Cardiovascular event rates increase after each recurrence and associate with poor statin adherence

Area of Science:

• Cardiology
• Public Health
• Clinical Practice

Background:

• Cardiovascular event recurrence risk and its variation is not well understood.
• Data on event recurrence beyond the second event is sparse.
• Real-world effectiveness of cardiovascular prevention strategies needs evaluation.

Purpose of the Study:

• To assess cardiovascular event recurrence and associated risk factors in real-world practice.
• To investigate interindividual variations in event rates after initial cardiovascular events.
• To examine low-density lipoprotein cholesterol levels and lipid-lowering therapy use post-event.

Main Methods:

• Retrospective register-based study of adult patients with incident cardiovascular events (2004-2016).
• Follow-up for consecutive cardiovascular events, cardiovascular death, and statin purchases.
• Evaluation of event recurrence timing and predictive factors.

Main Results:

• Significant interindividual variation in cardiovascular event recurrence observed.
• Median time to recurrence decreased from 7 years (2nd event) to 1 year (5th event).
• Event rates increased from 12 to 43/100 patient-years; low-density lipoprotein cholesterol goal (<1.8 mmol/l) reached by 18% post-event.
• Statin underuse and low high-intensity statin use (22% at 6 months) associated with increased recurrence risk.

Conclusions:

• Event rates are not stable and increase 1.2-1.9-fold per consecutive event, necessitating individualized risk assessment.
• Underuse of statins and poor adherence identify patients for intensified preventive measures.
• Study offers new perspectives on managing recurrent cardiovascular events.