Dataset Information

Low-density lipoprotein-cholesterol lowering in individuals at intermediate cardiovascular risk: Percent reduction or target level?

ABSTRACT:

Background

Recommendations for blood cholesterol management differ across different guidelines.

Hypothesis

Lipid-lowering strategies based on low-density lipoprotein-cholesterol (LDL-c) percent reduction or target concentration may have different effects on the expected cardiovascular benefit in intermediate-risk individuals.

Methods

We selected individuals between 40 and 75?years of age with 10-year risk for atherosclerotic cardiovascular disease (ASCVD) between 5.0% and <7.5% who underwent a routine health screening. For every subject, we simulated a strategy based on a 40% LDL-c reduction (S_40% ) and another strategy based on achieving LDL-c target ?100?mg/dL (S_target-100 ). The cardiovascular benefit was estimated assuming a 22% relative risk reduction in major cardiovascular events for each 39?mg/dL of LDL-c lowered.

Results

The study comprised 1756 individuals (94% men, 52?±?5?years old). LDL-c and predicted 10-year ASCVD risk would be slightly lower in S_40% compared to S_target-100 . The number needed to treat to prevent 1 major cardiovascular event in 10?years (NNT₁₀ ) would be 56 with S_40% and 66 with S_target-100 . S_40% would prevent more events in individuals with lower baseline LDL-c, whereas S_target-100 would be more protective in those with higher LDL-c. A dual-target strategy (40% minimum LDL-c reduction and achievement of LDL-c??100?mg/dL) would be associated with outcomes similar to those expected with the S_40% (NNT₁₀ =?55).

Conclusions

In an intermediate-risk population, cardiovascular benefit from LDL-c lowering may be optimized by tailoring the treatment according to the baseline LDL-c or by setting a dual-target strategy (fixed dose statin plus achievement of target LDL-c concentration).

SUBMITTER: Cesena FHY

PROVIDER: S-EPMC6489793 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Publications

Low-density lipoprotein-cholesterol lowering in individuals at intermediate cardiovascular risk: Percent reduction or target level?

Cesena Fernando H Y FHY Laurinavicius Antonio Gabriele AG Valente Viviane A VA Conceição Raquel D RD Santos Raul D RD Bittencourt Marcio S MS

Clinical cardiology 20180325 3

<h4>Background</h4>Recommendations for blood cholesterol management differ across different guidelines.<h4>Hypothesis</h4>Lipid-lowering strategies based on low-density lipoprotein-cholesterol (LDL-c) percent reduction or target concentration may have different effects on the expected cardiovascular benefit in intermediate-risk individuals.<h4>Methods</h4>We selected individuals between 40 and 75 years of age with 10-year risk for atherosclerotic cardiovascular disease (ASCVD) between 5.0% and < ...[more]

PMID: 29574925

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Dataset Information

Low-density lipoprotein-cholesterol lowering in individuals at intermediate cardiovascular risk: Percent reduction or target level?

Background

Hypothesis

Methods

Results

Conclusions

Publications

Low-density lipoprotein-cholesterol lowering in individuals at intermediate cardiovascular risk: Percent reduction or target level?

Similar Datasets

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