hdl.handle.net/1959.13/1339532
- Identifier
- uon:28276
- Identifier
- ISSN:1178-203X
- Rights
- This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
- Language
- eng
- Full Text
- Reviewed
- Hits: 6217
- Visitors: 3201
- Downloads: 739
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT02 | Publisher version (open access) | 407 KB | Adobe Acrobat PDF | View Details Download |