Achieving optimal lipid values in patients with dyslipidemia is associated with reduced risk of cardiovascular events

Scott L. Charland, Mark J. Cziraky, Ralph Quimbo, Richard H. Karas, William Insull, Michael Davidson, Eric J. Stanek

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)343-353
Number of pages11
JournalJournal of Clinical Lipidology
Volume2
Issue number5
DOIs
StatePublished - Oct 2008

Keywords

  • Cardiovascular diseases
  • Cardiovascular events
  • Cholesterol
  • Clinical practice
  • Dyslipidemia
  • Lipids
  • Lipoproteins
  • Managed care
  • Population study

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Nutrition and Dietetics

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