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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

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Title: Implications of ACC/AHA Versus ESC/EAS LDL-C recommendations for residual risk reduction in ASCVD: a simulation study from DA VINCI
Authors: Vallejo-Vaz, AJ
Bray, S
Villa, G
Brandts, J
Kiru, G
Murphy, J
Banach, M
De Servi, S
Gaita, D
Gouni-Berthold, I
Hovingh, GK
Jozwiak, JJ
Jukema, JW
Kiss, RG
Kownator, S
Iversen, HK
Maher, V
Masana, L
Parkhomenko, A
Peeters, A
Clifford, P
Raslova, K
Siostrzonek, P
Romeo, S
Tousoulis, D
Vlachopoulos, C
Vrablik, M
Catapano, AL
Poulter, NR
Ray, KK
Item Type: Journal Article
Abstract: 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.
Issue Date: 14-May-2022
Date of Acceptance: 27-Apr-2022
URI: http://hdl.handle.net/10044/1/97688
DOI: 10.1007/s10557-022-07343-x
ISSN: 0920-3206
Publisher: Springer
Journal / Book Title: Cardiovascular Drugs and Therapy
Copyright Statement: © The Author(s) 2022
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Pharmacology & Pharmacy
Cardiovascular System & Cardiology
Atherosclerotic cardiovascular disease
LDL-C
Lipid-lowering
Statins
Cardiovascular risk
Cardiovascular disease prevention
DENSITY-LIPOPROTEIN CHOLESTEROL
CARDIOVASCULAR OUTCOMES
STATIN THERAPY
EFFICACY
ATORVASTATIN
METAANALYSIS
SIMVASTATIN
EZETIMIBE
DISEASE
SAFETY
Atherosclerotic cardiovascular disease
Cardiovascular disease prevention
Cardiovascular risk
LDL-C
Lipid-lowering
Statins
DA VINCI Study Investigators
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Pharmacology & Pharmacy
Cardiovascular System & Cardiology
Atherosclerotic cardiovascular disease
LDL-C
Lipid-lowering
Statins
Cardiovascular risk
Cardiovascular disease prevention
DENSITY-LIPOPROTEIN CHOLESTEROL
CARDIOVASCULAR OUTCOMES
STATIN THERAPY
EFFICACY
ATORVASTATIN
METAANALYSIS
SIMVASTATIN
EZETIMIBE
DISEASE
SAFETY
Cardiovascular System & Hematology
1115 Pharmacology and Pharmaceutical Sciences
Publication Status: Published
Appears in Collections:School of Public Health



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