PDF(Pubmed)
Abstract：
UNASSIGNED: Prior studies have suggested significant underutilization of statins in women and worse cardiovascular outcomes. Data examining the impact of real-world coronary artery calcium (CAC) scoring to improve utilization of preventive therapies and outcomes is limited.
UNASSIGNED: In a prospective registry study of low cost or no-cost CAC scoring between 2014 and 19 (CLARIFY Study, Clinicaltrials.gov NCT04075162), we sought to study the association of CAC scoring on statin utilization, blood lipids (LDL, total cholesterol, triglycerides), downstream ischemic testing (coronary angiography and stress testing), coronary revascularization and outcomes (MI, stroke, death) in women compared with men. Eligibility for statin initiation was defined as atherosclerotic cardiovascular disease pooled cohort equation (ASCVD-PCE) ≥ 7.5% and CAC≥100/≥75th percentile.
UNASSIGNED: A total of 52,151 patients (26,336 women and 25,815 men) were enrolled. Women were more likely to have CAC 0 (51% vs 30%, P<0.001). Among patients not eligible for statin by PCE, CAC reclassified statin eligibility in a smaller proportion of women than men (25.4% vs 30%, P<0.001), while among patients eligible for statin by PCE, CAC was more likely to downgrade risk/statin eligibility in women than men (30.1% vs 48.4%, P<0.001). After CAC scoring, statin initiation was similar in women and men, but high-intensity statin use was lower in women (CAC-adjusted HR 0.76 [0.70-0.83], P<0.001). Women had similar reduction in LDL cholesterol levels compared with men. There was no difference between men and women with respect to CAC-stratified major adverse cardiovascular events.
UNASSIGNED: CAC scoring primarily served to downgrade statin eligibility in women compared with men. Women had similar CAC risk-guided reductions in LDL cholesterol compared with men.
UNASSIGNED: In a prospective registry study of low cost or no-cost CAC scoring between 2014 and 19 (CLARIFY Study, Clinicaltrials.gov NCT04075162), we sought to study the association of CAC scoring on statin utilization, blood lipids (LDL, total cholesterol, triglycerides), downstream ischemic testing (coronary angiography and stress testing), coronary revascularization and outcomes (MI, stroke, death) in women compared with men. Eligibility for statin initiation was defined as atherosclerotic cardiovascular disease pooled cohort equation (ASCVD-PCE) ≥ 7.5% and CAC≥100/≥75th percentile.
UNASSIGNED: A total of 52,151 patients (26,336 women and 25,815 men) were enrolled. Women were more likely to have CAC 0 (51% vs 30%, P<0.001). Among patients not eligible for statin by PCE, CAC reclassified statin eligibility in a smaller proportion of women than men (25.4% vs 30%, P<0.001), while among patients eligible for statin by PCE, CAC was more likely to downgrade risk/statin eligibility in women than men (30.1% vs 48.4%, P<0.001). After CAC scoring, statin initiation was similar in women and men, but high-intensity statin use was lower in women (CAC-adjusted HR 0.76 [0.70-0.83], P<0.001). Women had similar reduction in LDL cholesterol levels compared with men. There was no difference between men and women with respect to CAC-stratified major adverse cardiovascular events.
UNASSIGNED: CAC scoring primarily served to downgrade statin eligibility in women compared with men. Women had similar CAC risk-guided reductions in LDL cholesterol compared with men.
摘要：
未经评估：先前的研究表明，他汀类药物在女性中的使用严重不足，心血管结局更差。检查真实世界冠状动脉钙（CAC）评分对提高预防性治疗和结果利用率的影响的数据有限。
UNASSIGNED：在2014年至19年间低成本或无成本CAC评分的前瞻性注册研究中（CLARIFYStudy，Clinicaltrials.govNCT04075162),我们试图研究CAC评分与他汀类药物使用的相关性，血脂（LDL，总胆固醇,甘油三酯)，下游缺血测试（冠状动脉造影和压力测试），冠状动脉血运重建和结果(MI，中风,死亡)与男性相比。他汀类药物启动的资格定义为动脉粥样硬化性心血管疾病合并队列方程（ASCVD-PCE）≥7.5％，CAC≥100/≥第75百分位数。
UNASSIGNED：共纳入52,151名患者（26,336名女性和25,815名男性）。女性更有可能患有CAC0(51%vs30%，P<0.001)。在不符合PCE治疗他汀类药物的患者中，CAC将他汀类药物的资格重新分类为女性比例低于男性（25.4％vs30％，P<0.001)，而在符合PCE治疗他汀类药物的患者中，与男性相比，CAC更有可能降低女性的风险/他汀类药物资格（30.1％vs48.4％，P<0.001)。CAC评分后,他汀类药物的开始在女性和男性中相似，但高强度他汀类药物的使用在女性中更低（CAC校正HR0.76[0.70-0.83]，P<0.001)。与男性相比，女性的LDL胆固醇水平降低相似。在CAC分层的主要不良心血管事件方面，男性和女性之间没有差异。
UNASSIGNED：CAC评分主要用于降低女性与男性相比的他汀类药物资格。与男性相比，女性CAC风险指导的LDL胆固醇降低相似。
UNASSIGNED：在2014年至19年间低成本或无成本CAC评分的前瞻性注册研究中（CLARIFYStudy，Clinicaltrials.govNCT04075162),我们试图研究CAC评分与他汀类药物使用的相关性，血脂（LDL，总胆固醇,甘油三酯)，下游缺血测试（冠状动脉造影和压力测试），冠状动脉血运重建和结果(MI，中风,死亡)与男性相比。他汀类药物启动的资格定义为动脉粥样硬化性心血管疾病合并队列方程（ASCVD-PCE）≥7.5％，CAC≥100/≥第75百分位数。
UNASSIGNED：共纳入52,151名患者（26,336名女性和25,815名男性）。女性更有可能患有CAC0(51%vs30%，P<0.001)。在不符合PCE治疗他汀类药物的患者中，CAC将他汀类药物的资格重新分类为女性比例低于男性（25.4％vs30％，P<0.001)，而在符合PCE治疗他汀类药物的患者中，与男性相比，CAC更有可能降低女性的风险/他汀类药物资格（30.1％vs48.4％，P<0.001)。CAC评分后,他汀类药物的开始在女性和男性中相似，但高强度他汀类药物的使用在女性中更低（CAC校正HR0.76[0.70-0.83]，P<0.001)。与男性相比，女性的LDL胆固醇水平降低相似。在CAC分层的主要不良心血管事件方面，男性和女性之间没有差异。
UNASSIGNED：CAC评分主要用于降低女性与男性相比的他汀类药物资格。与男性相比，女性CAC风险指导的LDL胆固醇降低相似。
