Patients with very high-risk ASCVD had much higher rates of composite myocardial infarction or ischemic stroke compared to non-very high-risk patients (8.04 vs 0.82 events per 100 patient-years).
Cohort (n=230,920)
Do patients with very high-risk ASCVD have higher rates of major cardiovascular events compared to non-very high-risk ASCVD patients?
Patients with very high-risk ASCVD experience approximately a 10-fold higher rate of subsequent myocardial infarction or ischemic stroke compared to those with non-very high-risk ASCVD in real-world practice.
Absolute Event Rate: 8.04% vs 0.82%
BACKGROUND: The risk for subsequent major cardiovascular (CV) events among patients with very high-risk (VHR) atherosclerotic CV disease (ASCVD) remains to be fully elucidated. HYPOTHESIS: We assessed the characteristics and major CV event rates of patients with VHR versus non-VHR ASCVD in a real-world setting in the United States (US), hypothesizing that patients with VHR ASCVD would have higher CV event rates. METHODS: This was a retrospective cohort study conducted from January 01, 2011, to June 30, 2018, in the US using the Prognos LDL-C database linked to the IQVIA PharMetrics Plus® database supplemented with the IQVIA prescription claims (Dx/LRx) databases. Patients were ≥18 years old and had ≥2 non-ancillary medical claims in the linked databases at least 30 days apart. The study was conducted in 2 stages: (1) identification of patients with ASCVD who met the definition of VHR ASCVD and a matched cohort of non-VHR ASCVD patients using the incidence density sampling (IDS) approach; (2) estimation of the occurrence of major CV events. RESULTS: Among patients with ≥1 major ASCVD event (N=147,679), most qualified as VHR ASCVD (79.5%). There were 115,460 patients each in IDS-matched VHR and non-VHR ASCVD cohorts. The composite myocardial infarction/ischemic stroke event rates in the VHR and non-VHR ASCVD cohorts were 8.04 (95% confidence interval 95% CI: 7.87-8.22) and 0.82 (95% CI: 0.77-0.88) events per 100 patient-years, respectively, during the 1-year post-index period. CONCLUSIONS: Most patients with ≥1 previous major ASCVD event treated in real-world US clinical practice qualified as VHR ASCVD. Patients with VHR ASCVD had much higher rates of major CV events versus non-VHR ASCVD patients.
Fonarow et al. (Thu,) conducted a cohort in Atherosclerotic cardiovascular disease (ASCVD) (n=230,920). Very high-risk (VHR) ASCVD vs. Non-very high-risk (non-VHR) ASCVD was evaluated on Composite myocardial infarction/ischemic stroke. Patients with very high-risk ASCVD had much higher rates of composite myocardial infarction or ischemic stroke compared to non-very high-risk patients (8.04 vs 0.82 events per 100 patient-years).