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      Residual atherosclerotic cardiovascular disease risk in statin-treated adults: The Multi-Ethnic Study of Atherosclerosis

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d3608304e235">Background:</h5> <p id="P1">Residual atherosclerotic cardiovascular disease (ASCVD) risk in statin-treated U.S. adults without known ASCVD is not well-described. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d3608304e240">Objective:</h5> <p id="P2">To quantitate residual ASCVD risk and its predictors in statin-treated adults.</p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d3608304e245">Methods:</h5> <p id="P3">We studied 1,014 statin-treated adults (53.3% female, mean 66.0 years) free of clinical ASCVD in the Multiethnic Study of Atherosclerosis. We examined ASCVD event rates by National Lipid Association risk groups over 11-year follow-up and the relation of standard risk factors, biomarkers and subclinical atherosclerosis measures with residual ASCVD event risk. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d3608304e250">Results:</h5> <p id="P4">Overall, 5.3% of participants were at low, 12.2% at moderate, 60.3% at high, and 22.2% at very high baseline risk. Despite statin therapy, age-and-race standardized ASCVD rates per 1000 person years for men and women were both 4.9 for low/moderate risk, 19.1 and 14.2 for high risk and 35.6 and 26.7 for very high risk, respectively. Specific independent predictors of residual risk included current smoking, family history, diabetes, high sensitivity C-reactive protein, LDL-particle number, carotid intimal medial thickness, and especially coronary artery calcium score. Those on moderate or high intensity statins at baseline (compared to low intensity) had 39% lower risks, and those who increased statin intensity 62% lower ASCVD event risks (p&lt;0.01). </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d3608304e255">Conclusion:</h5> <p id="P5">Residual risk of ASCVD remains high despite statin treatment and is predicted by specific risk factors and subclinical atherosclerosis. These findings may be helpful for identifying those at highest risk needing more aggressive treatment. </p> </div>

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          Author and article information

          Journal
          Journal of Clinical Lipidology
          Journal of Clinical Lipidology
          Elsevier BV
          19332874
          September 2017
          September 2017
          : 11
          : 5
          : 1223-1233
          Article
          10.1016/j.jacl.2017.06.015
          6394854
          28754224
          bde7bd42-6aa9-4c6f-bbb2-a37498776df5
          © 2017

          http://www.elsevier.com/tdm/userlicense/1.0/

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