Abstract 4162: Cardiovascular Event Reduction Associated with Achieving Optimal Values for Multiple Lipids
Introduction: We hypothesized that achievement of optimal lipid values would significantly reduce the risk of CV event relative to patients with combined non-optimal lipid profiles, across patients with specific lipid abnormalities.
Methods: Retrospective analyses were conducted in patients ≥18 y/o with a lipid panel between 01/00–12/01 and ≥1 f/u panel through 06/04, ≥12 months continuous data pre- and post-initial lipid panel, and without dyslipidemia associated drug therapy. Optimal lipid values were defined as (mg/dL): LDL-C <100/<130 per CV risk level; HDL-C >40 men/>50 women; TG <200. Three cohorts were constructed -Cohort 1: non-optimal LDL-C; Cohort 2: non-optimal LDL-C and either non-optimal TG or HDL-C; and Cohort 3: non-optimal LDL-C, HDL-C, and TG. The primary outcome was risk of CV event, defined as any emergency or inpatient visit with ICD-9 codes corresponding to ischemic heart disease, peripheral vascular disease, and stroke/TIA. The relative risk of CV events in patients achieving versus not achieving combined optimal lipid values were determined using adjusted Cox proportional-hazards models, adjusted for age, sex, CV comorbidities, and dyslipidemia treatment.
Results: Events (3,956 total) were recorded over an average of 2.7 years in 23,234 at risk patients with suboptimal baseline lipid values. Decreasingly lower percentages of combined optimal lipid values were attained across cohorts as the number of suboptimal baseline lipid values increased (all p<0.001). While correction of baseline lipids with achievement of combined optimal lipid values was infrequent, it was associated with a significant CV risk reduction of 25% in patients with abnormal LDL-C only and 46% in patients with LDL-C + HDL-C and/or TG abnormalities.
Conclusion: Lifestyle and pharmacotherapy interventions sufficient to render LDL-C, HDL-C and TG optimal may substantially improve CV outcomes in patients with both simple and multiple lipid abnormalities.