Effectiveness of low-density lipoprotein cholesterol reduction with lipid lowering therapy for secondary prevention amongst older individuals: a nationwide cohort study
Abstract Background Data about the clinical benefit from initial low-density lipoprotein cholesterol (LDL-C) reduction with lipid lowering treatment for secondary prevention and risk of major vascular events amongst older as compared with younger individuals treated during routine clinical care are...
Gespeichert in:
| Veröffentlicht in: | Age and ageing 2024-01, Vol.53 (1) |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 1 |
| container_start_page | |
| container_title | Age and ageing |
| container_volume | 53 |
| creator | Andersson, Niklas W Corn, Giulia Dohlmann, Tine L Melbye, Mads Wohlfahrt, Jan Lund, Marie |
| description | Abstract
Background
Data about the clinical benefit from initial low-density lipoprotein cholesterol (LDL-C) reduction with lipid lowering treatment for secondary prevention and risk of major vascular events amongst older as compared with younger individuals treated during routine clinical care are limited. We investigated this in a nationwide cohort.
Methods
Individuals aged ≥ 50 years with a first-time hospitalisation for a cardiovascular event (index event, including acute coronary syndrome, non-haemorrhagic stroke, transient ischaemic attack and coronary revascularisation), 1 January 2008 to 31 October 2018, who subsequently used lipid lowering treatment, and had an LDL-C measurement before and after the event were included. Hazard ratios (HRs) for major vascular events per 1 mmol/L reduction in LDL-C were estimated for the included 21,751 older and 22,681 younger individuals (≥/ |
| doi_str_mv | 10.1093/ageing/afad241 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2914255977</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ageing/afad241</oup_id><sourcerecordid>2914255977</sourcerecordid><originalsourceid>FETCH-LOGICAL-c329t-9770a9e2534ccefb23cd85101165a660daa7cc4d5d43d73974fe5b358a83f1cd3</originalsourceid><addsrcrecordid>eNqFkbtuGzEURIkgRiw_2pQBy6RYm4_lPtwFhu0YMOAmqRcU76XEYEVuSK4F_ZE_M5Qlp01FXODMDAdDyGfOrjjr5bVeofOra201iJp_IAteN10lOll_JAvGmKhYK_pTcpbS73JyxcUncio7wXshmgV5vbMWTXYv6DElGiwdw7YC9MnlHR3dFKYYcsmgZh1GTBljGGlEmIsoeLp1eb3HHOyFGMtnaF5j1NOO2hBpQhM86LijU8QS8ibSm-BXKdMwAkbqPLgXB7Me0w3V1Os9s3WA1IR1iJmmPMPugpzYQuDl8T0nv-7vft7-qJ6eHx5vvz9VRoo-V33bMt2jULI2Bu1SSAOd4ozzRummYaB1a0wNCmoJrezb2qJaStXpTlpuQJ6Trwff0vvPXAoPG5cMjqP2GOY0iJ7XQqmSU9CrA2piSCmiHaboNqXrwNmwX2c4rDMc1ymCL0fveblB-Ie_z1GAbwcgzNP_zP4CBDihfw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2914255977</pqid></control><display><type>article</type><title>Effectiveness of low-density lipoprotein cholesterol reduction with lipid lowering therapy for secondary prevention amongst older individuals: a nationwide cohort study</title><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Andersson, Niklas W ; Corn, Giulia ; Dohlmann, Tine L ; Melbye, Mads ; Wohlfahrt, Jan ; Lund, Marie</creator><creatorcontrib>Andersson, Niklas W ; Corn, Giulia ; Dohlmann, Tine L ; Melbye, Mads ; Wohlfahrt, Jan ; Lund, Marie</creatorcontrib><description>Abstract
Background
Data about the clinical benefit from initial low-density lipoprotein cholesterol (LDL-C) reduction with lipid lowering treatment for secondary prevention and risk of major vascular events amongst older as compared with younger individuals treated during routine clinical care are limited. We investigated this in a nationwide cohort.
Methods
Individuals aged ≥ 50 years with a first-time hospitalisation for a cardiovascular event (index event, including acute coronary syndrome, non-haemorrhagic stroke, transient ischaemic attack and coronary revascularisation), 1 January 2008 to 31 October 2018, who subsequently used lipid lowering treatment, and had an LDL-C measurement before and after the event were included. Hazard ratios (HRs) for major vascular events per 1 mmol/L reduction in LDL-C were estimated for the included 21,751 older and 22,681 younger individuals (≥/<70 years old) using Cox regression.
Results
LDL-C lowering was associated with a 12% lower risk of major vascular events in older individuals per 1 mmol/L reduction in LDL-C (HR 0.88, 95% confidence interval [CI] 0.84–0.93), with no significant difference compared with the risk reduction amongst younger individuals (HR 0.88, 95% CI 0.83–0.93; P-value for difference between age groups: 0.86). The risk reduction was more pronounced when post hoc restricting, as a proxy for compliance, to new users with an LDL-C reduction above the lowest decile for both older (0.81, 95% CI 0.73–0.90) and younger (0.81, 95% CI 0.72–0.91) individuals.
Conclusions
This study strongly supports a similar relative clinical benefit of LDL-C reduction with lipid lowering treatment for secondary prevention of major vascular events amongst individuals aged ≥70 and <70 years.
Graphical Abstract
Graphical Abstract</description><identifier>ISSN: 0002-0729</identifier><identifier>ISSN: 1468-2834</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afad241</identifier><identifier>PMID: 38219226</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><ispartof>Age and ageing, 2024-01, Vol.53 (1)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-9770a9e2534ccefb23cd85101165a660daa7cc4d5d43d73974fe5b358a83f1cd3</citedby><cites>FETCH-LOGICAL-c329t-9770a9e2534ccefb23cd85101165a660daa7cc4d5d43d73974fe5b358a83f1cd3</cites><orcidid>0000-0001-7622-6303</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1585,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38219226$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Andersson, Niklas W</creatorcontrib><creatorcontrib>Corn, Giulia</creatorcontrib><creatorcontrib>Dohlmann, Tine L</creatorcontrib><creatorcontrib>Melbye, Mads</creatorcontrib><creatorcontrib>Wohlfahrt, Jan</creatorcontrib><creatorcontrib>Lund, Marie</creatorcontrib><title>Effectiveness of low-density lipoprotein cholesterol reduction with lipid lowering therapy for secondary prevention amongst older individuals: a nationwide cohort study</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><description>Abstract
Background
Data about the clinical benefit from initial low-density lipoprotein cholesterol (LDL-C) reduction with lipid lowering treatment for secondary prevention and risk of major vascular events amongst older as compared with younger individuals treated during routine clinical care are limited. We investigated this in a nationwide cohort.
Methods
Individuals aged ≥ 50 years with a first-time hospitalisation for a cardiovascular event (index event, including acute coronary syndrome, non-haemorrhagic stroke, transient ischaemic attack and coronary revascularisation), 1 January 2008 to 31 October 2018, who subsequently used lipid lowering treatment, and had an LDL-C measurement before and after the event were included. Hazard ratios (HRs) for major vascular events per 1 mmol/L reduction in LDL-C were estimated for the included 21,751 older and 22,681 younger individuals (≥/<70 years old) using Cox regression.
Results
LDL-C lowering was associated with a 12% lower risk of major vascular events in older individuals per 1 mmol/L reduction in LDL-C (HR 0.88, 95% confidence interval [CI] 0.84–0.93), with no significant difference compared with the risk reduction amongst younger individuals (HR 0.88, 95% CI 0.83–0.93; P-value for difference between age groups: 0.86). The risk reduction was more pronounced when post hoc restricting, as a proxy for compliance, to new users with an LDL-C reduction above the lowest decile for both older (0.81, 95% CI 0.73–0.90) and younger (0.81, 95% CI 0.72–0.91) individuals.
Conclusions
This study strongly supports a similar relative clinical benefit of LDL-C reduction with lipid lowering treatment for secondary prevention of major vascular events amongst individuals aged ≥70 and <70 years.
Graphical Abstract
Graphical Abstract</description><issn>0002-0729</issn><issn>1468-2834</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkbtuGzEURIkgRiw_2pQBy6RYm4_lPtwFhu0YMOAmqRcU76XEYEVuSK4F_ZE_M5Qlp01FXODMDAdDyGfOrjjr5bVeofOra201iJp_IAteN10lOll_JAvGmKhYK_pTcpbS73JyxcUncio7wXshmgV5vbMWTXYv6DElGiwdw7YC9MnlHR3dFKYYcsmgZh1GTBljGGlEmIsoeLp1eb3HHOyFGMtnaF5j1NOO2hBpQhM86LijU8QS8ibSm-BXKdMwAkbqPLgXB7Me0w3V1Os9s3WA1IR1iJmmPMPugpzYQuDl8T0nv-7vft7-qJ6eHx5vvz9VRoo-V33bMt2jULI2Bu1SSAOd4ozzRummYaB1a0wNCmoJrezb2qJaStXpTlpuQJ6Trwff0vvPXAoPG5cMjqP2GOY0iJ7XQqmSU9CrA2piSCmiHaboNqXrwNmwX2c4rDMc1ymCL0fveblB-Ie_z1GAbwcgzNP_zP4CBDihfw</recordid><startdate>20240102</startdate><enddate>20240102</enddate><creator>Andersson, Niklas W</creator><creator>Corn, Giulia</creator><creator>Dohlmann, Tine L</creator><creator>Melbye, Mads</creator><creator>Wohlfahrt, Jan</creator><creator>Lund, Marie</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7622-6303</orcidid></search><sort><creationdate>20240102</creationdate><title>Effectiveness of low-density lipoprotein cholesterol reduction with lipid lowering therapy for secondary prevention amongst older individuals: a nationwide cohort study</title><author>Andersson, Niklas W ; Corn, Giulia ; Dohlmann, Tine L ; Melbye, Mads ; Wohlfahrt, Jan ; Lund, Marie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-9770a9e2534ccefb23cd85101165a660daa7cc4d5d43d73974fe5b358a83f1cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andersson, Niklas W</creatorcontrib><creatorcontrib>Corn, Giulia</creatorcontrib><creatorcontrib>Dohlmann, Tine L</creatorcontrib><creatorcontrib>Melbye, Mads</creatorcontrib><creatorcontrib>Wohlfahrt, Jan</creatorcontrib><creatorcontrib>Lund, Marie</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andersson, Niklas W</au><au>Corn, Giulia</au><au>Dohlmann, Tine L</au><au>Melbye, Mads</au><au>Wohlfahrt, Jan</au><au>Lund, Marie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of low-density lipoprotein cholesterol reduction with lipid lowering therapy for secondary prevention amongst older individuals: a nationwide cohort study</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2024-01-02</date><risdate>2024</risdate><volume>53</volume><issue>1</issue><issn>0002-0729</issn><issn>1468-2834</issn><eissn>1468-2834</eissn><abstract>Abstract
Background
Data about the clinical benefit from initial low-density lipoprotein cholesterol (LDL-C) reduction with lipid lowering treatment for secondary prevention and risk of major vascular events amongst older as compared with younger individuals treated during routine clinical care are limited. We investigated this in a nationwide cohort.
Methods
Individuals aged ≥ 50 years with a first-time hospitalisation for a cardiovascular event (index event, including acute coronary syndrome, non-haemorrhagic stroke, transient ischaemic attack and coronary revascularisation), 1 January 2008 to 31 October 2018, who subsequently used lipid lowering treatment, and had an LDL-C measurement before and after the event were included. Hazard ratios (HRs) for major vascular events per 1 mmol/L reduction in LDL-C were estimated for the included 21,751 older and 22,681 younger individuals (≥/<70 years old) using Cox regression.
Results
LDL-C lowering was associated with a 12% lower risk of major vascular events in older individuals per 1 mmol/L reduction in LDL-C (HR 0.88, 95% confidence interval [CI] 0.84–0.93), with no significant difference compared with the risk reduction amongst younger individuals (HR 0.88, 95% CI 0.83–0.93; P-value for difference between age groups: 0.86). The risk reduction was more pronounced when post hoc restricting, as a proxy for compliance, to new users with an LDL-C reduction above the lowest decile for both older (0.81, 95% CI 0.73–0.90) and younger (0.81, 95% CI 0.72–0.91) individuals.
Conclusions
This study strongly supports a similar relative clinical benefit of LDL-C reduction with lipid lowering treatment for secondary prevention of major vascular events amongst individuals aged ≥70 and <70 years.
Graphical Abstract
Graphical Abstract</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>38219226</pmid><doi>10.1093/ageing/afad241</doi><orcidid>https://orcid.org/0000-0001-7622-6303</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-0729 |
| ispartof | Age and ageing, 2024-01, Vol.53 (1) |
| issn | 0002-0729 1468-2834 1468-2834 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2914255977 |
| source | Oxford University Press Journals All Titles (1996-Current) |
| title | Effectiveness of low-density lipoprotein cholesterol reduction with lipid lowering therapy for secondary prevention amongst older individuals: a nationwide cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-15T03%3A05%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effectiveness%20of%20low-density%20lipoprotein%20cholesterol%20reduction%20with%20lipid%20lowering%20therapy%20for%20secondary%20prevention%20amongst%20older%20individuals:%20a%20nationwide%20cohort%20study&rft.jtitle=Age%20and%20ageing&rft.au=Andersson,%20Niklas%20W&rft.date=2024-01-02&rft.volume=53&rft.issue=1&rft.issn=0002-0729&rft.eissn=1468-2834&rft_id=info:doi/10.1093/ageing/afad241&rft_dat=%3Cproquest_cross%3E2914255977%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2914255977&rft_id=info:pmid/38219226&rft_oup_id=10.1093/ageing/afad241&rfr_iscdi=true |