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Krobot, Karl J.; Yin, Donald D.; Alemao, Evo; Steinhagen-Thiessen, Elisabeth

Real-World Effectiveness of Lipid-Lowering Therapy in Male and Female Outpatients with Coronary Heart Disease: Relation to Pre-Treatment Low-Density Lipoprotein-Cholesterol, Pre-Treatment Coronary Heart Disease Risk, and other Factors

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  • Medientyp: E-Artikel
  • Titel: Real-World Effectiveness of Lipid-Lowering Therapy in Male and Female Outpatients with Coronary Heart Disease: Relation to Pre-Treatment Low-Density Lipoprotein-Cholesterol, Pre-Treatment Coronary Heart Disease Risk, and other Factors
  • Beteiligte: Krobot, Karl J.; Yin, Donald D.; Alemao, Evo; Steinhagen-Thiessen, Elisabeth
  • Erschienen: Oxford University Press (OUP), 2005
  • Erschienen in: European Journal of Cardiovascular Prevention & Rehabilitation
  • Sprache: Englisch
  • DOI: 10.1177/204748730501200106
  • ISSN: 1741-8267
  • Schlagwörter: Cardiology and Cardiovascular Medicine ; Epidemiology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Background</jats:title><jats:p> Determinants of the real-world effectiveness of lipid-lowering therapy have been rarely assessed in an unselected observational coronary heart disease (CHD) community cohort over time. </jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p> Randomly drawn patients (n = 605) from randomly drawn practices (n = 62) were retrospectively followed for a median of 3.6 years (1998-2002) on lipid-lowering therapy (98% statins). </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Coronary heart disease population-averaged estimates and variances accounting for repeated measurements within patients were obtained using generalized estimating equations. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Post-treatment low-density lipoprotein-cholesterol (LDL-C) was 124 mg/dl in men and 141 mg/dl in women and was independently associated (all P&lt;0.05) with pre-treatment LDL-C (+ 3.7 mg/dl per 10 mg/dl increment), female sex (+ 14.0 mg/dl), coronary bypass (-9.5 mg/dl), drug-treated diabetes mellitus (-6.8 mg/dl), and era 2002/2001 versus 1999/2000 (- 6.4 mg/dl) in age-adjusted multivariate analyses. Holding pre-treatment LDL-C constant post-treatment LDL-C was associated with pre-treatment Framingham CHD risk in men (- 13.9 mg/dl per doubling of risk), whereas LDL-C control in women resembled that in low-risk men. The likelihood of attaining LDL-C &lt; 100 mg/dl was 0.28 in men and 0.17 in women and was likewise associated with the above factors. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Low-density lipoprotein-cholesterol control remained low despite lipid-lowering therapy across a wide range of pre-treatment LDL-C and pre-treatment CHD risk. Low-density lipoprotein-cholesterol control in women was inferior to that in men, a finding that warrants attention and clarification. Eur J Cardiovasc Prev Rehabil 12:37-45 © 2005 The European Society of Cardiology </jats:p></jats:sec>