In patients with stable coronary heart disease, low-density lipoprotein-cholesterol levels < 70 mg/dL and glycosylated hemoglobin A1c < 7% are associated with lower major cardiovascular events

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F20%3A10412603" target="_blank" >RIV/00064165:_____/20:10412603 - isvavai.cz</a>

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=WaZfK-LQTO" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=WaZfK-LQTO</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ahj.2020.04.004" target="_blank" >10.1016/j.ahj.2020.04.004</a>

Jazyk výsledku

angličtina

Název v původním jazyce

In patients with stable coronary heart disease, low-density lipoprotein-cholesterol levels < 70 mg/dL and glycosylated hemoglobin A1c < 7% are associated with lower major cardiovascular events

Popis výsledku v původním jazyce

Background: In patients with stable coronary heart disease, it is not known whether achievement of standard of care (SOC) targets in addition to evidence-based medicine (EBM) is associated with lower major adverse cardiovascular events (MACE): cardiovascular death, myocardial infarction, and stroke. Methods: EBM use was recommended in the STabilisation of Atherosclerotic plaque By Initiation of darapLadIb TherapY trial. SOC targets were blood pressure (BP) &lt;140/90 mm Hg and low-density lipoprotein-cholesterol (LDL-C) &lt;100 mg/dL and &lt;70 mg/dL. In patients with diabetes, glycosylated hemoglobin A1c (HbA1c) &lt; 7% and BP of &lt;130/80 mm Hg were recommended. Feedback to investigators about rates of EBM and SOC was provided regularly. Results: In 13,623 patients, 1-year landmark analysis assessed the association between EBM, SOC targets, and MACE during follow-up of 2.7 years (median) after adjustment in a Cox proportional hazards model. At 1 year, aspirin was prescribed in 92.5% of patients, statins in 97.2%, β-blockers in 79.0%, and angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers in 76.9%. MACE was lower with LDL-C &lt; 100 mg/dL (70-99 mg/dL) compared with LDL-C &gt;= 100 mg/dL (hazard ratio [HR] 0.694, 95% CI 0.594-0.811) and lower with LDL-C &lt; 70 mg/dL compared with LDL-C &lt; 100 mg/dL (70-99 mg/dL) (HR 0.834, 95% CI 0.708-0.983). MACE was lower with HbA1c &lt; 7% compared with HbA1c &gt;= 7% (HR 0.705, 95% CI 0.573-0.866). There was no effect of BP targets on MACE. Conclusions: MACE was lower with LDL-C &lt; 100 mg/dL (70-99 mg/dL) and even lower with LDL-C &lt; 70 mg/dL. MACE in patients with diabetes was lower with HbA1c &lt; 7%. Achievement of targets is associated with improved patient outcomes.

Název v anglickém jazyce

In patients with stable coronary heart disease, low-density lipoprotein-cholesterol levels < 70 mg/dL and glycosylated hemoglobin A1c < 7% are associated with lower major cardiovascular events

Popis výsledku anglicky

Background: In patients with stable coronary heart disease, it is not known whether achievement of standard of care (SOC) targets in addition to evidence-based medicine (EBM) is associated with lower major adverse cardiovascular events (MACE): cardiovascular death, myocardial infarction, and stroke. Methods: EBM use was recommended in the STabilisation of Atherosclerotic plaque By Initiation of darapLadIb TherapY trial. SOC targets were blood pressure (BP) &lt;140/90 mm Hg and low-density lipoprotein-cholesterol (LDL-C) &lt;100 mg/dL and &lt;70 mg/dL. In patients with diabetes, glycosylated hemoglobin A1c (HbA1c) &lt; 7% and BP of &lt;130/80 mm Hg were recommended. Feedback to investigators about rates of EBM and SOC was provided regularly. Results: In 13,623 patients, 1-year landmark analysis assessed the association between EBM, SOC targets, and MACE during follow-up of 2.7 years (median) after adjustment in a Cox proportional hazards model. At 1 year, aspirin was prescribed in 92.5% of patients, statins in 97.2%, β-blockers in 79.0%, and angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers in 76.9%. MACE was lower with LDL-C &lt; 100 mg/dL (70-99 mg/dL) compared with LDL-C &gt;= 100 mg/dL (hazard ratio [HR] 0.694, 95% CI 0.594-0.811) and lower with LDL-C &lt; 70 mg/dL compared with LDL-C &lt; 100 mg/dL (70-99 mg/dL) (HR 0.834, 95% CI 0.708-0.983). MACE was lower with HbA1c &lt; 7% compared with HbA1c &gt;= 7% (HR 0.705, 95% CI 0.573-0.866). There was no effect of BP targets on MACE. Conclusions: MACE was lower with LDL-C &lt; 100 mg/dL (70-99 mg/dL) and even lower with LDL-C &lt; 70 mg/dL. MACE in patients with diabetes was lower with HbA1c &lt; 7%. Achievement of targets is associated with improved patient outcomes.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

American Heart Journal

ISSN

0002-8703

e-ISSN

—

Svazek periodika

225

Číslo periodika v rámci svazku

July

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

11

Strana od-do

97-107

Kód UT WoS článku

000541737100013

EID výsledku v databázi Scopus

2-s2.0-85085290726