Long-term outcomes of primary cardiovascular prevention: A retrospective study at a referral center in Portugal

Autores da FMUP

• Francisco Rocha Gonçalves

  Autor

Participantes de fora da FMUP

• Meireles-Brandao, JA
• Meireles-Brandao, LR
• Coelho, R

Abstract

Introduction and Objectives: Lifestyle changes are frequently insufficient to reduce cardio-vascular (CV) risk in patients with dyslipidemia. This study aims to characterize the long-term evolution of lipid profile and CV risk of patients under primary prevention.Methods: A retrospective study was performed of outpatients at a Portuguese cardiovascular risk clinic with >2 CV risk factors, followed for >2 years between 1995 and 2015. Statin therapy had been initiated early, in accordance with the clinic's practice. After written informed con-sent was obtained, sociodemographic and clinical characteristics were collected from medical charts, at baseline and last visit. Changes in lipid profile and CV risk scores were estimated. Associations between HDL-C or LDL-C changes and gender, age, observation time and treatments were assessed through bivariate analysis and multiple linear regression models.Results: Out of 516 participants with mean follow-up of 11.4 +/- 4.3 years, 56.6% were female and 91.5% received statins. Lipid profile showed statistically significant improvement, including median changes in LDL-C and HDL-C of-77.0 mg/dl and +19 mg/dl, respectively. CV risk also showed statistically significant improvements according to all scores. Statin therapy resulted in a mean HDL-C increase of 7.4 mg/dl (independently of gender and other treatments) and a mean LDL-C reduction of 51.8 mg/dl (irrespective of age and other treatments).Conclusion: Results from this long-term real-life study indicate that primary prevention, specif-ically early and continuous therapy with intermediate-intensity statins as an add-on to lifestyle interventions, was important in obtaining consistent and adequate metabolic correction in patients with additional risk factors.(c) 2022 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espan tilde a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Keywords

• Primary prevention; Statins; Atherosclerosis; Cardiovascular disease; Vascular risk