Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand

© 2015 Chinwong et al. Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of cardiovascular disease or mortality; however, the LDL-C goal for therapy in acute coronary syndrome (ACS) patients is controversial and varies among guidelines. This study...

Full description

Saved in:
Bibliographic Details
Main Authors: Chinwong D., Patumanond J., Chinwong S., Siriwattana K., Gunaparn S., Hall J., Phrommintikul A.
Format: Article
Published: Dove Medical Press Ltd. 2015
Subjects:
Online Access:http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84930199107&origin=inward
http://cmuir.cmu.ac.th/handle/6653943832/38515
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Chiang Mai University
id th-cmuir.6653943832-38515
record_format dspace
spelling th-cmuir.6653943832-385152015-06-16T07:47:24Z Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand Chinwong D. Chinwong D. Patumanond J. Chinwong S. Siriwattana K. Gunaparn S. Hall J. Phrommintikul A. Pharmacology, Toxicology and Pharmaceutics (all) Medicine (all) Chemical Health and Safety Safety Research Pharmacology (medical) © 2015 Chinwong et al. Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of cardiovascular disease or mortality; however, the LDL-C goal for therapy in acute coronary syndrome (ACS) patients is controversial and varies among guidelines. This study aimed to assess the effect of reaching an LDL-C goal of <70 mg/dL (<1.8 mmol/L) on first composite cardiovascular outcomes in routine clinical practice in Thailand. Methods: A retrospective cohort study was conducted using medical charts and the electronic hospital database of patients diagnosed with ACS and treated with statins at a tertiary care hospital in Thailand between 2009 and 2012. After admission, patients were followed from the date of LDL-C goal assessment until the first event of composite cardiovascular outcomes (nonfatal ACS, nonfatal stroke, or all-cause death). Cox proportional hazard models adjusted for potential confounders were used. Results: Of 405 patients, mean age was 65 years (60% males). Twenty-seven percent of the patients attained an LDL-C goal of<70 mg/dL, 38% had LDL-C between 70 and 99 mg/dL, and 35% had LDL-C ≥100 mg/dL. Forty-six patients experienced a composite cardiovascular outcome. Compared with patients with an LDL-C ≥100 mg/dL, patients achieving an LDL-C of <70 mg/dL were associated with a reduced composite cardiovascular outcome (adjusted hazard ratio [HR]=0.42; 95% confidence interval [CI]=0.18–0.95; P-value=0.037), but patients with an LDL-C between 70 and 99 mg/dL had a lower composite cardiovascular outcome, which was not statistically significant (adjusted HR=0.73; 95% CI=0.37–1.42; P-value=0.354). Conclusion: ACS patients who received statins and achieved an LDL-C of <70 mg/dL had significantly fewer composite cardiovascular outcomes, confirming “the lower the better” and the benefit of treating to LDL-C target in ACS patient management. 2015-06-16T07:47:24Z 2015-06-16T07:47:24Z 2015-04-24 Article 11766336 2-s2.0-84930199107 10.2147/TCRM.S78745 http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84930199107&origin=inward http://cmuir.cmu.ac.th/handle/6653943832/38515 Dove Medical Press Ltd.
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Pharmacology, Toxicology and Pharmaceutics (all)
Medicine (all)
Chemical Health and Safety
Safety Research
Pharmacology (medical)
spellingShingle Pharmacology, Toxicology and Pharmaceutics (all)
Medicine (all)
Chemical Health and Safety
Safety Research
Pharmacology (medical)
Chinwong D.
Chinwong D.
Patumanond J.
Chinwong S.
Siriwattana K.
Gunaparn S.
Hall J.
Phrommintikul A.
Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand
description © 2015 Chinwong et al. Background: Elevated low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk of cardiovascular disease or mortality; however, the LDL-C goal for therapy in acute coronary syndrome (ACS) patients is controversial and varies among guidelines. This study aimed to assess the effect of reaching an LDL-C goal of <70 mg/dL (<1.8 mmol/L) on first composite cardiovascular outcomes in routine clinical practice in Thailand. Methods: A retrospective cohort study was conducted using medical charts and the electronic hospital database of patients diagnosed with ACS and treated with statins at a tertiary care hospital in Thailand between 2009 and 2012. After admission, patients were followed from the date of LDL-C goal assessment until the first event of composite cardiovascular outcomes (nonfatal ACS, nonfatal stroke, or all-cause death). Cox proportional hazard models adjusted for potential confounders were used. Results: Of 405 patients, mean age was 65 years (60% males). Twenty-seven percent of the patients attained an LDL-C goal of<70 mg/dL, 38% had LDL-C between 70 and 99 mg/dL, and 35% had LDL-C ≥100 mg/dL. Forty-six patients experienced a composite cardiovascular outcome. Compared with patients with an LDL-C ≥100 mg/dL, patients achieving an LDL-C of <70 mg/dL were associated with a reduced composite cardiovascular outcome (adjusted hazard ratio [HR]=0.42; 95% confidence interval [CI]=0.18–0.95; P-value=0.037), but patients with an LDL-C between 70 and 99 mg/dL had a lower composite cardiovascular outcome, which was not statistically significant (adjusted HR=0.73; 95% CI=0.37–1.42; P-value=0.354). Conclusion: ACS patients who received statins and achieved an LDL-C of <70 mg/dL had significantly fewer composite cardiovascular outcomes, confirming “the lower the better” and the benefit of treating to LDL-C target in ACS patient management.
format Article
author Chinwong D.
Chinwong D.
Patumanond J.
Chinwong S.
Siriwattana K.
Gunaparn S.
Hall J.
Phrommintikul A.
author_facet Chinwong D.
Chinwong D.
Patumanond J.
Chinwong S.
Siriwattana K.
Gunaparn S.
Hall J.
Phrommintikul A.
author_sort Chinwong D.
title Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand
title_short Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand
title_full Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand
title_fullStr Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand
title_full_unstemmed Low-density lipoprotein cholesterol of less than 70 mg/dL is associated with fewer cardiovascular events in acute coronary syndrome patients: A real-life cohort in Thailand
title_sort low-density lipoprotein cholesterol of less than 70 mg/dl is associated with fewer cardiovascular events in acute coronary syndrome patients: a real-life cohort in thailand
publisher Dove Medical Press Ltd.
publishDate 2015
url http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84930199107&origin=inward
http://cmuir.cmu.ac.th/handle/6653943832/38515
_version_ 1681421487605547008