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Recurrent Atherosclerotic Cardiovascular Disease Events Potentially Prevented with Guideline-Recommended Cholesterol-Lowering Therapy following Myocardial Infarction.
Sakhuja, Swati; Bittner, Vera A; Brown, Todd M; Farkouh, Michael E; Levitan, Emily B; Safford, Monika M; Woodward, Mark; Chen, Ligong; Sun, Ruoyan; Dhalwani, Nafeesa; Jones, Jenna; Kalich, Bethany; Exter, Jason; Muntner, Paul; Rosenson, Robert S; Colantonio, Lisandro D.
Affiliation
  • Sakhuja S; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. ssakhuja@uab.edu.
  • Bittner VA; Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Brown TM; Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Farkouh ME; Peter Munk Cardiac Centre, University of Toronto and Heart and Stroke Richard Lewar Centre of Excellence, Toronto, ON, Canada.
  • Levitan EB; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Safford MM; Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
  • Woodward M; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
  • Chen L; The George Institute for Global Health, School of Public Health, Imperial College, London, UK.
  • Sun R; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Dhalwani N; Department of Healthcare Policy and Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Jones J; Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA.
  • Kalich B; Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA.
  • Exter J; Amgen Inc., Thousand Oaks, CA, USA.
  • Muntner P; Amgen Inc., Thousand Oaks, CA, USA.
  • Rosenson RS; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Colantonio LD; Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY, USA.
Cardiovasc Drugs Ther ; 2023 Apr 13.
Article in En | MEDLINE | ID: mdl-37052867
ABSTRACT

PURPOSE:

Many adults with atherosclerotic cardiovascular disease (ASCVD) who are recommended to take a statin, ezetimibe and/or a proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) by the 2018 American Heart Association/American College of Cardiology cholesterol guideline do not receive these medications. We estimated the percentage of recurrent ASCVD events potentially prevented with guideline-recommended cholesterol-lowering therapy following a myocardial infarction (MI) hospitalization.

METHODS:

We conducted simulations using data from US adults with government health insurance through Medicare or commercial health insurance in the MarketScan database. We used data from patients with an MI hospitalization in 2018-2019 to estimate the percentage receiving guideline-recommended therapy. We used data from patients with an MI hospitalization in 2013-2016 to estimate the 3-year cumulative incidence of recurrent ASCVD events (i.e., MI, coronary revascularization or ischemic stroke). The low-density lipoprotein cholesterol (LDL-C) reduction with guideline-recommended therapy was derived from trials of statins, ezetimibe and PCSK9i, and the associated ASCVD risk reduction was estimated from a meta-analysis by the Cholesterol-Lowering Treatment Trialists Collaboration.

RESULTS:

Among 279,395 patients with an MI hospitalization in 2018-2019 (mean age 75 years, mean LDL-C 92 mg/dL), 27.3% were receiving guideline-recommended cholesterol-lowering therapy. With current cholesterol-lowering therapy use, 25.3% (95%CI 25.2%-25.4%) of patients had an ASCVD event over 3 years. If all patients were to receive guideline-recommended therapy, 19.8% (95%CI 19.5%-19.9%) were estimated to have an ASCVD event over 3 years, representing a 21.6% (95%CI 20.5%-23.6%) relative risk reduction.

CONCLUSION:

Implementation of guideline-recommended cholesterol-lowering therapy could prevent a substantial percentage of recurrent ASCVD events.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Etiology_studies / Guideline Language: En Journal: Cardiovasc Drugs Ther Journal subject: ANGIOLOGIA / CARDIOLOGIA / TERAPIA POR MEDICAMENTOS Year: 2023 Document type: Article Affiliation country:
Fulltext
Add to My VHL
Print
XML
PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Etiology_studies / Guideline Language: En Journal: Cardiovasc Drugs Ther Journal subject: ANGIOLOGIA / CARDIOLOGIA / TERAPIA POR MEDICAMENTOS Year: 2023 Document type: Article Affiliation country: