Statins for prevention of cardiovascular events in a low-risk population with low ankle brachial index.

Ramos, Rafel; Garcia Gil, Maria; Comas Cufí, Marc; Quesada, Miquel; Marrugat de la Iglesia, Jaume; Elosua Llanos, Roberto; Sala, Joan; Grau Magaña, Maria; Martí, Ruth; Ponjoan, Anna; Alves-Cabratosa, Lia; Blanch, Jordi; Bolíbar, Bonaventura

Statins for prevention of cardiovascular events in a low-risk population with low ankle brachial index.

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dc.contributor.author Ramos, Rafelca
dc.contributor.author Garcia Gil, Mariaca
dc.contributor.author Comas Cufí, Marcca
dc.contributor.author Quesada, Miquelca
dc.contributor.author Marrugat de la Iglesia, Jaumeca
dc.contributor.author Elosua Llanos, Robertoca
dc.contributor.author Sala, Joanca
dc.contributor.author Grau Magaña, Mariaca
dc.contributor.author Martí, Ruthca
dc.contributor.author Ponjoan, Annaca
dc.contributor.author Alves-Cabratosa, Liaca
dc.contributor.author Blanch, Jordica
dc.contributor.author Bolíbar, Bonaventuraca
dc.date.accessioned 2016-05-05T08:33:31Z
dc.date.available 2016-05-05T08:33:31Z
dc.date.issued 2016
dc.description.abstract BACKGROUND: Evidence is lacking about the effectiveness of risk reduction interventions in patients with asymptomatic peripheral arterial disease. OBJECTIVES: This study aimed to assess whether statin therapy was associated with a reduction in major adverse cardiovascular events (MACE) and mortality in this population. METHODS: Data were obtained from 2006 through 2013 from the Catalan primary care system's clinical records database (SIDIAP). Patients age 35 to 85 years with an ankle-brachial index ≤0.95 and without clinically recognized cardiovascular disease (CVD) were included. Participants were categorized as statins nonusers or new-users (first prescription or represcribed after at least 6 months) and matched 1:1 by inclusion date and propensity score for statin treatment. Conditional Cox proportional hazards modeling was used to compare the groups for the incidence of MACE (myocardial infarction, cardiac revascularization, and ischemic stroke) and all-cause mortality. RESULTS: The matched-pair cohort included 5,480 patients (mean age 67 years; 44% women) treated/nontreated with statins. The 10-year coronary heart disease risk was low (median: 6.9%). Median follow-up was 3.6 years. Incidence of MACE was 19.7 and 24.7 events per 1,000 person-years in statin new-users and nonusers, respectively. Total mortality rates also differed: 24.8 versus 30.3 per 1,000 person-years, respectively. Hazards ratios were 0.80 for MACE and 0.81 for overall mortality. The 1-year number needed to treat was 200 for MACE and 239 for all-cause mortality. CONCLUSIONS: Statin therapy was associated with a reduction in MACE and all-cause mortality among participants without clinical CVD but with asymptomatic peripheral arterial disease, regardless of its low CVD risk. The absolute reduction was comparable to that achieved in secondary prevention.ca
dc.description.sponsorship This project was supported by clinical research grants from the Ministerio de Salud (EC10-84, EC10-83); Spain’s Ministry of Science and Innovation through the Carlos III Health Institute, cofinanced with European Union ERDF funds (Network for Prevention and Health Promotion in primary Care RedIAPP RD12/0005, Programa HERACLES RD12/0042, and Miguel Servet Contract CP12/03287); and by the Departament de Salut, Generalitat de Catalunya, Agency for Health Technology Assessment (AATRM 034/33/02), and Agency for Management of University and Research Grants (2005SGR00577). Drs. Ramos and Garcia-Gil collaborate (without receiving any personal fee) in 2 projects of primary care for the institute IDIAP Jordi Gol funded by AstraZeneca and AMGEN that are unrelated to the present work. Dr. Marrugat has received lecture fees from Ferrer-in-Code; holds a patent with Gendiag SL; and has received payment for development of educational presentations from AstraZeneca.
dc.format.mimetype application/pdfca
dc.identifier.citation Ramos R, García-Gil M, Comas-Cufí M, Quesada M, Marrugat J, Elosua R. et al. Statins for prevention of cardiovascular events in a low-risk population with low ankle brachial index. J Am Coll Cardiol. 2016 Feb 16;67(6):630-40. doi: 10.1016/j.jacc.2015.11.052ca
dc.identifier.doi http://dx.doi.org/10.1016/j.jacc.2015.11.052
dc.identifier.issn 0735-1097
dc.identifier.uri http://hdl.handle.net/10230/26246
dc.language.iso engca
dc.publisher Elsevierca
dc.relation.ispartof Journal of the American College of Cardiology. 2016 Feb 16;67(6):630-40
dc.rights © Elsevier This is the published version of an article http://dx.doi.org/10.1016/j.jacc.2015.11.052 that appeared in the journal Journal of the American College of Cardiology ]. It is published in an Open Archive under an Elsevier user license. Details of this licence are available here: http://www.elsevier.com/about/open-access/open-access-policies/oa-license-policy/elsevier-user-licenseca
dc.rights.accessRights info:eu-repo/semantics/openAccessca
dc.subject.other Artèries -- Malaltiesca
dc.subject.other Sistema cardiovascular -- Malaltiesca
dc.title Statins for prevention of cardiovascular events in a low-risk population with low ankle brachial index.ca
dc.type info:eu-repo/semantics/articleca
dc.type.version info:eu-repo/semantics/publishedVersionca

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