Abstract 18487: Predictors of Residual Cardiovascular Risk in Patients on Statin Therapy for Primary Prevention
Background: Low density lipoprotein cholesterol (LDL) lowering therapy is an important aspect of primary prevention of cardiovascular disease (CVD). Statins are the most widely used drug therapy for achieving the LDL goals based on an individual's 10 year risk. However, substantial risk for CVD events still exists even when a person is on statins. We sought to explore the predictors of future CVD events in individuals on statins with no pre-existing CVD.
Methods: The analysis was done on subjects who were on statins (n=1006) at baseline in the Multi Ethnic Study of Atherosclerosis limited access dataset from NHLBI. Primary outcome variable was all cause CVD events (CVDa)(n=70), defined as myocardial infarction, definite or probable angina if revascularization was preformed, resuscitated cardiac arrest, coronary heart disease death, stroke, stroke death, other atherosclerotic death or other CVD death. Baseline characteristic distribution between those with and without CVDa were compared using univariate Cox-proportional hazard analysis to identify variables with p <0.05. Multivariate regression Cox-proportional hazard analysis was done to identify potential independent predictors of CVDa.
Results: Table 1 Table 2
Conclusion: Homocysteine, waist circumference, coronary artery calcification and large artery elasticity index appear to be the major independent predictors of adverse cardiovascular outcomes in individuals on statins with no pre-existing CVD. In addition to emphasizing weight loss, alternative approaches beyond lipid reduction may need to be explored to better characterize and attenuate residual risk in subjects on Statin therapy for primary prevention.
- © 2010 by American Heart Association, Inc.