Implications of the new American College of Cardiology/American Heart Association cholesterol guidelines for primary atherosclerotic cardiovascular disease event prevention in a multi ethnic cohort: Multi-Ethnic Study of Atherosclerosis (MESA)

American Heart Journal
Joseph YeboahDavid M Herrington

Abstract

The impact of replacing the National Cholesterol Education Program (NCEP)/Adult Treatment Program (ATP) III cholesterol guidelines with the new 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for primary prevention of cardiovascular disease is unclear. We used risk factor and 10-year clinical event rate data from MESA, combined with estimates of efficacy of moderate and high-intensity statin therapy from meta-analyses of statin primary prevention trials to estimate (a) the change in number of subjects eligible for drug therapy and (2) the anticipated reduction in atherosclerotic cardiovascular disease (ASCVD) events and increment in type 2 diabetes mellitus (T2DM) associated with the change in cholesterol guidelines. Of the 6,814 MESA participants, 5,437 were not on statins at baseline and had complete data for analysis (mean age 61.4±10.3). Using the NCEP/ATP III guidelines, 1,334 (24.5%) would have been eligible for statin therapy compared with 3,015 (55.5%) under the new ACC/AHA guidelines. Among the subset of newly eligible, 127/1,742 (7.3%) had an ASCVD event during 10years of follow-up. Assuming 10years of moderate-intensity statin therapy, the estimated absolute reduction in ASCVD ev...Continue Reading

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Citations

Feb 20, 2016·Journal of Clinical Lipidology·Guadalupe EcheverríaAttilio Rigotti
Oct 23, 2015·Clinical Pharmacology and Therapeutics·G P S Shantha, J G Robinson
May 22, 2016·Journal of Clinical Lipidology·Salim S ViraniChristie M Ballantyne
Sep 8, 2015·Journal of Clinical Lipidology·Peter F Belamarich
Aug 16, 2016·International Journal of Environmental Research and Public Health·Nonanzit Pérez-HernándezJosé Manuel Rodríguez-Pérez
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Feb 6, 2017·Current Cardiovascular Risk Reports·Rebeccah A McKibbenErin D Michos
Apr 10, 2019·Journal of Clinical Pharmacy and Therapeutics·Nancy Borja-HartIrma B Ancheta

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