Association Between Patient Sex and Familial Hypercholesterolemia and Long-Term Cardiovascular Risk Factor Management 5 Years After Acute Coronary Syndrome.

Nanchen, D.

doi:10.1161/CIRCOUTCOMES.123.010790

Titre

Association Between Patient Sex and Familial Hypercholesterolemia and Long-Term Cardiovascular Risk Factor Management 5 Years After Acute Coronary Syndrome.

Type

article

Institution

UNIL/CHUV/Unisanté + institutions partenaires

Périodique

Circulation: Cardiovascular Quality and Outcomes

Auteur(s)

Krasieva, K.

Auteure/Auteur

Gencer, B.

Auteure/Auteur

Locatelli, I.

Auteure/Auteur

Carballo, D.

Auteure/Auteur

Muller, O.

Auteure/Auteur

Fournier, S.

Auteure/Auteur

Matter, C.M.

Auteure/Auteur

Räber, L.

Auteure/Auteur

Rodondi, N.

Auteure/Auteur

Mach, F.

Auteure/Auteur

Nanchen, D.

Auteure/Auteur

Liens vers les personnes

Locatelli, Isabella

Nanchen, David

Kovalevskaya, Kristina

Liens vers les unités

PMU/UNISANTE

ISSN

1941-7705

Statut éditorial

Publié

Date de publication

2024-08

Volume

17

Numéro

8

Première page

e010790

Peer-reviewed

Oui

Langue

anglais

Notes

Publication types: Journal Article ; Multicenter Study ; Comparative Study ; Observational Study
Publication Status: ppublish

Résumé

Long-term control of cardiovascular risk factors after acute coronary syndrome (ACS) is the cornerstone for preventing recurrence. We investigated the extent of cardiovascular risk factor management in males and females with and without familial hypercholesterolemia (FH) 5 years after ACS.
We studied patients hospitalized for ACS between 2009 and 2017 in a Swiss multicenter prospective cohort study. FH was defined based on clinical criteria from the Dutch Lipid Clinic Network and Simon Broome definitions. Five years post-ACS, we assessed low-density lipoprotein-cholesterol (LDL-c) levels, lipid-lowering therapy (LLT), and other cardiovascular risk factors, comparing males to females with and without FH using generalized estimating equations.
A total of 3139 patients were included; mean age was 61.4 years (SD, 12.1), 620 (19.8%) were female, and 747 (23.5%) had possible FH. Compared with males at 5-years post-ACS, females were more likely to not use statins (odds ratio, 1.61 [95% CI, 1.28-2.03]) and less likely to have combination LLT (odds ratio, 0.72 [95% CI, 0.55-0.93]), without difference between patients with FH and without FH. Females in both FH and non-FH groups less frequently reached LDL-c values ≤1.8 mmol/L (odds ratio, 0.78 [95% CI, 0.78-0.93]). Overall, patients with FH were more frequently on high-dose statins compared with patients without FH (51.0% versus 42.9%; P=0.001) and presented more frequently with a combination of 2 or more LLT compared with patients without FH (33.8% versus 17.7%; P<0.001), but less frequently reached LDL-c targets of ≤1.8 mmol/L (33.5% versus 44.3%; P<0.001) or ≤2.6 mmol/L (70.2% versus 78.1%; P=0.001).
Five years after ACS, females had less intensive LLT and were less likely to reach target LDL-c levels than males, regardless of FH status. Males and females with FH had less optimal control of LDL-c despite more frequently taking high-dose statins or combination LLT compared with patients without FH. Long-term management of patients with ACS and FH, especially females, warrants optimization.

PID Serval

serval:BIB_32B0D5479156

DOI

10.1161/CIRCOUTCOMES.123.010790

PMID

38899458

WOS

001293901800014

Permalien

https://iris.unil.ch/handle/iris/77740

Open Access

Oui

Date de création

2024-06-24T06:56:35.654Z

Date de création dans IRIS

2025-05-20T16:50:13Z

Fichier(s)

Nom

Thèse MD final.pdf

Version du manuscrit

published

Taille

614.13 KB

Format

Adobe PDF

PID Serval

serval:BIB_32B0D5479156.P002

URN

urn:nbn:ch:serval-BIB_32B0D54791566

Somme de contrôle

(MD5):d53caeac327a381282c5f709c9e1f44c

Nom

Imprimatur.pdf

Version du manuscrit

supplementary

Taille

172.86 KB

Format

Adobe PDF

PID Serval

serval:BIB_32B0D5479156.S001

Somme de contrôle

(MD5):91cf25a36b1108f8072efe7ad8bfcbaa

Nom

circcvqo_circcqo-2023-010790d_supp1.pdf

Version du manuscrit

supplementary

Taille

637.67 KB

Format

Adobe PDF

PID Serval

serval:BIB_32B0D5479156.S002

Somme de contrôle

(MD5):491bd145544f44c09d0246aeb03cd241