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Background: Many atherosclerotic cardiovascular disease (ASCVD) patients on statin therapy, despite well-controlled LDL-C levels, still suffer recurrent ASCVD events. Little information is known about the specific risk factors associated with increased residual risk.
Methods: We studied 3,196 subjects from the AIM-HIGH trial, all of whom had established ASCVD and were on statin therapy. Subsequent ASCVD events included a composite of death from coronary heart disease, nonfatal myocardial infarction, ischemic stroke, hospitalization for suspected acute coronary syndrome, or symptom-driven coronary or cerebral revascularization. We identified from bivariate analyses demographic and clinical variables that were significantly associated with subsequent ASCVD events (over a mean follow-up of 3.8 years) and then entered these risk factors into a stepwise Cox regression analysis to identify specific independent predictors of residual risk.
Results: Male gender, African-American race, and history of congestive heart failure were the strongest predictors of experiencing a recurrent ASCVD event [Table]. Baseline LDL-C, HDL-C, and triglycerides did not predict subsequent events.
Conclusions: Our study identified specific independent predictors of residual risk in ASCVD patients already at target LDL-C levels. These factors can be utilized to generate an ASCVD residual risk score in statin-treated subjects with known ASCVD.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-338
- 2017 American College of Cardiology Foundation