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Prescription of statins at discharge and 1-year risk of major clinical outcomes among acute coronary syndromes patients with extremely low LDL-cholesterol in clinical pathways for acute coronary syndromes studies

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机构: [1]China-Japan Friendship Hospital, Beijing, China [2]Peking University Clinical Research Institute, Beijing, China [3]The George Institute for Global Health, University of Sydney, Sydney, Australia [4]The George Institute for Global Health at Peking University Health Science Center (PUHSC), Beijing, China [5]Peking University Third Hospital, Beijing, China [6]Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China [7]Beijing Anzhen Hospital, Capital Medical University, Beijing, China [8]Peking University First Hospital, Beijing, China [9]Peking University People's Hospital, Beijing, China [10]Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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关键词: ACS patients cohort study major adverse cardiovascular events statin very low baseline LDL-c

摘要:
Objective: The aim of this study was to investigate statin description on discharge and the benefit on the long-term outcomes in acute coronary syndromes (ACS) patients with very low baseline LDL-cholesterol (LDL-c). Methods: This is a post-hoc analysis of 3374 ACS patients who were discharged alive and had baseline LDL-c levels below 70 mg/dL (1.8 mmol/L). The propensity score of using statin was estimated with a multivariable Logistic model including patient's demography, social economic status, cardiovascular risk factors, subtype of the diagnosis, and treatments received during hospitalization and current LDL-c level. The risk of major adverse cardiovascular events (MACEs) was compared between patients received and not-received statin with Cox-regression models adjusting for the propensity score plus other factors. A sensitivity analysis was done in propensity score matched patients. Results: Compared with nonstatin group, the incidence of MACE at 12 months after discharge was lower in the statin group (11.1% vs 5.8%; P < 0.001). The propensity score plus other factors-adjusted hazard ratios for MACEs was significant (0.58; 95% CI: 0.39, 0.87). The effect showed a significant dose-response relationship (P for trend = 0.02). The results in analyses with propensity-score matched participants were in consistent with above findings. Analyses on total mortality in 12 months showed similar results. Conclusions: Among ACS survivors with a very low baseline LDL-c, low to moderate intensity statin therapy was associated significantly with lower risk of MACEs and total mortality at 12 months. The results suggested that ACS survivors should take statin regardless of the baseline of LDL-c.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 4 区 心脏和心血管系统
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 心脏和心血管系统
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出版当年[2016]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]China-Japan Friendship Hospital, Beijing, China
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通讯机构: [2]Peking University Clinical Research Institute, Beijing, China [4]The George Institute for Global Health at Peking University Health Science Center (PUHSC), Beijing, China [6]Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China [*1]Peking University Clinical Research Institute, No. 38, Xueyuan Road, Beijing 100191, China
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