Effectiveness of Treat-to-target Cholesterol-lowering Interventions on Cardiovascular Disease and All-cause Mortality Risk in the Community-dwelling Population: a Target Trial Emulation

Overview

Journal Nat Commun

Specialty Biology

Date 2024 Nov 15

PMID 39548082

Authors

Zhao Yang

Qiujv Deng

Yongchen Hao

Na Yang

Lizhen Han

Pingping Jia

Pan Zhou

Yiming Hao

Ziyu Wang

Wenlang Zhao

Yue Qi

Jing Liu

Affiliations

Soon will be listed here.

Abstract

Little is known about the long-term effectiveness of risk-based treat-to-target cholesterol-lowering interventions on cardiovascular risk. Here, we show the emulated effectiveness of guideline-recommended low-density and non-high-density lipoprotein cholesterol-lowering interventions using the absolute risk reduction (ARR) and the restricted mean event-free time-based number needed to treat (NNT). With 5,375 participants, the 29-year risks for cardiovascular disease (CVD), all-cause mortality, and atherosclerotic CVD were 18.6%, 25.6%, and 17.7%, respectively. Long-term treat-to-target interventions showed significant reductions in CVD (ARR -2.3%, 95%CI -3.4% to -0.8%; NNT 115), all-cause mortality (-3.0%, -4.3% to -1.8%; 95), and atherosclerotic CVD (-2.6%, -3.5% to -1.2%; 104). Such effects appear more pronounced in women, smokers, and those with body mass index < 24 kg/m² or higher adherence rates.

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