Repositori URV

Identifier: imarina:9262472

Handle: https://hdl.handle.net/20.500.11797/imarina9262472

Authors:
Vallejo-Vaz, Antonio J.Bray, SarahVilla, GuillermoBrandts, JuliaKiru, GaiaMurphy, JenniferBanach, MaciejDe Servi, StefanoGaita, DanGouni-Berthold, IoannaHovingh, G. KeesJozwiak, Jacek J.Jukema, J. WouterKiss, Robert GaborKownator, SergeIversen, Helle K.Maher, VincentMasana, LuisParkhomenko, AlexanderPeeters, AndreClifford, PiersRaslova, KatarinaSiostrzonek, PeterRomeo, StefanoTousoulis, DimitriosVlachopoulos, CharalambosVrablik, MichalCatapano, Alberico L.Poulter, Neil R.Ray, Kausik K.DA VINCI Study Investigators

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.