Mohammad Alkhalil1. 1. Cardiology Department, Royal Victoria Hospital, Belfast, UK; Cardiology Department, Toronto General Hospital, 200 Elizabeth Street, Toronto, M5G 2C4, Canada. Electronic address: mak-83@hotmail.com.
Abstract
BACKGROUND AND AIMS: The recent reported analysis from the ODYSSEY OUTCOMES trial showed that patients with previous coronary bypass graft surgery (CABG) had enhanced clinical benefits in response to intensive low-density lipoprotein-cholesterol (LDL-c). Nonetheless, the impact on cardiovascular and all-cause mortality was difficult to ascertain given the relatively small number. METHODS: We conducted a meta-analysis investigating the role of more versus less intensive lipid-lowering treatment, taking into consideration the difference in studies duration when reporting treatment effect. RESULTS: A significant 14% reduction in deaths from any cause [RR 0.86 (95% CI, 0.74 to 0.99)] and 25% reduction in cardiovascular mortality [RR 0.75, (95% CI, 0.65 to 0.86)] were associated with intensive LDL-c reduction in patients post CABG. Importantly, this reduction was apparent in patients who were stable or developed an acute coronary syndrome following CABG. CONCLUSIONS: Patients with previous CABG incurred reduction in all-cause mortality and particularly cardiovascular mortality in response to intensive LDL-c reduction. Patient's clinical presentation following CABG did not modulate the associated benefits with intensive LDL-c reduction. Characterising atherosclerotic disease may help identify other high-risk groups who may benefit maximally from additional lipid-lowering therapies.
BACKGROUND AND AIMS: The recent reported analysis from the ODYSSEY OUTCOMES trial showed that patients with previous coronary bypass graft surgery (CABG) had enhanced clinical benefits in response to intensive low-density lipoprotein-cholesterol (LDL-c). Nonetheless, the impact on cardiovascular and all-cause mortality was difficult to ascertain given the relatively small number. METHODS: We conducted a meta-analysis investigating the role of more versus less intensive lipid-lowering treatment, taking into consideration the difference in studies duration when reporting treatment effect. RESULTS: A significant 14% reduction in deaths from any cause [RR 0.86 (95% CI, 0.74 to 0.99)] and 25% reduction in cardiovascular mortality [RR 0.75, (95% CI, 0.65 to 0.86)] were associated with intensive LDL-c reduction in patients post CABG. Importantly, this reduction was apparent in patients who were stable or developed an acute coronary syndrome following CABG. CONCLUSIONS:Patients with previous CABG incurred reduction in all-cause mortality and particularly cardiovascular mortality in response to intensive LDL-c reduction. Patient's clinical presentation following CABG did not modulate the associated benefits with intensive LDL-c reduction. Characterising atherosclerotic disease may help identify other high-risk groups who may benefit maximally from additional lipid-lowering therapies.
Authors: Mohammad Alkhalil; Michał Kuzemczak; Nicholas Whitehead; Charalampos Kavvouras; Vladimír Džavík Journal: J Am Heart Assoc Date: 2021-02-15 Impact factor: 5.501
Authors: Maks Mihalj; Paul Philipp Heinisch; Markus Huber; Joerg C Schefold; Alexander Hartmann; Michael Walter; Elisabeth Steinhagen-Thiessen; Juerg Schmidli; Frank Stüber; Lorenz Räber; Markus M Luedi Journal: Cells Date: 2021-10-11 Impact factor: 6.600