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

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

Residual atherosclerotic cardiovascular disease (ASCVD) risk in statin-treated US adults without known ASCVD is not well described. To quantitate residual ASCVD risk and its predictors in statin-treated adults. We studied 1014 statin-treated adults (53.3% female, mean 66.0 years) free of clinical AS...

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Bibliographic Details
Published in:Journal of clinical lipidology 2017-09, Vol.11 (5), p.1223-1233
Main Authors: Wong, Nathan D., Zhao, Yanglu, Quek, Ruben G.W., Blumenthal, Roger S., Budoff, Matthew J., Cushman, Mary, Garg, Parveen, Sandfort, Veit, Tsai, Michael, Lopez, J. Antonio G.
Format: Article
Language:eng
Subjects:
Aged
Aged, 80 and over
Atherosclerosis
Atherosclerosis - drug therapy
Atherosclerosis - ethnology
Cardiovascular disease risk
Dyslipidemia
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Middle Aged
Risk Assessment
Risk factors
Statins
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Summary:Residual atherosclerotic cardiovascular disease (ASCVD) risk in statin-treated US adults without known ASCVD is not well described. To quantitate residual ASCVD risk and its predictors in statin-treated adults. We studied 1014 statin-treated adults (53.3% female, mean 66.0 years) free of clinical ASCVD in the Multi-Ethnic 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. 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, low-density lipoprotein particle number, carotid intimal medial thickness, and especially coronary artery calcium score. Those on moderate- or high-intensity statins at baseline (compared with low intensity) had 39% lower risks and those who increased statin intensity 62% lower ASCVD event risks (P 
ISSN:1933-2874
1876-4789