Cardiovascular Outcomes in Patients with Initial Diagnosis of Obstructive Coronary Artery Disease and LDL-C below 1.8 mmol/L

Abstract

Background To investigate individuals at high risk for atherosclerotic cardiovascular disease (ASCVD), but, without previous events and with low-density lipoprotein cholesterol(LDL-C)<1.8 mmol/L should be treated with statin. Methods: We studied 1330 patients with LDL-C <1.8 mmol/L at the initial diagnosis of obstructive coronary atherosclerotic disease (OCAD) by angiography. Of 1330, 782 had not received prior statin therapy and 548 were treated with statin. Incidence of subsequent major adverse cardiac and cerebral event (MACCE) during a median of 25-month follow-up were identified and compared between patients with LDL-C <1.8 mmol/L without any prior statin [prior statin(-)] and those with LDL-C <1.8mmol/L achieved by prior statin therapy [prior statin(+)].Results ACS occurred in 93.4% of individuals with LDL-C <1.8 mmol/L as an initial diagnosis of OCAD. Prior statin(+), comparing to prior statin(-) who displayed similar ASCVD risk burden including 71.6% with hypertension, 39.1% with diabetes and 76.1% with ≥3 risk factors, had significantly lower incidence of acute myocardial infarction(AMI) (10.4% vs. 28.8%, P<0.001), higher left ventricular ejection fraction(LVEF)(0.67±0.07 vs. 0.64±0.09, P <0.001), lower incidences of subsequent MACCE (4.7% vs. 10.4%, P =0.001), total mortality (2.4% vs. 6.8%, P =0.001) and cardiovascular(CV) death (1.5% vs. 4.3%, P =0.006) during follow-up. After multivariable adjustment, no prior statin therapy was significantly and independently associated with subsequent CV death, particularly in the subgroups of age≥65 years and hypertension. Conclusions Prior statin therapy to achieve LDL-C <1.8 mmol/L comparing to LDL-C <1.8 mmol/L without statin independently predicted lower risk of subsequent CV death and better prognosis.

Need of Sentiments Analysis with CF for Quality Recommendations

“…They collected information of annotators to choose correct pairs. Therefore, identifying of accurate opinions is shown [15] given review analysis of Chinese reviews for recommendations.…”