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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

HD. White, RAH. Stewart, AJ. Dalby, A. Stebbins, CP. Cannon, A. Budaj, A. Linhart, P. Pais, R. Diaz, PG. Steg, S. Krug-Gourley, CB. Granger, JS. Hochman, W. Koenig, RA. Harrington, C. Held, L. Wallentin, STABILITY Investigators,

. 2020 ; 225 (-) : 97-107. [pub] 20200418

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc20024908
E-zdroje Online Plný text

NLK ProQuest Central od 2002-01-01 do Před 2 měsíci
Nursing & Allied Health Database (ProQuest) od 2002-01-01 do Před 2 měsíci
Health & Medicine (ProQuest) od 2002-01-01 do Před 2 měsíci
Health Management Database (ProQuest) od 2002-01-01 do Před 2 měsíci
Public Health Database (ProQuest) od 2002-01-01 do Před 2 měsíci

Odkazy

PubMed 32480059
DOI 10.1016/j.ahj.2020.04.004
Knihovny.cz E-zdroje

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) <140/90 mm Hg and low-density lipoprotein-cholesterol (LDL-C) <100 mg/dL and <70 mg/dL. In patients with diabetes, glycosylated hemoglobin A1c (HbA1c) < 7% and BP of <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 < 100 mg/dL (70-99 mg/dL) compared with LDL-C ≥ 100 mg/dL (hazard ratio [HR] 0.694, 95% CI 0.594-0.811) and lower with LDL-C < 70 mg/dL compared with LDL-C < 100 mg/dL (70-99 mg/dL) (HR 0.834, 95% CI 0.708-0.983). MACE was lower with HbA1c < 7% compared with HbA1c ≥ 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 < 100 mg/dL (70-99 mg/dL) and even lower with LDL-C < 70 mg/dL. MACE in patients with diabetes was lower with HbA1c < 7%. Achievement of targets is associated with improved patient outcomes.

2nd Department of Medicine Department of Cardiovascular Medicine General University Hospital Prague Czech Republic

Assistance Publique Hôpitaux de Paris Hôpital Bichat and Paris University FACT INSERM Paris France

Cardiovascular Division Brigham and Women's Hospital and Harvard Clinical Research Institute Harvard Medical School Boston MA

Department of Medical Sciences Cardiology Uppsala University Uppsala Sweden

Department of Medicine New York University Langone Medical Center New York NY

Deutsches Herzzentrum München Technische Universität München Munich Germany

Deutsches Zentrum fur Herz Kreislauf Forschung partner site Munich Heart Alliance Munich Germany

Duke Clinical Research Institute Duke Medicine Durham NC

Estudios Cardiológicos Latinoamérica Instituto Cardiovascular de Rosario Rosario Argentina

Green Lane Cardiovascular Service Auckland City Hospital University of Auckland Auckland New Zealand

Institute of Epidemiology and Medical Biometry University of Ulm Ulm Germany

Metabolic Pathways and Cardiovascular Therapeutic Area GlaxoSmithKline King of Prussia PA

Milpark Hospital Johannesburg Republic of South Africa

National Heart and Lung Institute Imperial College Royal Brompton Hospital London United Kingdom

Postgraduate Medical School Grochowski Hospital Warsaw Poland

St John's Research Institute Bangalore India

Stanford Center for Clinical Research Department of Medicine Stanford University Stanford CA

Uppsala Clinical Research Center Uppsala University Uppsala Sweden

Citace poskytuje Crossref.org

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