Baseline, Delta, and Achieved Low-Density Lipoprotein Cholesterol Levels and Cardiovascular Risk in Patients on Statin Therapy: A Post-Hoc Resampling Mediation Analysis of Treating New Targets [TNT] Trial.

Baseline, Delta, and Achieved Low-Density Lipoprotein Cholesterol Levels and Cardiovascular Risk in Patients on Statin Therapy: A Post-Hoc Resampling Mediation Analysis of Treating New Targets [TNT] Trial. Clin Exp Pharmacol Physiol. 2020 Jun 25;: Authors: Hyun MH, Won Jang J, Lee E, An H, Seog Seo H Abstract Clinical guidelines for monitoring low-density lipoprotein cholesterol (LDL-C) after statin therapy do not clearly define the clinical roles of baseline LDL-C, ΔLDL-C, and achieved LDL-C according to statin intensity. We performed post-hoc analysis of the Treating to New Target (TNT) study to evaluate individual LDL-C parameters after statin therapy. Primary outcome was the risk for total major adverse cardiovascular events (MACE). We use resampling multilevel mediation analysis to analyze complex relationships among LDL-C parameters based on similar statin intensities. Tertiles for resample A (matched baseline LDL-C; distinct achieved LDL), resample B (matched ΔLDL-C; distinct baseline LDL-C), and resample C (matched achieved LDL-C; distinct ΔLDL-C) were analyzed using Cox proportional hazard ratios. In original data analysis, the incidence of MACE was reduced in those with lower achieved LDL-C in total, low, and high intensity statin users (hazard ratios [HRs]=0.990, 0.992, 0.992; respectively; all p-values<0.001). In mediation analysis, resample A showed consistently high incidence for MACE in the middle tertile (HR=1.2...
Source: Clinical and Experimental Pharmacology and Physiology - Category: Drugs & Pharmacology Authors: Tags: Clin Exp Pharmacol Physiol Source Type: research