American journal of preventive cardiology最新文献

{"title":"Optimizing Long-term Cardiovascular Risk Stratification: Integrating Biomarkers into the Very High-Risk ASCVD Definition in Asian Patients","authors":"Jiaxi Cheng ,&nbsp;Hao-Yu Wang ,&nbsp;Chenxi Song ,&nbsp;Zheng Qiao ,&nbsp;Xiaohui Bian ,&nbsp;Dong Yin ,&nbsp;Lei Feng ,&nbsp;Chenggang Zhu ,&nbsp;Min Yang ,&nbsp;Guofeng Gao ,&nbsp;Kefei Dou","doi":"10.1016/j.ajpc.2025.100965","DOIUrl":"10.1016/j.ajpc.2025.100965","url":null,"abstract":"<div><h3>Background</h3><div>The 2018 American Heart Association/American College of Cardiology (AHA/ACC) cholesterol guideline defines very high-risk (VHR) atherosclerotic cardiovascular disease (ASCVD) patients to guide intensive lipid-lowering therapy.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate VHR's effectiveness in assessing cardiovascular (CV) risk in an Asian population and examine the predictive value of additional biomarkers for improving risk stratification.</div></div><div><h3>Methods</h3><div>26,752 ASCVD patients were prospectively enrolled at Fuwai Hospital (2017–2018). VHR was defined as multiple major ASCVD events or one major event with multiple high-risk conditions. The primary outcome was a composite of 3-year CV events, including cardiovascular mortality, myocardial infarction, stroke, and coronary revascularization.</div></div><div><h3>Results</h3><div>14,475 (54.1 %) patients were classified as VHR, with higher 3-year event rates than non-VHR (9.6 % vs. 7.3 %). Hemoglobin (Hb), high-sensitivity C-reactive protein (hs-CRP), lipoprotein(a) (Lp(a)), and high-density lipoprotein cholesterol (HDL-C) were significant CV risk influencers in VHR patients (hazard ratios [95 % CI]: 0.93 [0.90–0.96], 1.13 [1.06–1.21], 1.07 [1.04–1.11], 0.73 [0.61–0.89], respectively), but not in non-VHR patients. Within the VHR category, patients with ≥2 abnormal biomarkers (Hb &lt;12 g/dL for men, &lt;11 g/dL for women; hs-CRP &gt;3 mg/L; Lp(a) ≥50 mg/dL; HDL-C &lt; 1 mmol/L) were categorized as Very Very High Risk (VVHR), showing significantly higher event rates than those with fewer abnormal biomarkers (11.7 % vs. 8.9 %, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The VHR definition effectively identifies high-risk Asian patients but can be refined by integrating biomarker-based high-risk conditions. The proposed VVHR category enhances risk stratification, identifying those who may benefit most from intensive lipid-lowering and residual risk management.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100965"},"PeriodicalIF":4.3,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the future productivity burden of cardiovascular disease in Qatar: Investigating the modifiable risk factors control in type 2 diabetes","authors":"Dina Abushanab ,&nbsp;Daoud Al-Badriyeh ,&nbsp;Danny Liew ,&nbsp;Zanfina Ademi","doi":"10.1016/j.ajpc.2025.100961","DOIUrl":"10.1016/j.ajpc.2025.100961","url":null,"abstract":"<div><h3>Aims</h3><div>Insufficient risk factor control can lead to a loss of millions of productivity-adjusted life years (PALYs). We aimed to assess the productivity burden of cardiovascular disease (CVD) in type 2 diabetes (T2D) and examine the potential advantages of enhancing the control of modifiable CVD risk factors in Qatar.</div></div><div><h3>Materials and methods</h3><div>Models were developed to quantify the productivity burden, in terms of PALYs, of CVD in Qataris with T2D, aged 40–65 years, from 2024 to 2033. The financial value of PALYs was determined based on the gross domestic product (GDP) per full-time worker (i.e. US$80,573). The base-case model estimated the productivity burden of CVD, and interventional scenarios were simulated to assess potential gains resulting from improved control of modifiable risk factors, including reduced incidence of T2D, lower systolic blood pressure (SBP), decreased number of smokers, and reduced total cholesterol. All costs and outcomes were discounted at an annual rate of 3 %.</div></div><div><h3>Results</h3><div>The base-case analysis projected that CVD in T2D would result in an estimated 2,096,536 PALYs (95 % confidence interval, 1,689,272–2,182,939), contributing US$225.46 (95 %CI, 1,689,272–2,182,939) billion to the country's GDP. However, implementing interventions to decrease the T2D incidence, lower SBP, reduce the number of smokers, and improve the total cholesterol could yield gains of 200,408, 198,173, 194,725, and 113,462 PALYs, respectively. These improvements would also lead to economic gains of US$20.01 billion, US$20.17 billion, US$19.78, and US$12.79 billion, respectively.</div></div><div><h3>Conclusions</h3><div>Implementing interventions that prioritize risk factor control and prevention of CVD can help enhance overall productivity in the country.