Post-treatment level of LDL cholesterol and all-cause mortality in patients with atherosclerotic cardiovascular disease : evidence from real-world setting
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
AIMS: This study aimed to evaluate the safety of the currently recommended target of LDL cholesterol (LDL-C) control on mortality in patients with atherosclerotic cardiovascular disease (ASCVD).
METHODS AND RESULTS: Using deidentified electronic health record data, we conducted a multicentre retrospective cohort study involving individuals with documented ASCVD who had received statin treatment for at least 3 months across China. The primary outcomes assessed encompassed all-cause mortality, CV mortality, and non-CV mortality. Relationships between post-treatment LDL-C concentrations and outcomes were evaluated using restricted cubic spline curves based on Cox proportional hazards regression analyses. Additionally, competitive risk models were employed to explore associations between LDL-C levels and cause-specific mortality. Among 33 968 participants, we identified nearly linear associations of post-treatment LDL-C level with all-cause mortality and CV mortality during a median follow-up of 47 months. Notably, patients who achieved the recommended target of LDL-C (<1.4 mmol/L) were at significantly lower risks of all-cause mortality [hazard ratio (HR), 0.77; 95% confidence interval (CI), 0.69-0.86] and CV mortality (subdistribution HR, 0.68; 95% CI, 0.58-0.79), compared with those with LDL-C ≥ 3.4 mmol/L. This survival benefit was consistent in patients with different intensities of LDL-C reduction and other subgroup analyses. And no correlation was found between post-treatment LDL-C concentration and non-CV mortality.
CONCLUSION: Our findings supported the safety of currently recommended target of LDL-C control and the 'lower is better' principle in patients with ASCVD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
European journal of preventive cardiology - 31(2024), 3 vom: 15. Feb., Seite 337-345 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Luo, Fan [VerfasserIn] |
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| Links: |
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| Themen: |
All-cause mortality |
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| Anmerkungen: |
Date Completed 19.02.2024 Date Revised 19.02.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/eurjpc/zwad354 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364583177 |
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| 100 | 1 | |a Luo, Fan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Post-treatment level of LDL cholesterol and all-cause mortality in patients with atherosclerotic cardiovascular disease |b evidence from real-world setting |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a AIMS: This study aimed to evaluate the safety of the currently recommended target of LDL cholesterol (LDL-C) control on mortality in patients with atherosclerotic cardiovascular disease (ASCVD) | ||
| 520 | |a METHODS AND RESULTS: Using deidentified electronic health record data, we conducted a multicentre retrospective cohort study involving individuals with documented ASCVD who had received statin treatment for at least 3 months across China. The primary outcomes assessed encompassed all-cause mortality, CV mortality, and non-CV mortality. Relationships between post-treatment LDL-C concentrations and outcomes were evaluated using restricted cubic spline curves based on Cox proportional hazards regression analyses. Additionally, competitive risk models were employed to explore associations between LDL-C levels and cause-specific mortality. Among 33 968 participants, we identified nearly linear associations of post-treatment LDL-C level with all-cause mortality and CV mortality during a median follow-up of 47 months. Notably, patients who achieved the recommended target of LDL-C (<1.4 mmol/L) were at significantly lower risks of all-cause mortality [hazard ratio (HR), 0.77; 95% confidence interval (CI), 0.69-0.86] and CV mortality (subdistribution HR, 0.68; 95% CI, 0.58-0.79), compared with those with LDL-C ≥ 3.4 mmol/L. This survival benefit was consistent in patients with different intensities of LDL-C reduction and other subgroup analyses. And no correlation was found between post-treatment LDL-C concentration and non-CV mortality | ||
| 520 | |a CONCLUSION: Our findings supported the safety of currently recommended target of LDL-C control and the 'lower is better' principle in patients with ASCVD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a All-cause mortality | |
| 650 | 4 | |a Cardiovascular mortality | |
| 650 | 4 | |a LDL-C | |
| 650 | 4 | |a Secondary prevention | |
| 650 | 7 | |a Cholesterol, LDL |2 NLM | |
| 650 | 7 | |a Hydroxymethylglutaryl-CoA Reductase Inhibitors |2 NLM | |
| 700 | 1 | |a Lin, Yuxin |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xiaodong |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Yanqin |e verfasserin |4 aut | |
| 700 | 1 | |a Su, Licong |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Shiyu |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Ruqi |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Qi |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Ruixuan |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Zhixin |e verfasserin |4 aut | |
| 700 | 1 | |a Nie, Sheng |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Xin |e verfasserin |4 aut | |
| 700 | 0 | |a CRDS study Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Hong |e investigator |4 oth | |
| 700 | 1 | |a Liu, Bicheng |e investigator |4 oth | |
| 700 | 1 | |a Weng, Jianping |e investigator |4 oth | |
| 700 | 1 | |a Chunbo, Chen |e investigator |4 oth | |
| 700 | 1 | |a Liu, Huafeng |e investigator |4 oth | |
| 700 | 1 | |a Yang, Qiongqiong |e investigator |4 oth | |
| 700 | 1 | |a Li, Hua |e investigator |4 oth | |
| 700 | 1 | |a Kong, Yaozhong |e investigator |4 oth | |
| 700 | 1 | |a Li, Guisen |e investigator |4 oth | |
| 700 | 1 | |a Wan, Qijun |e investigator |4 oth | |
| 700 | 1 | |a Zha, Yan |e investigator |4 oth | |
| 700 | 1 | |a Hu, Ying |e investigator |4 oth | |
| 700 | 1 | |a Xu, Gang |e investigator |4 oth | |
| 700 | 1 | |a Shi, Yongjun |e investigator |4 oth | |
| 700 | 1 | |a Zhou, Yilun |e investigator |4 oth | |
| 700 | 1 | |a Su, Guobin |e investigator |4 oth | |
| 700 | 1 | |a Tang, Ying |e investigator |4 oth | |
| 700 | 1 | |a Gong, Mengchun |e investigator |4 oth | |
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