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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.

Titel:	Effectiveness of the low-density lipoprotein cholesterol goals in secondary cardiovascular prevention.
Autor/in / Beteiligte Person:	Garcia-Gil, M ; Alves-Cabratosa, L ; Cunillera, O ; Blanch, J ; Martí-Lluch, R ; Ponjoan, A ; Ribas-Aulinas, F ; Tornabell-Noguera, È ; Zacarías-Pons, L ; Domínguez-Armengol, G ; Guzmán, E ; Ramos, R
Link:	Full Text Finder (Volltext)
Zeitschrift:	European journal of clinical investigation, 2024-06-03, S. e14258
Veröffentlichung:	Ahead of Print, 2024
Medientyp:	academicJournal
ISSN:	1365-2362 (electronic)
DOI:	10.1111/eci.14258
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Long‐term safety and efficacy of achieving very low levels of low‐density lipoprotein cholesterol: a prespecified analysis of the IMPROVE‐IT trial. Supplement JAMA Cardiol. 2017;2(5):547‐555. ; Ray KK, Haq I, Bilitou A, et al. Treatment gaps in the implementation of LDL cholesterol control among high‐ and very high‐risk patients in Europe between 2020 and 2021: the multinational observational SANTORINI study. The Lancet Regional Health Europe. 2023;29:100624 https://pubmed.ncbi.nlm.nih.gov/37090089/. ; Garcia‐Gil M, Comas‐Cufí M, Blanch J, et al. Effectiveness of statins as primary prevention in people with different cardiovascular risk: a population‐based cohort study. Clin Pharmacol Ther. 2017;104(4):719‐732. http://doi.wiley.com/10.1002/cpt.954. Grant Information: 0018 RedIAPP, RETICS; RD06 RedIAPP, RETICS; PI16/00313 Instituto de Salud Carlos III- FIS grant; RD21/0016/0001 Instituto de Salud Carlos III- RICORS co-funded with European Union -Next GenerationEU funds; 2014 SGR 240 Agència de Gestió d'Ajuts Universitaris i de Recerca; 2014 SGR 902 Agència de Gestió d'Ajuts Universitaris i de Recerca Contributed Indexing: Keywords: cardiovascular disease; electronic health records; low‐density lipoprotein cholesterol goals; real‐world data; secondary cardiovascular prevention; statins Entry Date(s): Date Created: 20240603 Latest Revision: 20240603 Update Code: 20240603

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