{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:21:05Z","timestamp":1787829665793,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,5,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The extent to which outcome benefits may be achieved through the implementation of aggressive low\u2010density lipoprotein (LDL) cholesterol targets in real world settings remains unknown, especially among elderly statin users following acute coronary syndromes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A population\u2010based cohort study consisting of 19\u00a0544 post\u2010acute coronary syndrome statin\u2010users aged \u226566\u00a0years between January 1, 2017 and March 31, 2014 was used to project the number of adverse outcome events (acute myocardial infarction or death from any cause) that could be prevented if all post\u2010acute coronary syndrome elderly statin users were treated to 1 of 2\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              cholesterol target levels (\u226450 and \u226470\u00a0mg\/dL). The number of preventable adverse outcomes was estimated by using model\u2010based expected event probabilities as derived from Cox Proportional hazards models. In total, 61.6% and 25.5% of the elderly patients met\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              cholesterol targets of \u226470 and \u226450\u00a0mg\/dL, respectively, based on current management. No more than 2.3 adverse events per 1000 elderly statin users (95% confidence interval: \u22120.7 to 5.4,\n              <jats:italic>P<\/jats:italic>\n              =0.62) could be prevented over 8.1\u00a0years if all patients were to be treated from current\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              cholesterol levels to either of the 2\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              cholesterol targets of 70 or 50\u00a0mg\/dL.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The number of acute myocardial infarctions or death that could be prevented through the implementation of\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              cholesterol targets with statins is negligible among an elderly post\u2010acute coronary syndrome population. Such findings may have implications for the applicability of newer agents, such as proprotein convertase subtilisin\/kexin type\u20109\u2010 inhibitors.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.007535","type":"journal-article","created":{"date-parts":[[2018,5,12]],"date-time":"2018-05-12T09:20:09Z","timestamp":1526116809000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Projected Real\u2010World Effectiveness of Using Aggressive Low\u2010Density Lipoprotein Cholesterol Targets Among Elderly Statin Users Following Acute Coronary Syndromes in Canada"],"prefix":"10.1161","volume":"7","author":[{"given":"David A.","family":"Alter","sequence":"first","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"},{"name":"University of Toronto, Ontario, Canada"},{"name":"University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack V.","family":"Tu","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"},{"name":"Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Koh","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia A.","family":"Jackevicius","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"},{"name":"University of Toronto, Ontario, Canada"},{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"Western University of Health Sciences, Pomona, CA"},{"name":"VA Greater Los Angeles Healthcare System, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"},{"name":"University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad R.","family":"Rezai","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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