Projected Real-World Effectiveness of Using Aggressive Low-Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada

Journal of the American Heart Association
David A AlterDennis T Ko

Abstract

The extent to which outcome benefits may be achieved through the implementation of aggressive low-density lipoprotein (LDL) cholesterol targets in real world settings remains unknown, especially among elderly statin users following acute coronary syndromes. A population-based cohort study consisting of 19 544 post-acute coronary syndrome statin-users aged ≥66 years between January 1, 2017 and March 31, 2014 was used to project the number of adverse outcome events (acute myocardial infarction or death from any cause) that could be prevented if all post-acute coronary syndrome elderly statin users were treated to 1 of 2 LDL cholesterol target levels (≤50 and ≤70 mg/dL). The number of preventable adverse outcomes was estimated by using model-based expected event probabilities as derived from Cox Proportional hazards models. In total, 61.6% and 25.5% of the elderly patients met LDL cholesterol targets of ≤70 and ≤50 mg/dL, respectively, based on current management. No more than 2.3 adverse events per 1000 elderly statin users (95% confidence interval: -0.7 to 5.4, P=0.62) could be prevented over 8.1 years if all patients were to be treated from current LDL cholesterol levels to either of the 2 LDL cholesterol targets of 70 or 50 mg...Continue Reading

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Citations

Jul 11, 2019·European Journal of Preventive Cardiology·Irene Roman DéganoJaume Marrugat
Feb 6, 2020·European Journal of Preventive Cardiology·Armin Attar
Jul 31, 2020·Expert Opinion on Drug Metabolism & Toxicology·Jian-Jun LiStephen J Nicholls
Nov 2, 2019·Medicina·Ruxandra-Nicoleta HorodinschiCamelia Cristina Diaconu
Jun 21, 2019·Clinical Medicine Insights. Cardiology·Pattamawan Kosuma, Arom Jedsadayanmata
Feb 22, 2021·European Journal of Preventive Cardiology·Armin Attar

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