Long-term effect of 2 intensive statin regimens on treatment and incidence of cardiovascular events in familial hypercholesterolemia : The SAFEHEART study
Pérez de Isla, Leopoldo (Fundación Hipercolesterolemia Familiar)
Arroyo-Olivares, Raquel (Fundación Hipercolesterolemia Familiar)
Muñiz-Grijalvo, Ovidio (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Diaz-Díaz, José Luis (Hospital Abente y Lago)
Zambón, Daniel (Hospital Clínic i Provincial de Barcelona)
Fuentes, Francisco (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Sánchez Muñoz-Torrero, Juan F. (Hospital San Pedro de Alcántara)
Mediavilla, Juan Diego (Hospital Universitario Virgen de las Nieves (Granada))
Gonzalez-Estrada, Aurora (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Miramontes-González, José Pablo (Hospital Clínico Universitario de Valladolid)
de Andrés, Raimundo (Hospital Universitario Fundación Jiménez Díaz)
Mauri Pont, Marta (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Mosquera, Daniel (Hospital San Pedro de Alcántara)
Cepeda, Jose María (Hospital Vega Baja (Oriola, Alacant))
Suárez, Lorena (Hospital Universitario Central de Asturias)
Barba Romero, Miguel Ángel (Complejo Hospitalario Universitario de Albacete)
Argüeso, Rosa (Hospital de Lugo)
Álvarez-Baños, Pilar (Hospital Universitario de Burgos)
Michán, Alfredo (Hospital Universitario de Jerez (Jerez de la Frontera))
Romero-Jiménez, Manuel J. (Hospital Infanta Elena)
García-Cruces, Jesús (Hospital Universitario Río Hortega (Valladolid))
Padró, Teresa (Institut d'Investigació Biomèdica Sant Pau)
Alonso, Rodrigo (Clínica las Condes (Santiago de Chile))
Mata, Pedro (Fundación Hipercolesterolemia Familiar)

Data:	2019
Resum:	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.
Ajuts:	Instituto de Salud Carlos III FISPI12-01289
Nota:	Funding: This study was supported by Fundación Hipercolesterolemia Familiar; Grant G03/181 Grant 08-2008 Centro Nacional de Investigaci?n Cardiovascular (CNIC).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Atorvastatin ; Familial hypercholesterolemia ; Long-term prognosis ; Rosuvastatin
Publicat a:	Journal of Clinical Lipidology, Vol. 13 Núm. 6 (november 2019) , p. 989-996, ISSN 1876-4789

DOI: 10.1016/j.jacl.2019.10.005
PMID: 31706904

8 p, 855.5 KB

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