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100961"},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disorders as risk factors for calcific aortic stenosis.","authors":"Nadim El Jamal ,&nbsp;Thomas G. Brooks ,&nbsp;Carsten Skarke ,&nbsp;Garret A. FitzGerald","doi":"10.1016/j.ajpc.2025.100958","DOIUrl":"10.1016/j.ajpc.2025.100958","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Circadian disruption and sleep disorders have been shown to increase the risk for many cardiovascular diseases. Their association specifically with valvular heart disease, however, is inconclusive. In this study we test the association between sleep disorders and the future incidence of aortic stenosis using two large electronic health record (EHR) databases datasets (the TriNetX network and the All <em>of</em> Us study). We also explore biochemical data for potential mechanistic insights into that association.</div></div><div><h3>Methods</h3><div>We fitted Cox proportional hazards models to quantify the risk of future incidence of AS in patients with sleep disorders. We also explored clinical laboratory test datasets for biochemical signals that might explain the association, running mediation analyses.</div></div><div><h3>Results</h3><div>In our fully adjusted Cox models, we find that having any sleep disorder increases the risk for the future incidence of AS (HR: 1.15 95 % CI: 1.13–1.18). Changes in lipid profile mediate a proportion of that association.</div></div><div><h3>Conclusion</h3><div>Sleep disorders are associated with an increased risk of AS incidence. That association is independent of classical cardiovascular risk factors even though dyslipidemia plays a large role in mediating this risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100958"},"PeriodicalIF":4.3,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating cardiovascular disease disparities: The potential role of artificial intelligence","authors":"Chisom J. Orakwue ,&nbsp;Farbod Zahedi Tajrishi ,&nbsp;Constance M. Gistand ,&nbsp;Han Feng ,&nbsp;Keith C. Ferdinand","doi":"10.1016/j.ajpc.2025.100954","DOIUrl":"10.1016/j.ajpc.2025.100954","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100954"},"PeriodicalIF":4.3,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between potassium, arterial stiffness, and risk of cardiovascular disease in the Jackson Heart Study","authors":"Ranee Chatterjee ,&nbsp;Clemontina A Davenport ,&nbsp;Ervin R. Fox ,&nbsp;Ramachandran S. Vasan ,&nbsp;Gary F Mitchell","doi":"10.1016/j.ajpc.2025.100955","DOIUrl":"10.1016/j.ajpc.2025.100955","url":null,"abstract":"<div><h3>Background</h3><div>Potassium (K) measures are associated with cardiovascular disease (CVD) risk factors, particularly blood pressure (BP). Arterial stiffness is a pre-clinical marker of CVD risk. We sought to study associations of K measures with arterial stiffness and CVD risk in a population at high-risk of CVD.</div></div><div><h3>Methods</h3><div>We studied participants from the Jackson Heart Study (JHS), a longitudinal cohort of adults racially minoritized as Black, who were without CVD at Visit 1 (2000–2004). We compared characteristics between participants with low-normal (lowK) (≤4.0 mmol/L) vs. high-normal (highK) (&gt;4.0 mmol/L) serum K. We used multivariable regression to examine associations of serum and dietary K at Visit 1 with arterial stiffness [brachial artery pulse pressure (PP) and carotid-femoral pulse wave velocity (CFPWV)], measured between 2012 and 2017, incident CVD overall over up to 15 years of follow-up, and individual CVD outcomes.</div></div><div><h3>Results</h3><div>We included 4035 JHS participants in our analyses; mean age was 54 years, 64 % were female. Participants with highK as compared to lowK had lower mean baseline BP and had reduced arterial stiffness. In adjusted models, higher serum K (per standard deviation increase) was associated with lower CFPWV [estimate (95 % CI) -1.66 (-2.88, -0.44)]. There was a significant difference in cumulative incidence of CVD, with the highK group having lower risk (<em>P</em> = 0.047); however, we did not observe statistically significant associations between serum K and any CVD outcomes after multivariable adjustment. We found no significant associations between dietary K and arterial stiffness or incident CVD.</div></div><div><h3>Conclusions</h3><div>In this cohort of Black adults, higher serum K was significantly associated with lower arterial stiffness. Further study is needed to assess the relationship between K's association with arterial stiffness and future CVD risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100955"},"PeriodicalIF":4.