Home > Riviste > Gazzetta Medica Italiana Archivio per le Scienze Mediche > Fascicoli precedenti > Gazzetta Medica Italiana Archivio per le Scienze Mediche 2015 October;174(10) > Gazzetta Medica Italiana Archivio per le Scienze Mediche 2015 October;174(10):441-7

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Estratti
Permessi
Per citare questo articolo

 

ORIGINAL ARTICLES   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2015 October;174(10):441-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Three-year mortality of patients with cardiovascular risk receiving lipid-lowering therapy using statins in clinical practice in Thailand

Sriratanasathavorn C. 1, Silaruks S. 2, Rawdaree P. 3, Kunjara-Na-Ayudhaya R. 4, Thinkhamrop B. 5, Sritara P. 6

1 Her Majesty Cardiac Center, Siriraj Hospital, Mahidol University, Siriraj, Tailandia; 2 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Tailandia; 3 Endocrinology Unit, BMA Medical College and Vajira Hospital, Bangkok, Tailandia; 4 Vichaiyut Hospital, Bangkok, Tailandia; 5 Department of Biostatistics and Demography Faculty of Public Health, Khon Kaen, Tailandia; 6 Cardiology Unit, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Tailandia


PDF


AIM: We assessed overall mortality among dyslipidemia patients in clinical practice in Thailand: all participants were receiving lipid-lowering statins.
METHODS: A total of 1240 patients were selected consecutively from 50 hospitals across Thailand. Patients were enrolled if treated with statins for at least 3 months. Mortality was determined over 3 years. Patients were classified as: (1) very high risk – post myocardial infarction with diabetes mellitus (DM), or post-stroke with DM, or peripheral artery disease with DM; (b) high risk – coronary artery disease, or cardiovascular disease, or post-stroke, or DM; or, (c) moderate risk – 2 or more risks plus either hypertension or dyslipidemia. Mortality was estimated using the exact Poisson distribution and compared between groups using a multivariable Cox proportional hazards regression model.
RESULTS: Overall, two-thirds of the patients were female, mean age was 61.7±9.5 and 73.7% were at high-risk. One-half (51.1%) achieved the LDL-C guideline goals. Over the 3-year follow-up, the mortality rate was 10.1% (95%CI: 8.5% to 11.9%). Overall mortality since beginning statin treatment was 1.7 per 100 person-years (95%CI: 1.4 to 2.0). Heart failure was the most common cause of death (17.6%): 18.6% in the very high risk group (p-value = 0.005). The respective risk of death in the high and very high risk group was double and quadruple of that in the moderate risk group (HR 2.0; 95%CI: 1.2 to 3.3, p-value = 0.012 vs. HR 3.9; 95%CI: 1.7 to 9.1; p-value = 0.002).
CONCLUSION: Among patients with a cardiovascular risk—half of whom achieved the prescribed LDL-C goals—10% died within 3 years of enrolment, i.e. 1.7 per 100 person-years after starting statin treatment. Patients with a high and very high risk for CHD need more aggressive lipid-lowering management than usual.

inizio pagina