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- Publisher Website: 10.1371/journal.pone.0260839
- Scopus: eid_2-s2.0-85120633157
- PMID: 34855879
- WOS: WOS:000735299000135
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Article: Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease
Title | Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease |
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Authors | |
Issue Date | 2021 |
Citation | PLoS ONE, 2021, v. 16, n. 12 December, article no. e0260839 How to Cite? |
Abstract | Background Variability in low-density lipoprotein cholesterol (LDL-C) response to statins is underappreciated. We characterised patients by their statin response (SR), baseline risk of cardiovascular disease (CVD) and 10-year CVD outcomes. Methods and results A multivariable model was developed using 183,213 United Kingdom (UK) patients without CVD to predict probability of sub-optimal SR, defined by guidelines as <40% reduction in LDL-C. We externally validated the model in a Hong Kong (HK) cohort (n = 170,904). Patients were stratified into four groups by predicted SR and 10-year CVD risk score: [SR1] optimal SR & low risk; [SR2] sub-optimal SR & low risk; [SR3] optimal SR & high risk; [SR4] sub-optimal SR & high risk; and 10-year hazard ratios (HR) determined for first major adverse cardiovascular event (MACE). Our SR model included 12 characteristics, with an area under the curve of 0.70 (95% confidence interval [CI] 0.70–0.71; UK) and 0.68 (95% CI 0.67–0.68; HK). HRs for MACE in predicted sub-optimal SR with low CVD risk groups (SR2 to SR1) were 1.39 (95% CI 1.35–1.43, p<0.001; UK) and 1.14 (95% CI 1.11–1.17, p<0.001; HK). In both cohorts, patients with predicted sub-optimal SR with high CVD risk (SR4 to SR3) had elevated risk of MACE (UK HR 1.36, 95% CI 1.32–1.40, p<0.001: HK HR 1.25, 95% CI 1.21–1.28, p<0.001). Conclusions Patients with sub-optimal response to statins experienced significantly more MACE, regardless of baseline CVD risk. To enhance cholesterol management for primary prevention, statin response should be considered alongside risk assessment. |
Persistent Identifier | http://hdl.handle.net/10722/341338 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Weng, Stephen Franklin | - |
dc.contributor.author | Akyea, Ralph Kwame | - |
dc.contributor.author | Man, Kenneth KC | - |
dc.contributor.author | Lau, Wallis C.Y. | - |
dc.contributor.author | Iyen, Barbara | - |
dc.contributor.author | Blais, Joseph Edgar | - |
dc.contributor.author | Chan, Esther W. | - |
dc.contributor.author | Siu, Chung Wah | - |
dc.contributor.author | Qureshi, Nadeem | - |
dc.contributor.author | Wong, Ian C.K. | - |
dc.contributor.author | Kai, Joe | - |
dc.date.accessioned | 2024-03-13T08:42:01Z | - |
dc.date.available | 2024-03-13T08:42:01Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | PLoS ONE, 2021, v. 16, n. 12 December, article no. e0260839 | - |
dc.identifier.uri | http://hdl.handle.net/10722/341338 | - |
dc.description.abstract | Background Variability in low-density lipoprotein cholesterol (LDL-C) response to statins is underappreciated. We characterised patients by their statin response (SR), baseline risk of cardiovascular disease (CVD) and 10-year CVD outcomes. Methods and results A multivariable model was developed using 183,213 United Kingdom (UK) patients without CVD to predict probability of sub-optimal SR, defined by guidelines as <40% reduction in LDL-C. We externally validated the model in a Hong Kong (HK) cohort (n = 170,904). Patients were stratified into four groups by predicted SR and 10-year CVD risk score: [SR1] optimal SR & low risk; [SR2] sub-optimal SR & low risk; [SR3] optimal SR & high risk; [SR4] sub-optimal SR & high risk; and 10-year hazard ratios (HR) determined for first major adverse cardiovascular event (MACE). Our SR model included 12 characteristics, with an area under the curve of 0.70 (95% confidence interval [CI] 0.70–0.71; UK) and 0.68 (95% CI 0.67–0.68; HK). HRs for MACE in predicted sub-optimal SR with low CVD risk groups (SR2 to SR1) were 1.39 (95% CI 1.35–1.43, p<0.001; UK) and 1.14 (95% CI 1.11–1.17, p<0.001; HK). In both cohorts, patients with predicted sub-optimal SR with high CVD risk (SR4 to SR3) had elevated risk of MACE (UK HR 1.36, 95% CI 1.32–1.40, p<0.001: HK HR 1.25, 95% CI 1.21–1.28, p<0.001). Conclusions Patients with sub-optimal response to statins experienced significantly more MACE, regardless of baseline CVD risk. To enhance cholesterol management for primary prevention, statin response should be considered alongside risk assessment. | - |
dc.language | eng | - |
dc.relation.ispartof | PLoS ONE | - |
dc.title | Determining propensity for sub-optimal low-density lipoprotein cholesterol response to statins and future risk of cardiovascular disease | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1371/journal.pone.0260839 | - |
dc.identifier.pmid | 34855879 | - |
dc.identifier.scopus | eid_2-s2.0-85120633157 | - |
dc.identifier.volume | 16 | - |
dc.identifier.issue | 12 December | - |
dc.identifier.spage | article no. e0260839 | - |
dc.identifier.epage | article no. e0260839 | - |
dc.identifier.eissn | 1932-6203 | - |
dc.identifier.isi | WOS:000735299000135 | - |