Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study
Abstract In this retrospective study, we investigated whether lipid-lowering therapy (LLT) escalation has clinical benefits in patients with atherosclerotic cardiovascular disease (ASCVD) and low-density lipoprotein cholesterol (LDL-C) levels of 55–99 mg/dL (1.4–2.6 mmol/L), post high-intensity. Out...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-04-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-88416-z |
| _version_ | 1818344638919999488 |
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| author | Jaehyung Ha Bom Lee Jung Mi Park Moonjong Kang Jaewon Oh Chan Joo Lee Sungha Park Seok-Min Kang Sang-Hak Lee |
| author_facet | Jaehyung Ha Bom Lee Jung Mi Park Moonjong Kang Jaewon Oh Chan Joo Lee Sungha Park Seok-Min Kang Sang-Hak Lee |
| author_sort | Jaehyung Ha |
| collection | DOAJ |
| description | Abstract In this retrospective study, we investigated whether lipid-lowering therapy (LLT) escalation has clinical benefits in patients with atherosclerotic cardiovascular disease (ASCVD) and low-density lipoprotein cholesterol (LDL-C) levels of 55–99 mg/dL (1.4–2.6 mmol/L), post high-intensity. Out of 6317 Korean patients screened in 2005–2018, 1159 individuals with ASCVD and LDL-C levels of 55–99 mg/dL after statin use equivalent to 40 mg atorvastatin were included. After 1:2 propensity score matching, 492 patients (164 with LLT escalation, 328 controls without LLT escalation) were finally analysed. Primary outcome variables were major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause death. At median follow-up (1.93 years), the escalation group had a lower MACCE rate (1.72 vs. 3.38 events/100 person-years; hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.14–0.83; p = 0.018) than the control group. The incidence of all-cause death (0.86 vs. 1.02 events/100 person-years; HR 0.58, 95% CI 0.15–2.19; p = 0.42) and each MACCE component did not differ between groups. Kaplan–Meier curves exhibited lower risk of MACCE in the escalation group (HR 0.36, 95% CI 0.12–0.97; p = 0.040) but a difference not statistically significant in all-cause death (HR 0.30, 95% CI 0.04–2.48; p = 0.26). LLT escalation was associated with reduced cardiovascular risk, supporting more aggressive LLT in this population. |
| first_indexed | 2024-12-13T16:49:40Z |
| format | Article |
| id | doaj.art-3a6419087aa740d3bbddc86e514189e5 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-13T16:49:40Z |
| publishDate | 2021-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-3a6419087aa740d3bbddc86e514189e52022-12-21T23:38:04ZengNature PortfolioScientific Reports2045-23222021-04-011111810.1038/s41598-021-88416-zEscalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH studyJaehyung Ha0Bom Lee1Jung Mi Park2Moonjong Kang3Jaewon Oh4Chan Joo Lee5Sungha Park6Seok-Min Kang7Sang-Hak Lee8Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDepartment of Biostatistics and Computing, Graduate School, Yonsei UniversityDepartment of Biostatistics and Computing, Graduate School, Yonsei UniversityDivision of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineDivision of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of MedicineAbstract In this retrospective study, we investigated whether lipid-lowering therapy (LLT) escalation has clinical benefits in patients with atherosclerotic cardiovascular disease (ASCVD) and low-density lipoprotein cholesterol (LDL-C) levels of 55–99 mg/dL (1.4–2.6 mmol/L), post high-intensity. Out of 6317 Korean patients screened in 2005–2018, 1159 individuals with ASCVD and LDL-C levels of 55–99 mg/dL after statin use equivalent to 40 mg atorvastatin were included. After 1:2 propensity score matching, 492 patients (164 with LLT escalation, 328 controls without LLT escalation) were finally analysed. Primary outcome variables were major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause death. At median follow-up (1.93 years), the escalation group had a lower MACCE rate (1.72 vs. 3.38 events/100 person-years; hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.14–0.83; p = 0.018) than the control group. The incidence of all-cause death (0.86 vs. 1.02 events/100 person-years; HR 0.58, 95% CI 0.15–2.19; p = 0.42) and each MACCE component did not differ between groups. Kaplan–Meier curves exhibited lower risk of MACCE in the escalation group (HR 0.36, 95% CI 0.12–0.97; p = 0.040) but a difference not statistically significant in all-cause death (HR 0.30, 95% CI 0.04–2.48; p = 0.26). LLT escalation was associated with reduced cardiovascular risk, supporting more aggressive LLT in this population.https://doi.org/10.1038/s41598-021-88416-z |
| spellingShingle | Jaehyung Ha Bom Lee Jung Mi Park Moonjong Kang Jaewon Oh Chan Joo Lee Sungha Park Seok-Min Kang Sang-Hak Lee Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study Scientific Reports |
| title | Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study |
| title_full | Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study |
| title_fullStr | Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study |
| title_full_unstemmed | Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study |
| title_short | Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study |
| title_sort | escalation of lipid lowering therapy in patients with vascular disease receiving high intensity statins the retrospective post high study |
| url | https://doi.org/10.1038/s41598-021-88416-z |
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