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Implications of ACC/AHA Versus ESC/EAS LDL-C Recommendations for Residual Risk Reduction in ASCVD: A Simulation Study From DA VINCI
AJ. Vallejo-Vaz, S. Bray, G. Villa, J. Brandts, G. Kiru, J. Murphy, M. Banach, S. De Servi, D. Gaita, I. Gouni-Berthold, G. Kees Hovingh, JJ. Jozwiak, JW. Jukema, R. Gabor Kiss, S. Kownator, HK. Iversen, V. Maher, L. Masana, A. Parkhomenko, A....
Language English Country United States
Document type Observational Study, Journal Article
NLK
ProQuest Central
from 1999-03-01 to 1 year ago
Medline Complete (EBSCOhost)
from 2011-02-01 to 1 year ago
Health & Medicine (ProQuest)
from 1999-03-01 to 1 year ago
- MeSH
- Atherosclerosis * diagnosis drug therapy epidemiology MeSH
- Risk Reduction Behavior MeSH
- Cardiovascular Diseases * diagnosis epidemiology prevention & control MeSH
- Cholesterol, LDL MeSH
- Humans MeSH
- Cross-Sectional Studies MeSH
- Risk Factors MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors * therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Geographicals
- United States MeSH
PURPOSE: Low-density lipoprotein cholesterol (LDL-C) recommendations differ between the 2018 American College of Cardiology/American Heart Association (ACC/AHA) and 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines for patients with atherosclerotic cardiovascular disease (ASCVD) (< 70 vs. < 55 mg/dl, respectively). In the DA VINCI study, residual cardiovascular risk was predicted in ASCVD patients. The extent to which relative and absolute risk might be lowered by achieving ACC/AHA versus ESC/EAS LDL-C recommended approaches was simulated. METHODS: DA VINCI was a cross-sectional observational study of patients prescribed lipid-lowering therapy (LLT) across 18 European countries. Ten-year cardiovascular risk (CVR) was predicted among ASCVD patients receiving stabilized LLT. For patients with LDL-C ≥ 70 mg/dl, the absolute LDL-C reduction required to achieve an LDL-C of < 70 or < 55 mg/dl (LDL-C of 69 or 54 mg/dl, respectively) was calculated. Relative and absolute risk reductions (RRRs and ARRs) were simulated. RESULTS: Of the 2039 patients, 61% did not achieve LDL-C < 70 mg/dl. For patients with LDL-C ≥ 70 mg/dl, median (interquartile range) baseline LDL-C and 10-year CVR were 93 (81-115) mg/dl and 32% (25-43%), respectively. Median LDL-C reductions of 24 (12-46) and 39 (27-91) mg/dl were needed to achieve an LDL-C of 69 and 54 mg/dl, respectively. Attaining ACC/AHA or ESC/EAS goals resulted in simulated RRRs of 14% (7-25%) and 22% (15-32%), respectively, and ARRs of 4% (2-7%) and 6% (4-9%), respectively. CONCLUSION: In ASCVD patients, achieving ESC/EAS LDL-C goals could result in a 2% additional ARR over 10 years versus the ACC/AHA approach.
1st Medical Faculty Charles University and General University Hospital Prague Czech Republic
Advanced Lipid Management and Research Centre Tallaght University Hospital Dublin Ireland
Cardiology Department Sahlgrenska University Hospital Gothenburg Sweden
Cardiovascular Research Centre University of Zielona Góra Zielona Góra Poland
Centre Cardiologique et Vasculaire Thionville France
Cliniques Universitaires Saint Luc Brussels Belgium
Department of Family Medicine and Public Health Faculty of Medicine University of Opole Opole Poland
Department of Hypertension Medical University of Łódź Łódź Poland
Department of Internal Medicine 1 University Hospital RWTH Aachen Aachen Germany
Department of Medicine Faculty of Medicine University of Seville Seville Spain
Department of Molecular and Clinical Medicine University of Gothenburg Gothenburg Sweden
Department of Neurology Stroke Centre Rigshospitalet Copenhagen Rigshospitalet Denmark
Emergency Cardiology Department Institute of Cardiology Kiev Ukraine
Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
Global Biostatistical Science Amgen Ltd Cambridge UK
Global Health Economics Amgen Europe Rotkreuz Switzerland
Hungarian Army Medical Center Budapest Hungary
Imperial Clinical Trials Unit Imperial College London London UK
Imperial Hospitals NHS Trust London UK
Krankenhaus Barmherzige Schwestern Linz Linz Austria
Leiden University Medical Center Leiden Netherlands
National and Kapodistrian University of Athens Medical School Athens Greece
Polish Mother's Memorial Hospital Research Institute Łódź Poland
School of Public Health Imperial College London London UK
Slovak Medical University Bratislava Slovakia
Trinity College Dublin Dublin Ireland
Universitat Rovira 1 Virgili IISPV CIBERDEM Saint Joan University Hospital Reus Spain
References provided by Crossref.org
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