Long-term effect of 2 intensive statin regimens on treatment and incidence of cardiovascular events in familial hypercholesterolemia: The SAFEHEART study
Perez de Isla, Leopoldo; Arroyo-Olivares, Raquel; Muniz-Grijalvo, Ovidio; Díaz Díaz, Jose Luis; Zambon, Daniel; Fuentes, Francisco; Sanchez Munoz-Torrero, Juan F; Mediavilla, Juan Diego; Gonzalez-Estrada, Aurora; Miramontes-Gonzalez, Jose Pablo; de Andres, Raimundo; Mauri, Marta; Mosquera, Daniel; Cepeda, Jose M; Suarez, Lorena; Barba-Romero, Miguel Angel; Argueso, Rosa; Alvarez-Banos, Pilar; Michan, Alfredo; Romero-Jimenez, Manuel J; Garcia-Cruces, Jesus; Padro, Teresa; Alonso, Rodrigo; Mata, Pedro
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Identificadores
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Fecha de publicación
2019Título de revista
J Clin Lipidol
Tipo de contenido
Artigo
DeCS
resultado del tratamiento | anciano | hipercolesterolemia familiar | estudios prospectivos | mediana edad | farmacoterapia | humanos | estudios de cohortes | adulto | inhibidores de las hidroximetilglutaril-CoA reductasas | colesterolMeSH
Drug Therapy | Adult | Middle Aged | Humans | Treatment Outcome | Hyperlipoproteinemia Type II | Cholesterol | Prospective Studies | Hydroxymethylglutaryl-CoA Reductase Inhibitors | Aged | Cohort StudiesResumen
BACKGROUND: Maximal doses of potent statins are the basement of treatment of familial hypercholesterolemia (FH). Little is known about the use of different statin regimens in FH. OBJECTIVES: The objectives of the study were to describe the treatment changes and low-density lipoprotein cholesterol (LDL-C) goal achievement with atorvastatin (ATV) and rosuvastatin (RV) in the SAFEHEART cohort, as well as to analyze the incidence of atherosclerotic cardiovascular events (ACVEs) and changes in the cardiovascular risk. METHODS: SAFEHEART is a prospective follow-up nationwide cohort study in a molecularly defined FH population. The patients were contacted on a yearly basis to obtain relevant changes in life habits, medication, and ACVEs. RESULTS: A total of 1939 patients were analyzed. Median follow-up was 6.6 years (5-10). The estimated 10-year risk according the SAFEHEART risk equation was 1.61 (0.67-3.39) and 1.22 (0.54-2.93) at enrollment for ATV and RV, respectively (P < .001). There were no significant differences at the follow-up: 1.29 (0.54-2.82) and 1.22 (0.54-2.76) in the ATV and RV groups, respectively (P = .51). Sixteen percent of patients in primary prevention with ATV and 18% with RV achieved an LDL-C <100 mg/dL and 4% in secondary prevention with ATV and 5% with RV achieved an LDL-C <70 mg/dL. The use of ezetimibe was marginally greater in the RV group. One hundred sixty ACVEs occurred during follow-up, being its incidence rate 1.1 events/100 patient-years in the ATV group and 1.2 in the RV group (P = .58). CONCLUSION: ATV and RV are 2 high-potency statins widely used in FH. Although the reduction in LDL-C levels was greater with RV than with ATV, the superiority of RV for reducing ACVEs was not demonstrated.
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