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AHA: Predictors for Meeting LDL-C, SBP Goals ID’d in ISCHEMIA

Older age, male sex, high-intensity statin use, lower baseline LDL-C predict LDL-C goal attainment

MONDAY, Nov. 18, 2019 (HealthDay News) — Predictors of attaining low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP) goals have been identified, according to a study published online Nov. 13 in Circulation: Cardiovascular Quality and Outcomes. The research was published to coincide with a presentation of results from the ISCHEMIA study at the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

Jonathan D. Newman, M.D., M.P.H., from the New York University School of Medicine in New York City, and colleagues determined predictors of meeting trial goals for LDL-C (goal <70 mg/dL) and SBP (goal <140 mm Hg) at one year after random assignment among individuals in the ISCHEMIA trial. Data were available for 3,984 randomly assigned participants.

Of the participants, 35 and 65 percent were at goal for LDL-C and SBP, respectively, at baseline, increasing to 52 and 75 percent at one year, respectively. The researchers found increased adjusted odds of one-year LDL-C goal attainment for older age (odds ratio [OR], 1.11 per 10 years), lower baseline LDL-C (OR, 1.19 per 10 mg/dL), high-intensity statin use (OR, 1.30), nonwhite race (OR, 1.32), and North American enrollment (OR, 1.32). One-year LDL-C goal attainment was less likely for women (OR, 0.68). Greater adjusted odds of one-year SBP goal attainment were seen with lower baseline SBP (OR, 1.27 per 10 mm Hg) and with North American enrollment (OR, 1.35).

“The relatively modest rates of goal attainment in the setting of a rigorously conducted randomized trial emphasize the need to improve methods to achieve optimal risk factor control for patients with stable ischemic heart disease,” the authors write.

Arbor Pharmaceuticals and AstraZeneca contributed funding for the study and, together with other pharmaceutical companies, provided device donations and medications.

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