Li-Ting Ho1, Fang-Ju Lin2, Wei-Kung Tseng3, Wei-Hsian Yin4, Yen-Wen Wu5, Yi-Heng Li6, Hung-I Yeh7, Jaw-Wen Chen8, Chau-Chung Wu9. 1. Department of Internal Medicine (Cardiology Section), National Taiwan University Hospital, Taipei, Taiwan. 2. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan. 3. Department of Medical Imaging and Radiological Sciences, I-Shou University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan. 4. Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. 5. Department of Internal Medicine (Cardiology Section), National Taiwan University Hospital, Taipei, Taiwan; Cardiology Division, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; National Yang-Ming University School of Medicine, Taipei, Taiwan. 6. Department of Internal Medicine, National Cheng Kung University Hospital and National Cheng Kung University, Tainan, Taiwan. 7. Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan. 8. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan. 9. Department of Internal Medicine (Cardiology Section), National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Medical Education & Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: chauchungwu@ntu.edu.tw.
Abstract
BACKGROUND: The aim of this study is to determine the relationship between the on-treatment lipid profiles and the CV events in CKD and non-CKD population. METHOD: This study was a multi-center observational registry, the Taiwanese Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) Registry. This study follows up patients with CV diseases in Taiwan who have secondary prevention therapies. The primary outcome is the time of first occurrence of a major adverse cardiac events (MACEs). RESULT: 5388 patients with ASCVD were included and 1478 (27.4%) had CKD without dialysis. CKD patients had higher TG and lower LDL-C levels. The incidence of recurrent MACEs per 1000 person-years in CKD patients was 19.5 (95% CI 15.5-24.9), compared with 9.1 (95% CI 7.4-11.1) in non-CKD patients. In patients with statin therapy, there were no differences in MACE risk between each level of on-treatment LDL-C, TG and HDL-C level. Higher on-treatment non-HDL-C level was a significant predictor for higher MACE risk in patients without CKD, and borderline significant in CKD patients under statin therapy. Heart failure history was also associated with higher MACE risk in both group. Lower body mass index (BMI < 23 kg/m2) was associated with higher MACE risk in CKD patients. CONCLUSION: In ASCVD patients, on-treatment LDL-C was not a good CV outcome predictor. Instead, on-treatment non-HDL-C was a better predictor. Heart failure history was also associated with higher MACE risk in both group of patients. Lower BMI (<23 kg/m2) was associated with higher recurrent MACE risk in CKD patients.
BACKGROUND: The aim of this study is to determine the relationship between the on-treatment lipid profiles and the CV events in CKD and non-CKD population. METHOD: This study was a multi-center observational registry, the Taiwanese Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) Registry. This study follows up patients with CV diseases in Taiwan who have secondary prevention therapies. The primary outcome is the time of first occurrence of a major adverse cardiac events (MACEs). RESULT: 5388 patients with ASCVD were included and 1478 (27.4%) had CKD without dialysis. CKDpatients had higher TG and lower LDL-C levels. The incidence of recurrent MACEs per 1000 person-years in CKDpatients was 19.5 (95% CI 15.5-24.9), compared with 9.1 (95% CI 7.4-11.1) in non-CKDpatients. In patients with statin therapy, there were no differences in MACE risk between each level of on-treatment LDL-C, TG and HDL-C level. Higher on-treatment non-HDL-C level was a significant predictor for higher MACE risk in patients without CKD, and borderline significant in CKDpatients under statin therapy. Heart failure history was also associated with higher MACE risk in both group. Lower body mass index (BMI < 23 kg/m2) was associated with higher MACE risk in CKDpatients. CONCLUSION: In ASCVD patients, on-treatment LDL-C was not a good CV outcome predictor. Instead, on-treatment non-HDL-C was a better predictor. Heart failure history was also associated with higher MACE risk in both group of patients. Lower BMI (<23 kg/m2) was associated with higher recurrent MACE risk in CKDpatients.