Association Between Patient Sex and Familial Hypercholesterolemia and Long-Term Cardiovascular Risk Factor Management 5 Years After Acute Coronary Syndrome.
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Download: circcvqo_circcqo-2023-010790d_supp1.pdf (637.67 [Ko])
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Serval ID
serval:BIB_32B0D5479156
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Association Between Patient Sex and Familial Hypercholesterolemia and Long-Term Cardiovascular Risk Factor Management 5 Years After Acute Coronary Syndrome.
Journal
Circulation. Cardiovascular quality and outcomes
ISSN
1941-7705 (Electronic)
ISSN-L
1941-7713
Publication state
Published
Issued date
08/2024
Peer-reviewed
Oui
Volume
17
Number
8
Pages
e010790
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Comparative Study ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Long-term control of cardiovascular risk factors after acute coronary syndrome (ACS) is the cornerstone for preventing recurrence. We investigated the extent of cardiovascular risk factor management in males and females with and without familial hypercholesterolemia (FH) 5 years after ACS.
We studied patients hospitalized for ACS between 2009 and 2017 in a Swiss multicenter prospective cohort study. FH was defined based on clinical criteria from the Dutch Lipid Clinic Network and Simon Broome definitions. Five years post-ACS, we assessed low-density lipoprotein-cholesterol (LDL-c) levels, lipid-lowering therapy (LLT), and other cardiovascular risk factors, comparing males to females with and without FH using generalized estimating equations.
A total of 3139 patients were included; mean age was 61.4 years (SD, 12.1), 620 (19.8%) were female, and 747 (23.5%) had possible FH. Compared with males at 5-years post-ACS, females were more likely to not use statins (odds ratio, 1.61 [95% CI, 1.28-2.03]) and less likely to have combination LLT (odds ratio, 0.72 [95% CI, 0.55-0.93]), without difference between patients with FH and without FH. Females in both FH and non-FH groups less frequently reached LDL-c values ≤1.8 mmol/L (odds ratio, 0.78 [95% CI, 0.78-0.93]). Overall, patients with FH were more frequently on high-dose statins compared with patients without FH (51.0% versus 42.9%; P=0.001) and presented more frequently with a combination of 2 or more LLT compared with patients without FH (33.8% versus 17.7%; P<0.001), but less frequently reached LDL-c targets of ≤1.8 mmol/L (33.5% versus 44.3%; P<0.001) or ≤2.6 mmol/L (70.2% versus 78.1%; P=0.001).
Five years after ACS, females had less intensive LLT and were less likely to reach target LDL-c levels than males, regardless of FH status. Males and females with FH had less optimal control of LDL-c despite more frequently taking high-dose statins or combination LLT compared with patients without FH. Long-term management of patients with ACS and FH, especially females, warrants optimization.
We studied patients hospitalized for ACS between 2009 and 2017 in a Swiss multicenter prospective cohort study. FH was defined based on clinical criteria from the Dutch Lipid Clinic Network and Simon Broome definitions. Five years post-ACS, we assessed low-density lipoprotein-cholesterol (LDL-c) levels, lipid-lowering therapy (LLT), and other cardiovascular risk factors, comparing males to females with and without FH using generalized estimating equations.
A total of 3139 patients were included; mean age was 61.4 years (SD, 12.1), 620 (19.8%) were female, and 747 (23.5%) had possible FH. Compared with males at 5-years post-ACS, females were more likely to not use statins (odds ratio, 1.61 [95% CI, 1.28-2.03]) and less likely to have combination LLT (odds ratio, 0.72 [95% CI, 0.55-0.93]), without difference between patients with FH and without FH. Females in both FH and non-FH groups less frequently reached LDL-c values ≤1.8 mmol/L (odds ratio, 0.78 [95% CI, 0.78-0.93]). Overall, patients with FH were more frequently on high-dose statins compared with patients without FH (51.0% versus 42.9%; P=0.001) and presented more frequently with a combination of 2 or more LLT compared with patients without FH (33.8% versus 17.7%; P<0.001), but less frequently reached LDL-c targets of ≤1.8 mmol/L (33.5% versus 44.3%; P<0.001) or ≤2.6 mmol/L (70.2% versus 78.1%; P=0.001).
Five years after ACS, females had less intensive LLT and were less likely to reach target LDL-c levels than males, regardless of FH status. Males and females with FH had less optimal control of LDL-c despite more frequently taking high-dose statins or combination LLT compared with patients without FH. Long-term management of patients with ACS and FH, especially females, warrants optimization.
Keywords
Humans, Male, Female, Acute Coronary Syndrome/diagnosis, Acute Coronary Syndrome/epidemiology, Acute Coronary Syndrome/therapy, Acute Coronary Syndrome/blood, Middle Aged, Hyperlipoproteinemia Type II/diagnosis, Hyperlipoproteinemia Type II/blood, Hyperlipoproteinemia Type II/drug therapy, Hyperlipoproteinemia Type II/epidemiology, Hyperlipoproteinemia Type II/complications, Sex Factors, Aged, Time Factors, Prospective Studies, Treatment Outcome, Cholesterol, LDL/blood, Switzerland/epidemiology, Risk Assessment, Biomarkers/blood, Heart Disease Risk Factors, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Recurrence, Healthcare Disparities, Secondary Prevention, Health Status Disparities, acute coronary syndrome, hyperlipoproteinemia type II, lipids, lipoproteins, LDL, risk factors
Pubmed
Web of science
Open Access
Yes
Create date
24/06/2024 7:56
Last modification date
20/11/2024 7:19
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