Open AccessLow‐Density Lipoprotein Reduction and Magnitude of Cardiovascular Risk Reduction
Author(s) -
RahillyTierney Catherine R.,
Lawler Elizabeth V.,
Scranton Richard E.,
Michael Gaziano J.
Publication year - 2009
Publication title -
preventive cardiology
Language(s) - English
Resource type - Journals
eISSN - 1751-7141
pISSN - 1520-037X
DOI - 10.1111/j.1751-7141.2008.00018.x
Subject(s) - medicine , cardiology , hazard ratio , diabetes mellitus , reduction (mathematics) , myocardial infarction , endocrinology , confidence interval , geometry , mathematics
The authors examined the relationship between the magnitude of low‐density lipoprotein cholesterol (LDL‐C) reduction and the magnitude of cardiovascular risk reduction. From the Veterans Integrated Service Network 1 databases, the authors selected 54,611 patients with prevalent ischemic heart disease, peripheral vascular disease or diabetes mellitus, and ≥2 documented LDL‐C levels who were followed between 1997 and 2006. The outcome was defined as acute myocardial infarction or revascularization. Preoutcome LDL‐C reduction was categorized as follows: <10 mg/dL, reference; ≥10 but <40 mg/dL, small reduction; ≥40 but <70 mg/dL, moderate reduction; ≥70 mg/dL, large reduction. Proportional hazards were used to determine the hazard ratio for the outcome for each LDL‐C reduction category compared with the reference. Results revealed a graded relationship between the magnitude of reduction in LDL‐C and cardiovascular risk reduction. Stratified analyses demonstrated these findings to be robust regardless of initial LDL‐C levels or whether patients achieved “target” final LDL‐C values of <100 mg/dL.