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

Joaquim A Meireles-Brandão; Lúcia R Meireles-Brandão; Rui Coelho; Francisco Rocha-Gonçalves

doi:10.1016/j.repc.2021.05.017

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

Rev Port Cardiol. 2022 Aug;41(8):681-688. doi: 10.1016/j.repc.2021.05.017. Epub 2022 May 28.

[Article in English, Portuguese]

Authors

Joaquim A Meireles-Brandão¹, Lúcia R Meireles-Brandão², Rui Coelho³, Francisco Rocha-Gonçalves³

Affiliations

¹ Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal; Starmedica Clinica, Paredes, Portugal. Electronic address: dr.meirelesbrandao@gmail.com.
² Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal; Starmedica Clinica, Paredes, Portugal; Centro Hospitalar e Universitário de São João - EPE, Porto, Portugal.
³ Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal.

PMID: 36073267
DOI: 10.1016/j.repc.2021.05.017

Abstract

Introduction and objectives: Lifestyle changes are frequently insufficient to reduce cardiovascular (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 consent 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, specifically 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.

Keywords: Aterosclerose; Atherosclerosis; Cardiovascular disease; Doença cardiovascular; Estatinas; Prevenção primária; Primary prevention; Risco vascular; Statins; Vascular risk.