Guideline LDL-C Threshold Achievement in Acute Myocardial Infarction Patients: A Real-World Evidence Study Demonstrating the Impact of Treatment Intensification with PCSK9i (jan, 10.1007/s40119-022-00300-7, 2023)

被引：1

作者：

Mackinnon, Erin S. ^{[1
]}

Har, Bryan ^{[2
]}

Champsi, Salimah ^{[1
]}

Wani, Rajvi J. ^{[1
]}

Geyer, Lee ^{[3
]}

Shaw, Eileen ^{[3
]}

Farris, Megan S. ^{[3
]}

Anderson, Todd J. ^{[2
]}

机构：

[1] Amgen Canada Inc, 6775 Financial Dr 100, Mississauga, ON L5N 0A4, Canada

[2] Univ Calgary, Libin Cardiovasc Inst, Cumming Sch Med, Calgary, AB, Canada

[3] Medlior Hlth Outcomes Res Ltd, Calgary, AB, Canada

来源：

CARDIOLOGY AND THERAPY | 2023年 / 12卷 / 02期

关键词：

Acute myocardial infarction; Lipid-lowering therapy; Low-density lipoprotein cholesterol; Proprotein convertase subtilisin/kexin type 9 inhibitors; Real-world evidence;

D O I：

10.1007/s40119-023-00310-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: A high proportion of Canadian patients with acute myocardial infarction (AMI) do not achieve the threshold low-density lipoprotein cholesterol (LDL-C) levels recommended by the Canadian Cardiovascular Society in 2021. This increases the risk of subsequent atherosclerotic cardiovascular disease (ASCVD) events. Here, we assess LDL-C levels and threshold achievement among patients by lipid-lowering therapies (LLT) received post-AMI. Methods: A retrospective cohort study of patients identified with AMI between 2015 and 2019 was conducted using administrative health databases in Alberta, Canada. Patients were grouped by their highest-intensity LLT post-AMI (proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) + another LLT; PCSK9i alone; ezetimibe + statin; statins (high, moderate, low intensity); or ezetimibe alone), and available LDL-C levels were examined in the year before and after LLT dispense date. Results: The cohort included 15,283 patients. In patients on PCSK9i + LLT, the median [95% confidence interval (CI)] LDL-C levels decreased from 2.7 (2.3–3.4) before to 0.9 (0.5–1.2) mmol/l after treatment, the largest decrease among treatment groups. In the ezetimibe + statin and high-intensity statin groups, median (95% CI) values after treatment were 1.5 (1.5–1.6) and 1.4 (1.4–1.4) mmol/l, respectively. The proportion of patients below the 1.8 mmol/l threshold increased by 77.7% in the PSCK9i + LLT group after treatment, compared to 45.4 and 32.4% in the ezetimibe + statin and high-intensity statin groups, respectively. Conclusions: Intensification with PCSK9i in AMI patients results in a greater proportion of patients achieving below the recommended LDL-C threshold versus statins and or ezetimibe alone. Increased focus on achieving below the LDL-C thresholds with additional LLT as required may benefit patient cardiovascular outcomes. © 2022, The Author(s).

引用

页码：339 / 339

页数：1