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Cardiovascular event rates in a high atherosclerotic cardiovascular disease risk population: estimates from Swedish population-based register data
Quantify Res, Hantverkargatan 8, S-11221 Stockholm, Sweden.
Quantify Res, Hantverkargatan 8, S-11221 Stockholm, Sweden.
Strateg Healthcare Solut LLC, 133 Cottonwood Creek Lane, Aiken, SC 29803 USA.
Quantify Res, Hantverkargatan 8, S-11221 Stockholm, Sweden.
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2019 (English)In: European Heart Journal - Quality of Care and Clinical Outcomes, ISSN 2058-5225, E-ISSN 2058-1742, Vol. 5, no 3, p. 225-232Article in journal (Refereed) Published
Abstract [en]

Aims: This study aimed to estimate the rate of cardiovascular (CV) events in the real world in patients at high risk of recurrent CV events similar to the FOURIER trial population.

Methods and results: A retrospective population-based cohort study was conducted using Swedish national registers from 1 July 2001 to 31 December 2015. Patients in the atherosclerotic cardiovascular disease (ASCVD) prevalent cohort met the FOURIER-like inclusion criteria, including treatment with high/moderate-intensity statins, on 1 July 2006. Additionally, two cohorts defined by diagnosis of incident ischaemic stroke (IS) and incident myocardial infarction (MI), meeting the FOURIER-like inclusion criteria were followed from date of diagnosis. Event rates were calculated for the hard major adverse cardiovascular events (MACE) composite: MI, IS, and CV death; and the ASCVD composite: MI, IS, unstable angina, coronary revascularization, and CV death. Approximately half of patients experienced a CV event (ASCVD composite) during follow-up. The MACE composite rates/100 person-years were 6.3, 11.9, and 12.3 in the ASCVD prevalent (n = 54 992), MI incident (n = 45 895), and IS incident (n = 36 134) cohorts, respectively. The ASCVD composite rates/100 person-years were 7.0, 21.7, and 12.9 in the ASCVD prevalent, MI incident, and IS incident cohorts, respectively. The multiple-event MACE composite rates/100 person-years were 8.5 (ASCVD prevalent cohort), 15.4 (MI incident cohort), and 14.4 (IS incident cohort).

Conclusion: In this real-world setting, CV event rates were high in all studied cohorts. In particular, the MACE composite rates were two to three times higher than in the FOURIER clinical trial, indicating a substantial disease burden despite treatment with moderate or high-intensity statins.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2019. Vol. 5, no 3, p. 225-232
Keywords [en]
Cardiovascular outcomes, Cardiovascular event rates, Secondary prevention, ASCVD
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-397794DOI: 10.1093/ehjqcco/qcy058ISI: 000493732200010PubMedID: 30649251OAI: oai:DiVA.org:uu-397794DiVA, id: diva2:1373391
Available from: 2019-11-27 Created: 2019-11-27 Last updated: 2019-11-27Bibliographically approved

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