Patient characteristics and acute cardiovascular event rates among patients with very high-risk and non-very high-risk atherosclerotic cardiovascular disease.
atherosclerotic cardiovascular disease
major cardiovascular events
real-world evidence
very high-risk
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
19
07
2021
received:
14
06
2021
accepted:
24
07
2021
pubmed:
6
8
2021
medline:
16
10
2021
entrez:
5
8
2021
Statut:
ppublish
Résumé
The risk for subsequent major cardiovascular (CV) events among patients with very high-risk (VHR) atherosclerotic CV disease (ASCVD) remains to be fully elucidated. We assessed the characteristics and major CV event rates of patients with VHR versus non-VHR ASCVD in a real-world setting in the United States (US), hypothesizing that patients with VHR ASCVD would have higher CV event rates. This was a retrospective cohort study conducted from January 01, 2011, to June 30, 2018, in the US using the Prognos LDL-C database linked to the IQVIA PharMetrics Plus® database supplemented with the IQVIA prescription claims (Dx/LRx) databases. Patients were ≥18 years old and had ≥2 non-ancillary medical claims in the linked databases at least 30 days apart. The study was conducted in 2 stages: (1) identification of patients with ASCVD who met the definition of VHR ASCVD and a matched cohort of non-VHR ASCVD patients using the incidence density sampling (IDS) approach; (2) estimation of the occurrence of major CV events. Among patients with ≥1 major ASCVD event (N=147,679), most qualified as VHR ASCVD (79.5%). There were 115,460 patients each in IDS-matched VHR and non-VHR ASCVD cohorts. The composite myocardial infarction/ischemic stroke event rates in the VHR and non-VHR ASCVD cohorts were 8.04 (95% confidence interval [95% CI]: 7.87-8.22) and 0.82 (95% CI: 0.77-0.88) events per 100 patient-years, respectively, during the 1-year post-index period. Most patients with ≥1 previous major ASCVD event treated in real-world US clinical practice qualified as VHR ASCVD. Patients with VHR ASCVD had much higher rates of major CV events versus non-VHR ASCVD patients.
Sections du résumé
BACKGROUND
BACKGROUND
The risk for subsequent major cardiovascular (CV) events among patients with very high-risk (VHR) atherosclerotic CV disease (ASCVD) remains to be fully elucidated.
HYPOTHESIS
OBJECTIVE
We assessed the characteristics and major CV event rates of patients with VHR versus non-VHR ASCVD in a real-world setting in the United States (US), hypothesizing that patients with VHR ASCVD would have higher CV event rates.
METHODS
METHODS
This was a retrospective cohort study conducted from January 01, 2011, to June 30, 2018, in the US using the Prognos LDL-C database linked to the IQVIA PharMetrics Plus® database supplemented with the IQVIA prescription claims (Dx/LRx) databases. Patients were ≥18 years old and had ≥2 non-ancillary medical claims in the linked databases at least 30 days apart. The study was conducted in 2 stages: (1) identification of patients with ASCVD who met the definition of VHR ASCVD and a matched cohort of non-VHR ASCVD patients using the incidence density sampling (IDS) approach; (2) estimation of the occurrence of major CV events.
RESULTS
RESULTS
Among patients with ≥1 major ASCVD event (N=147,679), most qualified as VHR ASCVD (79.5%). There were 115,460 patients each in IDS-matched VHR and non-VHR ASCVD cohorts. The composite myocardial infarction/ischemic stroke event rates in the VHR and non-VHR ASCVD cohorts were 8.04 (95% confidence interval [95% CI]: 7.87-8.22) and 0.82 (95% CI: 0.77-0.88) events per 100 patient-years, respectively, during the 1-year post-index period.
CONCLUSIONS
CONCLUSIONS
Most patients with ≥1 previous major ASCVD event treated in real-world US clinical practice qualified as VHR ASCVD. Patients with VHR ASCVD had much higher rates of major CV events versus non-VHR ASCVD patients.
Identifiants
pubmed: 34351003
doi: 10.1002/clc.23706
pmc: PMC8495090
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1457-1466Subventions
Organisme : Amgen
Informations de copyright
© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
Références
JAMA Cardiol. 2019 Jul 1;4(7):691-695
pubmed: 31166576
JAMA Cardiol. 2020 Aug 1;5(8):952-957
pubmed: 32432684
Occup Environ Med. 2004 Dec;61(12):e59
pubmed: 15550597
Clin Cardiol. 2019 Jan;42(1):101-110
pubmed: 30444024
Clin J Am Soc Nephrol. 2009 Jul;4(7):1213-21
pubmed: 19541817
Am Heart J. 2020 Jan;219:70-77
pubmed: 31726422
N Engl J Med. 2015 Jun 18;372(25):2387-97
pubmed: 26039521
N Engl J Med. 2017 May 4;376(18):1713-1722
pubmed: 28304224
J Am Coll Cardiol. 2019 Jun 25;73(24):3168-3209
pubmed: 30423391
Circulation. 2019 Nov 5;140(19):1578-1589
pubmed: 31475572
Clin Cardiol. 2021 Oct;44(10):1457-1466
pubmed: 34351003
N Engl J Med. 2018 Nov 29;379(22):2097-2107
pubmed: 30403574
JAMA Cardiol. 2017 Aug 1;2(8):890-895
pubmed: 28423147
Circulation. 2018 Aug 21;138(8):756-766
pubmed: 29626068
EGEMS (Wash DC). 2014 Jan 14;1(3):1023
pubmed: 25848582
J Am Coll Cardiol. 2019 Nov 19;74(20):2496-2507
pubmed: 31727288
Ther Clin Risk Manag. 2019 Nov 13;15:1325-1332
pubmed: 32009789
Eur Heart J. 2017 Aug 21;38(32):2459-2472
pubmed: 28444290
Lancet. 2010 Nov 13;376(9753):1670-81
pubmed: 21067804
BMC Cardiovasc Disord. 2016 Apr 26;16:74
pubmed: 27114245
Gastroenterology. 2012 Aug;143(2):390-399.e1
pubmed: 22584081
JAMA Dermatol. 2013 Feb;149(2):216-20
pubmed: 23426479
J Am Coll Cardiol. 2014 Aug 5;64(5):485-94
pubmed: 25082583