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

Zhao Yang, Qiujv Deng, Yongchen Hao, Na Yang, Lizhen Han, Pingping Jia, Pan Zhou, Yiming Hao, Ziyu Wang, Wenlang Zhao, Yue Qi and Jing Liu ()
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Zhao Yang: Lung and Blood Vessel Diseases
Qiujv Deng: Lung and Blood Vessel Diseases
Yongchen Hao: Lung and Blood Vessel Diseases
Na Yang: Lung and Blood Vessel Diseases
Lizhen Han: Lung and Blood Vessel Diseases
Pingping Jia: Lung and Blood Vessel Diseases
Pan Zhou: Lung and Blood Vessel Diseases
Yiming Hao: Lung and Blood Vessel Diseases
Ziyu Wang: Lung and Blood Vessel Diseases
Wenlang Zhao: Lung and Blood Vessel Diseases
Yue Qi: Lung and Blood Vessel Diseases
Jing Liu: Lung and Blood Vessel Diseases

Nature Communications, 2024, vol. 15, issue 1, 1-12

Abstract: 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

Date: 2024
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DOI: 10.1038/s41467-024-54078-4

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