Articles producció científica> Medicina i Cirurgia

Implications of ACC/AHA Versus ESC/EAS LDL-C Recommendations for Residual Risk Reduction in ASCVD: A Simulation Study From DA VINCI

  • Identification data

    Identifier: imarina:9262472
    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.
  • Others:

    Author, as appears in the article.: Vallejo-Vaz, Antonio J.; Bray, Sarah; Villa, Guillermo; Brandts, Julia; Kiru, Gaia; Murphy, Jennifer; Banach, Maciej; 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.; Ray, Kausik K.;DA VINCI Study Investigators
    Department: Medicina i Cirurgia
    URV's Author/s: Masana Marín, Luis
    Keywords: Statins Statin therapy Simvastatin Safety Metaanalysis Lipid-lowering Ldl-c Ezetimibe Efficacy Disease Density-lipoprotein cholesterol Cardiovascular risk Cardiovascular outcomes Cardiovascular disease prevention Atorvastatin Atherosclerotic cardiovascular disease
    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.
    Thematic Areas: Pharmacology (medical) Pharmacology & pharmacy Pharmacology Medicine (miscellaneous) Medicina ii Medicina i Farmacia Educação física Ciências biológicas ii Ciências biológicas i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: luis.masana@urv.cat
    Author identifier: 0000-0002-0789-4954
    Record's date: 2024-08-03
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://link.springer.com/article/10.1007/s10557-022-07343-x
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Cardiovascular Drugs And Therapy. 37 (5): 941-953
    APA: Vallejo-Vaz, Antonio J.; Bray, Sarah; Villa, Guillermo; Brandts, Julia; Kiru, Gaia; Murphy, Jennifer; Banach, Maciej; De Servi, Stefano; Gaita, Dan; G (2023). 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, 37(5), 941-953. DOI: 10.1007/s10557-022-07343-x
    Article's DOI: 10.1007/s10557-022-07343-x
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2023
    Publication Type: Journal Publications
  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine,Medicine (Miscellaneous),Pharmacology,Pharmacology & Pharmacy,Pharmacology (Medical)
    Statins
    Statin therapy
    Simvastatin
    Safety
    Metaanalysis
    Lipid-lowering
    Ldl-c
    Ezetimibe
    Efficacy
    Disease
    Density-lipoprotein cholesterol
    Cardiovascular risk
    Cardiovascular outcomes
    Cardiovascular disease prevention
    Atorvastatin
    Atherosclerotic cardiovascular disease
    Pharmacology (medical)
    Pharmacology & pharmacy
    Pharmacology
    Medicine (miscellaneous)
    Medicina ii
    Medicina i
    Farmacia
    Educação física
    Ciências biológicas ii
    Ciências biológicas i
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
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