Baseline, delta, and achieved low-density lipoprotein cholesterol levels and cardiovascular risk in patients on statin therapy: A post-hoc resampling mediation analysis of treating new targets [TNT] trial
DC Field | Value | Language |
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dc.contributor.author | Hyun, Myung Han | - |
dc.contributor.author | Jang, Jae Won | - |
dc.contributor.author | Lee, Eunmi | - |
dc.contributor.author | An, Hyonggin | - |
dc.contributor.author | Seog Seo, Hong | - |
dc.date.accessioned | 2021-08-30T13:26:01Z | - |
dc.date.available | 2021-08-30T13:26:01Z | - |
dc.date.created | 2021-06-18 | - |
dc.date.issued | 2020-10 | - |
dc.identifier.issn | 0305-1870 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/52708 | - |
dc.description.abstract | Clinical guidelines for monitoring low-density lipoprotein cholesterol (LDL-C) after statin therapy do not clearly define the clinical roles of baseline LDL-C, Delta LDL-C, and achieved LDL-C according to statin intensity. We performed post-hoc analysis of the Treating to New Target (TNT) study to evaluate individual LDL-C parameters after statin therapy. Primary outcome was the risk for total major adverse cardiovascular events (MACE). We use resampling multilevel mediation analysis to analyze complex relationships among LDL-C parameters based on similar statin intensities. Tertiles for resample A (matched baseline LDL-C; distinct achieved LDL), resample B (matched Delta LDL-C; distinct baseline LDL-C), and resample C (matched achieved LDL-C; distinct Delta LDL-C) were analyzed using Cox proportional hazard ratios. In original data analysis, the incidence of MACE was reduced in those with lower achieved LDL-C in total, low, and high intensity statin users (hazard ratios [HRs] = 0.990, 0.992, 0.992; respectively; allP-values < .001). In mediation analysis, resample A showed consistently high incidence for MACE in the middle tertile (HR = 1.237; 95% confidential interval [CI] = 1.008-1.517;P-value = .041) and highest tertile (HR = 1.275; 95% CI = 1.021-1.592;P-value = .032) compared to the lowest tertile. However, resamples B and C did not show consistent differences. Similarly, no consistent statistical difference in MACE according to statin intensity. Lower achieved LDL-C decreased MACE in participants with a similar baseline LDL-C after statin therapy. However, the change in absolute values of Delta LDL-C and achieved LDL-C should be interpreted in an individualized manner due to their complex collinearity, and statin intensity should also be taken into consideration. | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | WILEY | - |
dc.subject | ESC/EAS GUIDELINES | - |
dc.subject | LDL CHOLESTEROL | - |
dc.subject | MANAGEMENT | - |
dc.subject | ATORVASTATIN | - |
dc.subject | ASSOCIATION | - |
dc.subject | INHIBITION | - |
dc.subject | ABSORPTION | - |
dc.subject | DISEASE | - |
dc.subject | SERUM | - |
dc.title | Baseline, delta, and achieved low-density lipoprotein cholesterol levels and cardiovascular risk in patients on statin therapy: A post-hoc resampling mediation analysis of treating new targets [TNT] trial | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | An, Hyonggin | - |
dc.contributor.affiliatedAuthor | Seog Seo, Hong | - |
dc.identifier.doi | 10.1111/1440-1681.13367 | - |
dc.identifier.scopusid | 2-s2.0-85088153204 | - |
dc.identifier.wosid | 000566329900002 | - |
dc.identifier.bibliographicCitation | CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, v.47, no.10, pp.1649 - 1658 | - |
dc.relation.isPartOf | CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY | - |
dc.citation.title | CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY | - |
dc.citation.volume | 47 | - |
dc.citation.number | 10 | - |
dc.citation.startPage | 1649 | - |
dc.citation.endPage | 1658 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Pharmacology & Pharmacy | - |
dc.relation.journalResearchArea | Physiology | - |
dc.relation.journalWebOfScienceCategory | Pharmacology & Pharmacy | - |
dc.relation.journalWebOfScienceCategory | Physiology | - |
dc.subject.keywordPlus | ESC/EAS GUIDELINES | - |
dc.subject.keywordPlus | LDL CHOLESTEROL | - |
dc.subject.keywordPlus | MANAGEMENT | - |
dc.subject.keywordPlus | ATORVASTATIN | - |
dc.subject.keywordPlus | ASSOCIATION | - |
dc.subject.keywordPlus | INHIBITION | - |
dc.subject.keywordPlus | ABSORPTION | - |
dc.subject.keywordPlus | DISEASE | - |
dc.subject.keywordPlus | SERUM | - |
dc.subject.keywordAuthor | cardiovascular outcome | - |
dc.subject.keywordAuthor | low-density lipoprotein cholesterol | - |
dc.subject.keywordAuthor | resampling mediation analysis | - |
dc.subject.keywordAuthor | statin therapy | - |
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