TY - JOUR
T1 - Implications of ACC/AHA Versus ESC/EAS LDL-C Recommendations for Residual Risk Reduction in ASCVD
T2 - A Simulation Study From DA VINCI
AU - Vallejo-Vaz, Antonio J
AU - Bray, Sarah
AU - Villa, Guillermo
AU - Brandts, Julia
AU - Kiru, Gaia
AU - Murphy, Jennifer
AU - Banach, Maciej
AU - De Servi, Stefano
AU - Gaita, Dan
AU - Gouni-Berthold, Ioanna
AU - Kees Hovingh, G
AU - Jozwiak, Jacek J
AU - Jukema, J Wouter
AU - Gabor Kiss, Robert
AU - Kownator, Serge
AU - Iversen, Helle K
AU - Maher, Vincent
AU - Masana, Luis
AU - Parkhomenko, Alexander
AU - Peeters, André
AU - Clifford, Piers
AU - Raslova, Katarina
AU - Siostrzonek, Peter
AU - Romeo, Stefano
AU - Tousoulis, Dimitrios
AU - Vlachopoulos, Charalambos
AU - Vrablik, Michal
AU - Catapano, Alberico L
AU - Poulter, Neil R
AU - Ray, Kausik K
AU - DA VINCI Study Investigators
A2 - Iversen, Helle Klingenberg
N1 - © 2022. The Author(s).
PY - 2023/10
Y1 - 2023/10
N2 - 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.
AB - 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.
KW - Atherosclerotic cardiovascular disease
KW - Cardiovascular disease prevention
KW - Cardiovascular risk
KW - LDL-C
KW - Lipid-lowering
KW - Statins
UR - https://www.scopus.com/pages/publications/85130226697
U2 - 10.1007/s10557-022-07343-x
DO - 10.1007/s10557-022-07343-x
M3 - Journal article
C2 - 35567726
SN - 0920-3206
VL - 37
SP - 941
EP - 953
JO - Cardiovascular Drugs and Therapy
JF - Cardiovascular Drugs and Therapy
IS - 5
ER -