ISTO STUDY - INTENSIV-INTERMEDIATE STATIN THERAPY OBSERVATIONAL STUDY

Abstract

Objective: lifestyle changes are frequently insufficient to reduce cardiovascular risk (CVR) in patients with dislipidemia. This study aims to characterize the long-term evolution of lipid profile and CVR of patients under primary prevention. Design and method: A retrospective study was performed of outpatients at a Portuguese cardiovascular risk clinic with > 2 CVRF, followed >2 years between 1995 and 2015 (Fig. 1). Intermediate-intensity statin therapy had initiated early, in accordance with the clinićs practice. After written informed consent was obtained, sociodemographic and clinical charecteristics were collected from medical charts, at baseline and last visit. Changes in lipid profile and CV risk scores (FRS, ASCVD, SCORE) were estimated. Associations between HDL-C or LDL-C changes and gender, age, observation times 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 and received intermediate-intensity statins. Lipid profile showed statistically significant improvment, including median changes in LDL-C and HDL-C of - 77.0 mg/dl and +19 mg/dl, respectively. CVR also showed statistically significant improvements according to all scores. Statin therapy resulted in a mean HDL-C ncrease 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). Conclusions: 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.