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

BackgroundThe 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. Methods and ResultsA population‐...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	David A. Alter, Jack V. Tu, Maria Koh, Cynthia A. Jackevicius, Peter C. Austin, Mohammad R. Rezai, R. Sacha Bhatia, Sharon Johnston, Jacob A. Udell, Dennis T. Ko
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2018
Materias:	aging cardiology cardiovascular disease epidemiology geriatrics health services research Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/84bd0b4f46ca48cfa7fd819e23900a06
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:84bd0b4f46ca48cfa7fd819e23900a06
record_format	dspace
spelling	oai:doaj.org-article:84bd0b4f46ca48cfa7fd819e23900a062021-11-12T17:01:59ZProjected Real‐World Effectiveness of Using Aggressive Low‐Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada10.1161/JAHA.117.0075352047-9980https://doaj.org/article/84bd0b4f46ca48cfa7fd819e23900a062018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.117.007535https://doaj.org/toc/2047-9980BackgroundThe 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. Methods and ResultsA 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/dL. ConclusionsThe number of acute myocardial infarctions or death that could be prevented through the implementation of LDL cholesterol targets with statins is negligible among an elderly post‐acute coronary syndrome population. Such findings may have implications for the applicability of newer agents, such as proprotein convertase subtilisin/kexin type‐9‐ inhibitors.David A. AlterJack V. TuMaria KohCynthia A. JackeviciusPeter C. AustinMohammad R. RezaiR. Sacha BhatiaSharon JohnstonJacob A. UdellDennis T. KoWileyarticleagingcardiologycardiovascular diseaseepidemiologygeriatricshealth services researchDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	aging cardiology cardiovascular disease epidemiology geriatrics health services research Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	aging cardiology cardiovascular disease epidemiology geriatrics health services research Diseases of the circulatory (Cardiovascular) system RC666-701 David A. Alter Jack V. Tu Maria Koh Cynthia A. Jackevicius Peter C. Austin Mohammad R. Rezai R. Sacha Bhatia Sharon Johnston Jacob A. Udell Dennis T. Ko Projected Real‐World Effectiveness of Using Aggressive Low‐Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada
description	BackgroundThe 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. Methods and ResultsA 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/dL. ConclusionsThe number of acute myocardial infarctions or death that could be prevented through the implementation of LDL cholesterol targets with statins is negligible among an elderly post‐acute coronary syndrome population. Such findings may have implications for the applicability of newer agents, such as proprotein convertase subtilisin/kexin type‐9‐ inhibitors.
format	article
author	David A. Alter Jack V. Tu Maria Koh Cynthia A. Jackevicius Peter C. Austin Mohammad R. Rezai R. Sacha Bhatia Sharon Johnston Jacob A. Udell Dennis T. Ko
author_facet	David A. Alter Jack V. Tu Maria Koh Cynthia A. Jackevicius Peter C. Austin Mohammad R. Rezai R. Sacha Bhatia Sharon Johnston Jacob A. Udell Dennis T. Ko
author_sort	David A. Alter
title	Projected Real‐World Effectiveness of Using Aggressive Low‐Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada
title_short	Projected Real‐World Effectiveness of Using Aggressive Low‐Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada
title_full	Projected Real‐World Effectiveness of Using Aggressive Low‐Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada
title_fullStr	Projected Real‐World Effectiveness of Using Aggressive Low‐Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada
title_full_unstemmed	Projected Real‐World Effectiveness of Using Aggressive Low‐Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada
title_sort	projected real‐world effectiveness of using aggressive low‐density lipoprotein cholesterol targets among elderly statin users following acute coronary syndromes in canada
publisher	Wiley
publishDate	2018
url	https://doaj.org/article/84bd0b4f46ca48cfa7fd819e23900a06
work_keys_str_mv	AT davidaalter projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT jackvtu projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT mariakoh projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT cynthiaajackevicius projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT petercaustin projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT mohammadrrezai projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT rsachabhatia projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT sharonjohnston projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT jacobaudell projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada AT dennistko projectedrealworldeffectivenessofusingaggressivelowdensitylipoproteincholesteroltargetsamongelderlystatinusersfollowingacutecoronarysyndromesincanada
_version_	1718430379169284096

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

Ejemplares similares