| アブストラクト | BACKGROUND AND AIMS: Utilising real-world data, we quantified the burden of cardiovascular risk factors and long-term residual risk of atherothrombotic events among routine care cohorts with coronary (CAD) or peripheral (PAD) artery disease or ischemic stroke (IS) on guideline-recommended antiplatelet monotherapy (APMT). METHODS: Retrospective cohort study using data (2010-2020) from the United Kingdom Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics, including adults with CAD, PAD or IS who were first prescribed APMT (CAD/IS: aspirin; PAD: clopidogrel). Primary outcomes (recurrent events): major adverse cardiovascular events (MACE) for CAD/PAD/IS cohorts, major adverse limb events (MALE) for PAD. RESULTS: 266,478 CAD, 13,162 PAD, and 14,788 IS patients were included (mean age: 71 years; women 37.7%-47.5 %). Risk factor burden was high and attainment of recommended goals was low. There were 73,691, 3,121 and 7,137 MACE among CAD, PAD and IS patients, respectively (median follow-up: 89.9, 42.4 and 75.9 months, respectively), and 4,767 MALE among PAD patients. MACE incidence rate per 1000 person-years was higher in IS (268.7; 95%CI 265.3-272.0) than CAD (92.9; 95%CI 92.5-93.4) or PAD cohorts (97.2; 95%CI 94.6-99.8). MALE incidence rate was 195.9 (95%CI 192.2-199.6) per 1000 person-years. IS patients presented a lower rate of hospitalisations and longer time-to-first hospitalisation, but once hospitalised, they had a longer length-of-stay. PAD patients had the highest hospitalisation rate. CONCLUSIONS: Among a contemporary cohort with cardiovascular disease on APMT, long-term residual atherothrombotic risk remains high despite being on APMT. Greater attention to risk factor control and use of appropriate evidence-based therapy is required to reduce residual risk among this very high-risk population. |
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| ジャーナル名 | Atherosclerosis |
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| 投稿日 | 2024/9/16 |
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| 投稿者 | Vallejo-Vaz, Antonio J; Dharmayat, Kanika I; Nzeakor, Nnanyelu; Carrasco, Carlos P; Fatoba, Samuel T; Fonseca, Maria J; Tolani, Esther; Lee, Christopher; Ray, Kausik K |
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| 組織名 | Department of Primary Care and Public Health, School of Public Health, Imperial;College London, London, United Kingdom; Department of Medicine, Faculty of;Medicine, Universidad de Sevilla, Sevilla, Spain; Clinical Epidemiology and;Vascular Risk, Instituto de Biomedicina de Sevilla (IBiS), IBiS/Hospital;Universitario Virgen Del Rocio/Universidad de Sevilla/CSIC, Sevilla, Spain;;Centro de Investigacion Biomedica en Red (CIBER) de Epidemiologia y Salud;Publica, Instituto de Salud Carlos III, Spain. Electronic address:;ajvallejo-ibis@us.es.;College London, London, United Kingdom.;Medical Affairs, Bayer Plc. Reading, United Kingdom.;Global Pharmacovigilance, Bayer Plc. Reading, United Kingdom.;Medical Affairs, Bayer LLC, Whippany, NJ, USA.;EMEA Real World Methods & Evidence Generation, IQVIA, Lisbon, Portugal.;EMEA Real World Methods & Evidence Generation, IQVIA, London, United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39277962/ |
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