TY - JOUR
T1 - Achieving optimal lipid values in patients with dyslipidemia is associated with reduced risk of cardiovascular events
AU - Charland, Scott L.
AU - Cziraky, Mark J.
AU - Quimbo, Ralph
AU - Karas, Richard H.
AU - Insull, William
AU - Davidson, Michael
AU - Stanek, Eric J.
N1 - Funding Information:
This study was funded by an unrestricted research grant from Kos Laboratories, Inc., a Subsidiary of Abbott Laboratories and Abbott Laboratories. The sponsor was permitted to review the manuscript, but all final decisions regarding content remained the sole responsibility of the investigators.
Funding Information:
Dr. Charland received an unrestricted research grant from Abbott Laboratories. Mr. Quimbo and Dr. Cziraky are employees of HealthCore, Inc. and have received research grants from Abbott Laboratories, AstraZeneca PLC, Bristol-Myers Squibb, Merck & Co., Inc., Novartis International AG, and Pfizer Incorporated. Dr. Karas has served as a consultant and speaker for Abbott Laboratories, and additionally has provided research support for Merck & Co., Inc.
Funding Information:
This study was funded by Kos Pharmaceuticals, Inc, and Abbott Laboratories. The authors wish to thank Patti Peeples, PhD (HealthEconomics.Com, Ponte Vedra Beach, FL), for her assistance with this manuscript.
Funding Information:
Dr. Insull has served as a speaker for Abbott Laboratories, Schering-Plough Corporation, and Merck and Co., Inc., as an editor for AstraZeneca Pharmaceuticals LP, and a consultant for Daichi Sankyo, Inc. Dr. Davidson has served as a speaker/consultant and has received research grants from Abbott Laboratories, AstraZeneca Pharmaceuticals, Daiichi-Sankyo, Inc., Merck & Co., Inc. Merck/Schering-Plough, Pfizer Laboratories, Reliant Pharmaceuticals, Inc., and Takeda Pharmaceuticals. Additionally, Dr. Davidson has received research grants from Oscient Pharmaceuticals (also served as a speaker), Roche Pharmaceuticals (also served as consultant), Access Health, Atherogenics and Xinthria Pharmaceuticals. Dr. Davidson has also served as a consultant for Sanofi Aventis, and diaDexus, Inc. (also served as speaker). Finally, Dr. Davidson serves on the Board of Directors for Angiogen and Sonogene, while serving as chief medical officer for Professional Evaluation, Inc. Dr. Davidson has no stock ownership or options, etc., in Radiant Research, a Division of Swiss BioScience or any of the above listed companies. Dr. Stanek has served as a consultant for Abbott Laboratories, Oscient Pharmaceuticals, Inc., and HealthCore, Inc.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/10
Y1 - 2008/10
N2 - Background: Cardiovascular (CV) event risk is significantly lower in patients with combined low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) at desired levels versus those without lower levels. However, this has not been investigated relative to specific patterns of baseline lipid abnormalities. Objective: To evaluate the association between desired combined lipid value achievement and risk of CV events in patients with different baseline lipid profiles. Methods: A retrospective managed care database analysis among treatment-naïve adults with elevated CV event risk, ≥12 months follow-up, and full lipid panel from January 1, 2001 to December 31, 2001 plus ≥1 panel before a CV event or study end. Patients were stratified into three baseline cohorts: isolated high LDL-C (Cohort 1), high LDL-C + low HDL-C or high TG (Cohort 2), and high LDL-C, low HDL-C, and high TG (Cohort 3). CV event risk stratified by combined desired lipid value achievement was assessed in each cohort. Results: Achievement of combined desired lipid values/median days to achievement was 29% in 385 days (Cohort 1), 11% in 413 days (Cohort 2), and 7% in 505 days (Cohort 3). Achievement of combined desired lipid values was associated with an adjusted 25%-46% lower CV event risk in Cohort 1 (hazards ratio, 0.75; 95% confidence interval 0.65-0.87), Cohort 2 (hazards ratio, 0.54; 95% confidence interval 0.43-0.67), and Cohort 3 (hazard ratio, 0.54; 95% confidence interval 0.37-0.78). Conclusion: Patients with combined desired lipid values had lower risk of CV events versus those without such values. The risk reduction was greatest among patients with multiple lipid abnormalities, suggesting a potential benefit of interventions targeting low HDL-C and/or high TG in addition to high LDL-C.
AB - Background: Cardiovascular (CV) event risk is significantly lower in patients with combined low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) at desired levels versus those without lower levels. However, this has not been investigated relative to specific patterns of baseline lipid abnormalities. Objective: To evaluate the association between desired combined lipid value achievement and risk of CV events in patients with different baseline lipid profiles. Methods: A retrospective managed care database analysis among treatment-naïve adults with elevated CV event risk, ≥12 months follow-up, and full lipid panel from January 1, 2001 to December 31, 2001 plus ≥1 panel before a CV event or study end. Patients were stratified into three baseline cohorts: isolated high LDL-C (Cohort 1), high LDL-C + low HDL-C or high TG (Cohort 2), and high LDL-C, low HDL-C, and high TG (Cohort 3). CV event risk stratified by combined desired lipid value achievement was assessed in each cohort. Results: Achievement of combined desired lipid values/median days to achievement was 29% in 385 days (Cohort 1), 11% in 413 days (Cohort 2), and 7% in 505 days (Cohort 3). Achievement of combined desired lipid values was associated with an adjusted 25%-46% lower CV event risk in Cohort 1 (hazards ratio, 0.75; 95% confidence interval 0.65-0.87), Cohort 2 (hazards ratio, 0.54; 95% confidence interval 0.43-0.67), and Cohort 3 (hazard ratio, 0.54; 95% confidence interval 0.37-0.78). Conclusion: Patients with combined desired lipid values had lower risk of CV events versus those without such values. The risk reduction was greatest among patients with multiple lipid abnormalities, suggesting a potential benefit of interventions targeting low HDL-C and/or high TG in addition to high LDL-C.
KW - Cardiovascular diseases
KW - Cardiovascular events
KW - Cholesterol
KW - Clinical practice
KW - Dyslipidemia
KW - Lipids
KW - Lipoproteins
KW - Managed care
KW - Population study
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U2 - 10.1016/j.jacl.2008.06.009
DO - 10.1016/j.jacl.2008.06.009
M3 - Article
C2 - 21291759
AN - SCOPUS:53249115184
VL - 2
SP - 343
EP - 353
JO - Journal of Clinical Lipidology
JF - Journal of Clinical Lipidology
SN - 1933-2874
IS - 5
ER -