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Sex differences in LDL-C control in a primary care population: the PORTRAIT-DYS study

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dc.contributor.authorGavina, Cristina
dc.contributor.authorAraújo, Francisco
dc.contributor.authorTeixeira, Carla
dc.contributor.authorRuivo, Jorge
dc.contributor.authorCorte-Real, Ana Luísa
dc.contributor.authorLuz-Duarte, Leonor
dc.contributor.authorCanelas-Pais, Mariana
dc.contributor.authorTaveira-Gomes, Tiago
dc.date.accessioned2023-11-22T14:56:11Z
dc.date.available2023-11-22T14:56:11Z
dc.date.issued2023
dc.description© 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by- nc-nd/4.0/).pt_PT
dc.description.abstractBackground and aims: Cardiovascular (CV) diseases show clear differences in clinical manifestation and treatment outcomes between men and women. To reduce sex disparities in achieving lipid-lowering therapy (LLT) goals, a sex-focused assessment is essential and more studies are needed to bring new evidence to clinicians. This study aims to assess the role of sex in attaining low-density lipoprotein cholesterol (LDL-C) goals, after correction for age, CV risk category, LLT intensity, and presence of mental health disorder and social deprivation. Methods: A retrospective cohort analysis of patients aged 40-85, followed in 1 hospital and 14 primary care centers in Portugal, using electronic health records from 1/1/2012 to 31/12/2020, was performed. The analysis considered an episode-based design, where exposure consists of any time when LLT was started or intensity changed. The likelihood of reaching the LDL-C goal according to contemporary ESC/EAS guidelines was modeled using multivariate Cox regression. LDL-C goal achievement at 180 days was defined as the outcome. The analysis was repeated at 30-day follow-up intervals up to 360 days, and also stratified by CV risk category. Results: We identified 40,032 exposure episodes (LLT initiation or intensity change) in 30,323 distinct patients. Male sex, older age, lower CV risk and increasing LLT intensity were associated with improved LDL-C control. Women were 22% less likely to reach the LDL-C goal than men (HR = 0.78, 95% CI:0.73, 0.82) independently of covariates. Conclusions: Women have a lower likelihood of attaining LDL-C goals than men after adjustment for LLT intensity, age, CV risk category, presence of mental health disorder and social deprivation. This finding underscores the need for further investigation and tailoring of LLT management strategies in women.pt_PT
dc.description.sponsorshipThis study was funded by Daiichi Sankyo Europept_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAtherosclerosis. 2023 Nov:384:117148pt_PT
dc.identifier.doi10.1016/j.atherosclerosis.2023.05.017pt_PT
dc.identifier.eissn1879-1484
dc.identifier.issn0021-9150
dc.identifier.urihttp://hdl.handle.net/10451/60749
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/atherosclerosispt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAnticholesteremic agentspt_PT
dc.subjectDyslipidemiapt_PT
dc.subjectLDL-C managementpt_PT
dc.subjectReal-world evidencept_PT
dc.subjectSex differencespt_PT
dc.titleSex differences in LDL-C control in a primary care population: the PORTRAIT-DYS studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleAtherosclerosispt_PT
oaire.citation.volume384pt_PT
person.familyNameRuivo
person.givenNameJorge
person.identifier.ciencia-id0D11-0660-62B4
person.identifier.orcid0000-0002-3219-4028
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationcf0dbf19-3dbb-41be-911c-6e08524702ed
relation.isAuthorOfPublication.latestForDiscoverycf0dbf19-3dbb-41be-911c-6e08524702ed

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