Projected impact of treatment intensification with statin, ezetimibe, and statin plus ezetimibe fixed-dose combination on MACE across six countries

被引:9
作者
Farnier, Michel [1 ]
Santos, Raul D. [2 ,3 ]
Cosin-Sales, Juan [4 ,5 ]
Ezhov, Marat, V [6 ]
Liu, Jian [7 ]
Granados, Denis [8 ]
Santoni, Serena [9 ]
Khan, Irfan [10 ]
Catapano, Alberico L. [11 ,12 ]
机构
[1] Univ Bourgogne Franche Comte, Serv Cardiol, Equipe PEC2, EA 7460,CHU Dijon Bourgogne, F-21000 Dijon, France
[2] Univ Sao Paulo, Lipid Clin Heart Inst InCor, Med Sch Hosp, Av Dr Eneas C Aguiar 44, BR-05403900 Sao Paulo, Brazil
[3] Hosp Israelita Albert Einstein, Av Albert Einstein 627-701, BR-05652900 Sao Paulo, Brazil
[4] Hosp Arnau Vilanova, Dept Cardiol, Calle San Clemente 12, Valencia 46015, Spain
[5] Univ CEU Cardenal Herrena, Fac Ciencias Salud, Dept Med, Valencia 46113, Spain
[6] Minist Hlth Russian Federat, AL Myasnikov Inst Clin Cardiol, Dept Atherosclerosis, Lab Lipid Disorders,Natl Med Res Ctr Cardiol, 15A,3rd Cherepkovskaya St, Moscow 121552, Russia
[7] Peking Univ Peoples Hosp, Dept Cardiol, 11 Xizhimen South St, Beijing 100044, Peoples R China
[8] Sanofi, Res & Dev, Epidemiol & Benefit Risk, 1 Ave Pierre Brossolette, F-91380 Chilly Mazarin, France
[9] Inst Hlth Metr & Evaluat, Populat Hlth Bldg, Hans Rosling Ctr, 3980 15th Ave NE, Seattle, WA 98195 USA
[10] Sanofi, Gen Med, Med Evidence Generat, Bridgewater, NJ 08807 USA
[11] Univ Milan, Dept Pharmacol & Biomol Sci, Via Balzaretti 9, I-20133 Milan, Italy
[12] IRCCS Multimed, Via Balzaretti 9, I-20133 Milan, Italy
关键词
Atherosclerotic cardiovascular disease; Dyslipidaemia; Ezetimibe; Global burden of disease; Ischaemic stroke; Low-density lipoprotein cholesterol; Myocardial infarction; Statin; GLOBAL BURDEN; SYSTEMATIC ANALYSIS; CHOLESTEROL; DYSLIPIDEMIA; PREVALENCE; GUIDELINES; SIMULATION; DISEASES; THERAPY;
D O I
10.1093/eurjpc/zwac214
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims The 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) dyslipidaemia guidelines recommend achievement of low-density lipoprotein cholestrol (LDL-C) goals based on an individual's risk. We aimed to evaluate the impact of guideline adoption with statin, ezetimibe, and statin plus ezetimibe fixed-dose combination (FDC) on LDL-C goal achievement and incidence of major adverse cardiovascular events (MACE) across six countries. Methods and results A simulation model with a five-year horizon (2020-2024) was developed based on Institute for Health Metrics and Evaluation Global Burden of Disease Study database with a business-as-usual (BAU) scenario representing status quo, intervention scenario-1 representing treatment with statin and ezetimibe as separate agents, and intervention scenario-2 representing treatment with statin or statin plus ezetimibe FDC. MACE was defined as the composite of myocardial infarction, ischaemic stroke, and cardiovascular death. The mean population LDL-C was reduced from 4.25 mmol/L in the BAU scenario, to 3.65 mmol/L and 3.59 mmol/L in intervention scenarios-1 and -2, respectively. Compared with BAU, intervention scenarios-1 and-2 resulted in relative reduction of MACE by 5.4% and 6.4% representing similar to 3.7 and 4.4 million MACE averted, respectively, across six countries over 5 years. The absolute benefit in terms of MACE averted was highest for China, whereas France had highest relative reduction in MACE with both intervention scenarios compared with BAU. Conclusion The 2019 ESC/EAS guideline-based treatment intensification with strategies based on statin, ezetimibe, and statin plus ezetimibe FDC is estimated to result in a substantial population-level benefit in terms of MACE averted compared with BAU.
引用
收藏
页码:2264 / 2271
页数:8
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