Critical pathways in cardiology · 2026
Lipid-Lowering Treatment Patterns and Risk of Subsequent Cardiovascular Outcomes in Patients With Recent Coronary Revascularization.
СтатьяНазвание и аннотация: Перевод в очереди
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Gazda Casey, Rane Pallavi B, Nunna Sasikiran, Zhou Zifan, Exter Jason, Pinto Lionel, Habib Mohdhar, McGuiness Catherine B, Wade Rolin L, Cavender Matthew A
Аннотация
BACKGROUND: Lipid-lowering reduces cardiovascular events (CVEs) in patients with coronary artery disease. We sought to understand lipid-lowering therapy (LLT), low-density lipoprotein cholesterol (LDL-C) levels, and CVEs after coronary revascularization (CR).
METHODS: We identified adults who underwent CR from 2014 to 2019 in linked datasets (IQVIA PharMetrics Plus health plan claims, IQVIA longitudinal prescription claims, and Prognos LDL-C database) using established methodology for extraction of deidentified claims data.
RESULTS: A total of 184,271 patients were identified, 73,619 (40.0%) of whom were hospitalized for myocardial infarction (MI) in the 30 days before the index revascularization. Utilization of LLT increased from 46.0% at 3 months prerevascularization to 92.7% 12 months postrevascularization. Only 56.4% of patients were prescribed high-intensity statins. In a subset of patients with LDL-C values (n = 5496), the mean (SD) LDL-C decreased from 108 (41) mg/dL at 6 months prerevascularization to 82 (33) mg/dL at 12 months postrevascularization ( P < 0.0001). At 12 months after revascularization, LDL-C was ≥70 mg/dL in 55.7% of patients with prior MI and 62.1% of patients without recent MI. CVEs rates (per 100 patient-years) at 12 months postrevascularization were 5.2 (95% confidence interval [CI], 5.1-5.3) for MI, 2.0 (95% CI, 1.9-2.0) for stroke, and 6.6 (95% CI, 6.5-6.7) for unstable angina.
CONCLUSIONS: Although LLT utilization increased after revascularization, high-intensity statins were underutilized. LDL-C levels remained above 70 mg/dL in more than half of the patients. Systematic efforts are needed after CR to improve lipid control and prevent recurrent CV events.
METHODS: We identified adults who underwent CR from 2014 to 2019 in linked datasets (IQVIA PharMetrics Plus health plan claims, IQVIA longitudinal prescription claims, and Prognos LDL-C database) using established methodology for extraction of deidentified claims data.
RESULTS: A total of 184,271 patients were identified, 73,619 (40.0%) of whom were hospitalized for myocardial infarction (MI) in the 30 days before the index revascularization. Utilization of LLT increased from 46.0% at 3 months prerevascularization to 92.7% 12 months postrevascularization. Only 56.4% of patients were prescribed high-intensity statins. In a subset of patients with LDL-C values (n = 5496), the mean (SD) LDL-C decreased from 108 (41) mg/dL at 6 months prerevascularization to 82 (33) mg/dL at 12 months postrevascularization ( P < 0.0001). At 12 months after revascularization, LDL-C was ≥70 mg/dL in 55.7% of patients with prior MI and 62.1% of patients without recent MI. CVEs rates (per 100 patient-years) at 12 months postrevascularization were 5.2 (95% confidence interval [CI], 5.1-5.3) for MI, 2.0 (95% CI, 1.9-2.0) for stroke, and 6.6 (95% CI, 6.5-6.7) for unstable angina.
CONCLUSIONS: Although LLT utilization increased after revascularization, high-intensity statins were underutilized. LDL-C levels remained above 70 mg/dL in more than half of the patients. Systematic efforts are needed after CR to improve lipid control and prevent recurrent CV events.