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generalizability of VICTORION-1 PREVENT enrollment criteria to the United States population","authors":"Rahul Aggarwal ,&nbsp;Deepak L. Bhatt ,&nbsp;Marc P. Bonaca ,&nbsp;Catrin Deck ,&nbsp;Anastasia Lesogor ,&nbsp;Manesh R. Patel ,&nbsp;Erik S.G. Stroes ,&nbsp;Pam R. Taub ,&nbsp;Stephan Windecker","doi":"10.1016/j.ajpc.2025.100957","DOIUrl":"10.1016/j.ajpc.2025.100957","url":null,"abstract":"<div><h3>Background</h3><div>VICTORION-1 PREVENT (V-1P) is an ongoing trial evaluating inclisiran for lipid lowering in patients with high cardiovascular (CV) risk without established atherosclerotic CV disease (ASCVD). This study evaluates the generalizability of V-1P enrollment criteria to the US population and their clinical comorbidity and CV risk factor burden.</div></div><div><h3>Methods</h3><div>Data from National Health and Nutrition Examination Surveys (2015-March 2020) were used to determine nationally representative estimates. Inclusion criteria were low-density lipoprotein cholesterol (LDL-C) of 70–189 mg/dL and a 10-year ASCVD risk of ≥20% or 7.5%-19.9% with two CV risk enhancers. The pooled cohort equations (PCE) was used to stratify ASCVD risk in primary analysis. Estimates of the US population were compared with the V-1P eligible population.</div></div><div><h3>Results</h3><div>The V-1P eligible population included 23,837,940 adults. Compared with US adults ages 40-79 years, V-1P eligible adults had higher mean 10-year ASCVD risk by PCE (21.1% [95% CI: 20.1%-22.2%] vs 10.0% [95% CI: 9.4%-10.6%]). The V-1P eligible population also had higher rates of hypertension (85.4% [95% CI: 81.6%-89.1%] vs 59.4% [95% CI: 56.7%-62.2%], diabetes (35.6% [95% CI: 31.3%-40.0%] vs 18.7% [95% CI: 16.9%- 20.5%]) and metabolic syndrome (81.6% [95% CI: 78.4%-84.7%] vs 51.1% [48.3%- 53.9%]). Adults meeting V-1P eligibility had high levels of LDL-C (117.8 mg/dL [95% CI: 114.3 mg/dL-121.2 mg/dL]) and low statin use (36.7% [95% CI: 31.9%-41.5%]).</div></div><div><h3>Conclusions</h3><div>Many primary prevention patients have high CV risk, significant comorbidity burden, and are eligible for lipid-lowering therapy, yet rates of treatment are low. Public health interventions to improve CV risk factor management are necessary.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100957"},"PeriodicalIF":4.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of long-term insulin variability before the onset of diabetes with cardiovascular outcomes in later life: Findings from the coronary artery risk development in young adults (CARDIA) study","authors":"Kun Zhang ,&nbsp;Chunlan Huang ,&nbsp;Junping Li ,&nbsp;Peibiao Mai ,&nbsp;Shuwan Xu ,&nbsp;Feifei Huang ,&nbsp;Wanbing He ,&nbsp;Huanji Zhang ,&nbsp;Yang Liu ,&nbsp;Weijing Feng","doi":"10.1016/j.ajpc.2025.100952","DOIUrl":"10.1016/j.ajpc.2025.100952","url":null,"abstract":"<div><h3>Background</h3><div>The important effects of variability of some physiological/biological characteristics (such as LDL cholesterol, blood pressure) on cardiovascular outcomes have been elucidated, while the role of insulin variability is undefined.</div></div><div><h3>Objectives</h3><div>To investigate the associations of long-term fasting insulin variability during young adulthood before the onset of diabetes with subsequent cardiovascular outcomes in middle age.</div></div><div><h3>Methods</h3><div>We included 3,983 CARDIA (Coronary Artery Risk Development Study in Young Adults) participants aged 18 to 30 years with at least three fasting insulin measurements. Intra-individual fasting insulin variability was defined by the average real variability (ARV) of insulin and standard deviation (SD) of insulin during 30-year follow-up. The presence and the degree of coronary artery calcification (CAC) were assessed by computed tomography at year 25. Incident cardiovascular disease (CVD) and all-cause mortality were adjudicated.</div></div><div><h3>Results</h3><div>After multivariable adjustment, comparing high versus low tertile of insulin ARV, the hazard of CVD increased by 65 % (HR, 1.65; 95 % CI, 1.13–2.39) and all-cause mortality by 97 % (HR, 1.97; 95 % CI, 1.38–2.82). Higher tertile of insulin ARV was associated with significantly worse degree of CAC (β =0.1; 95 % CI, 0.03–0.18) but not with the presence of CAC (<em>P</em> = 0.197). Similar results were also observed in insulin SD.</div></div><div><h3>Conclusion</h3><div>High long-term insulin variability in young adulthood before the onset of diabetes was associated with an increased risk of CVD and all-cause mortality in later life, independent of average FG, HOMA-IR and other established cardiovascular risk factors. Long-term insulin variability was associated with the degree but not the presence of CAC.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100952"},"PeriodicalIF":4.