Journal article
Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
Journal of the American Heart Association, Vol.8(19), pp.e013229-e013229
10/01/2019
DOI: 10.1161/JAHA.119.013229
PMCID: PMC6806030
PMID: 31554462
Abstract
Background-Current treatment guidelines strongly recommend statin therapy for secondary prevention. However, it remains unclear whether patients' perceptions of cardiovascular risk, beliefs on cholesterol, or the intensity of prescribed statin therapy differs for patients with coronary artery disease (CAD) versus cerebrovascular disease (CeVD) versus both CAD and CeVD (CAD&CeVD).
Methods and Results-The PALM (Patient and Provider Assessment of Lipid Management) registry collected data on statin use, intensity, and core laboratory low-density lipoprotein cholesterol levels for 3232 secondary prevention patients treated at 133 US clinics. Among individuals with CeVD only (n=403), CAD only (n=2202), and CeVD&CAD (n=627), no significant differences were observed in patient-perceived cardiovascular disease risk, beliefs on cholesterol lowering, or perceived effectiveness and safety of statin therapy. However, patients with CeVD only were less likely to receive any statin therapy (76.2% versus 86.2%; adjusted odds ratio 0.64, 95% CI 0.45-0.91), or guideline-recommended statin intensity (34.6% versus 50.4%; adjusted odds ratio 0.60, 95% CI 0.45-0.81) than those with CAD only. Individuals with CeVD only were also less likely to achieve low-density lipoprotein cholesterol <100 mg/dL (59.2% versus 69.7%; adjusted odds ratio 0.79, 95% CI 0.64-0.99) than individuals with CAD alone. There were no significant differences in the use of any statin therapy or guideline-recommended statin intensity between individuals with CAD&CeVD and those with CAD only.
Conclusions-Despite lack of significant differences in patient-perceived cardiovascular risk or statin beliefs, patients with CeVD were significantly less likely to receive higher intensity statin or achieve low-density lipoprotein cholesterol <100 mg/dL than those with CAD only.
Details
- Title: Subtitle
- Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry
- Creators
- Ying Xian - Duke Medical CenterAnn Marie Navar - Duke Medical CenterShuang Li - Duke Medical CenterZhuokai Li - Duke Medical CenterJennifer Robinson - University of IowaSalim S. Virani - Baylor College of MedicineMichael J. Louie - Regeneron (United States)Andrew Koren - Sanofi (France)Anne Goldberg - Washington University in St. LouisVeronique L. Roger - Mayo ClinicPeter W. F. Wilson - Emory UniversityEric D. Peterson - Duke Medical CenterTracy Y. Wang - Duke Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.8(19), pp.e013229-e013229
- DOI
- 10.1161/JAHA.119.013229
- PMID
- 31554462
- PMCID
- PMC6806030
- NLM abbreviation
- J Am Heart Assoc
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Publisher
- Wiley
- Number of pages
- 15
- Grant note
- Regeneron Pharmaceuticals; Regeneron Sanofi Pharmaceuticals
- Language
- English
- Date published
- 10/01/2019
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984364431602771
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