Article
Implications of ACC/AHA Versus ESC/EAS LDL‑C Recommendations for Residual Risk Reduction in ASCVD: A Simulation Study From DA VINCI
Author/s | Vallejo Vaz, Antonio Javier
Bray, Sarah Villa, Guillermo Brandts, Julia Kiru, Gaia Murphy, Jennifer Ray, Kausik K. |
Department | Universidad de Sevilla. Departamento de Medicina |
Publication Date | 2022 |
Deposit Date | 2023-04-18 |
Published in |
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Abstract | Purpose Low-density lipoprotein cholesterol (LDL-C) recommendations difer between the 2018 American College of Cardi ology/American Heart Association (ACC/AHA) and 2019 European Society of Cardiology/European Atherosclerosis ... Purpose Low-density lipoprotein cholesterol (LDL-C) recommendations difer between the 2018 American College of Cardi ology/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 (inter quartile 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 ver sus the ACC/AHA approa. |
Citation | Vallejo Vaz, A.J., Bray, S., Villa, G., Brandts, J., Kiru, G., Murphy, J. y Ray, K.K. (2022). Implications of ACC/AHA Versus ESC/EAS LDL‑C Recommendations for Residual Risk Reduction in ASCVD: A Simulation Study From DA VINCI. Cardiovascular Drugs and Therapy. https://doi.org/10.1007/s10557-022-07343-x. |
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