Vallejo-Vaz, Antonio J. ORCID: 0000-0001-7954-1253, Bray, Sarah, Villa, Guillermo, Brandts, Julia, Kiru, Gaia, Murphy, Jennifer, Banach, Maciej ORCID: 0000-0001-6690-6874, De Servi, Stefano, Gaita, Dan, Gouni-Berthold, Ioanna, Hovingh, G. Kees, Jozwiak, Jacek J., Jukema, J. Wouter, Kiss, Robert Gabor, Kownator, Serge, Iversen, Helle K., Maher, Vincent, Masana, Luis, Parkhomenko, Alexander, Peeters, Andre, Clifford, Piers, Raslova, Katarina, Siostrzonek, Peter, Romeo, Stefano, Tousoulis, Dimitrios, Vlachopoulos, Charalambos, Vrablik, Michal, Catapano, Alberico L., Poulter, Neil R. and Ray, Kausik K. . Implications of ACC/AHA Versus ESC/EAS LDL-C Recommendations for Residual Risk Reduction in ASCVD: A Simulation Study From DA VINCI. Cardiovasc. Drugs Ther.. DORDRECHT: SPRINGER. ISSN 1573-7241

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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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Vallejo-Vaz, Antonio J.UNSPECIFIEDorcid.org/0000-0001-7954-1253UNSPECIFIED
Bray, SarahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Villa, GuillermoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brandts, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kiru, GaiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Murphy, JenniferUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Banach, MaciejUNSPECIFIEDorcid.org/0000-0001-6690-6874UNSPECIFIED
De Servi, StefanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gaita, DanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gouni-Berthold, IoannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hovingh, G. KeesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jozwiak, Jacek J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jukema, J. WouterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kiss, Robert GaborUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kownator, SergeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Iversen, Helle K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maher, VincentUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Masana, LuisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Parkhomenko, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peeters, AndreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clifford, PiersUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Raslova, KatarinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Siostrzonek, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Romeo, StefanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tousoulis, DimitriosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vlachopoulos, CharalambosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vrablik, MichalUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Catapano, Alberico L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Poulter, Neil R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ray, Kausik K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-698444
DOI: 10.1007/s10557-022-07343-x
Journal or Publication Title: Cardiovasc. Drugs Ther.
Publisher: SPRINGER
Place of Publication: DORDRECHT
ISSN: 1573-7241
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DENSITY-LIPOPROTEIN CHOLESTEROL; CARDIOVASCULAR OUTCOMES; STATIN THERAPY; EFFICACY; ATORVASTATIN; METAANALYSIS; SIMVASTATIN; EZETIMIBE; DISEASE; SAFETYMultiple languages
Cardiac & Cardiovascular Systems; Pharmacology & PharmacyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69844

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