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editors’ Message – March 2025","authors":"Nathan D. Wong ,&nbsp;Erin D. Michos","doi":"10.1016/j.ajpc.2025.100962","DOIUrl":"10.1016/j.ajpc.2025.100962","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"21 ","pages":"Article 100962"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking cardiovascular risk: The emerging role of lipoprotein(a) screening","authors":"Victoria Clair ,&nbsp;Francis M. Zirille ,&nbsp;Edward Gill","doi":"10.1016/j.ajpc.2025.100945","DOIUrl":"10.1016/j.ajpc.2025.100945","url":null,"abstract":"<div><div>Lipoprotein(a) [Lp(a)] is a genetically inherited, independent risk factor for cardiovascular disease (CVD), affecting approximately 20–25% of the global population. Elevated Lp(a) levels are associated with a 2–3-fold increased risk of myocardial infarction and aortic valve stenosis, comparable to the risk seen in individuals with familial hypercholesterolemia. Despite its clinical relevance, the integration of Lp(a) screening into routine practice has been limited by inconsistent measurement techniques and a lack of targeted treatments. Recent advancements, including improved assays and the development of potential Lp(a)-lowering therapies, have renewed focus on the importance of Lp(a) screening.</div><div>This review aims to clarify the role of Lp(a) in cardiovascular health by examining current evidence on who should be screened, when screening should occur, and the most accurate methods for measuring Lp(a). Key recommendations include universal, one-time screening for adults, selective screening for high-risk pediatric patients, and special considerations for individuals with conditions such as familial hypercholesterolemia and chronic kidney disease. Advances in assay technology now allow for more precise Lp(a) measurement, supporting better risk stratification. Additionally, emerging therapies that specifically target elevated Lp(a) levels could lead to more personalized management of CVD risk.</div><div>Our findings support the integration of Lp(a) screening into routine cardiovascular risk assessment, highlighting its potential to improve early detection and prevention strategies across diverse patient populations.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"21 ","pages":"Article 100945"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment strategies and LDL cholesterol target attainment in patients with statin intolerance: Insights from the multicentre statin intolerance registry","authors":"Paulina E. Stürzebecher ,&nbsp;Julius L. Katzmann ,&nbsp;Ionna Gouni-Berthold ,&nbsp;Christina Mateev ,&nbsp;Ole Frenzel ,&nbsp;Ulrike Schatz ,&nbsp;Andrea Baessler ,&nbsp;Wolfgang Koenig ,&nbsp;Stephan H. Schirmer ,&nbsp;Irina Müller-Kozarez ,&nbsp;Oliver Weingärtner ,&nbsp;Ursula Kassner ,&nbsp;Ulrich Laufs ,&nbsp;Statin Intolerance Registry investigators","doi":"10.1016/j.ajpc.2025.100953","DOIUrl":"10.1016/j.ajpc.2025.100953","url":null,"abstract":"<div><h3>Objective and methods</h3><div>Statin intolerance (SI) is an important cause of insufficient low-density lipoprotein cholesterol (LDL-C) target attainment. Contemporary treatment strategies and symptoms in patients with SI are incompletely understood. We report baseline lipid-lowering therapies (LLTs) and LDL-C target attainment in the Statin Intolerance Registry, an observational, prospective, multicenter study that recruited 1,111 patients with SI between 2021 and 2023 in Germany.</div></div><div><h3>Results</h3><div>The mean age was 66.1 (SD 9.9) years, 57.7 % were female. At study inclusion, 83.1 % received at least one LLT, and 47.0 % received combination LLT. A higher number of LLTs was associated with lower LDL-C, lower systolic blood pressure, more atherosclerotic disease, more elevations of creatine kinase and liver enzymes but not with impaired quality of life as measured by EuroQol (EQ-5D-5L). PCSK9 inhibitors were most frequently prescribed (48.0 %), followed by ezetimibe (39.2 %), statins (26.9 %), most commonly rosuvastatin, and bempedoic acid (25.4 %). Patients who had been prescribed multiple statins before were more likely to take a statin at baseline. Patients on a statin, even at low intensity, had lower LDL-C levels compared to patients without statin therapy (mean [SD] 2.4 [1.2] vs. 2.9 [1.6] mmol/L, <em>p</em> &lt; 0.001). Significantly more men than women achieved the LDL-C target (21.7 % vs. 11.4 %, <em>p</em> &lt; 0.001, total cohort: 15.8 %).</div></div><div><h3>Conclusion</h3><div>LDL-C target attainment is low in patients with SI, especially among women, despite high cardiovascular risk. The use of a greater number of LLTs, including statins, is not associated with reduced quality of life but is associated with lower LDL-C levels.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"21 ","pages":"Article 100953"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}