scholarly journals Statin Use in Primary Prevention of Atherosclerotic Cardiovascular Disease According to 5 Major Guidelines for Sensitivity, Specificity, and Number Needed to Treat

2019 ◽  
Vol 4 (11) ◽  
pp. 1131 ◽  
Author(s):  
Martin Bødtker Mortensen ◽  
Børge Grønne Nordestgaard
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Number Needed To Treat ◽  
Atherosclerotic Cardiovascular Disease ◽  
Sensitivity Specificity ◽  
Statin Use

Abstract 05: Assessing Population Impact of Statin Treatment for Primary Prevention of Atherosclerotic Cardiovascular Diseases in US

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Quanhe Yang ◽  
Yuna Zhong ◽  
Catheen Gillespie ◽  
Robert Merritt ◽  
Barbara Bowman ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Adverse Effects ◽  
Randomized Clinical Trials ◽  
Statin Treatment ◽  
Population Based ◽  
Number Needed To Treat ◽  
Atherosclerotic Cardiovascular Disease ◽  
Population Impact ◽  
New Guidelines ◽  
Statin Use

Introduction: American College of Cardiology/American Heart Association (ACC/AHA) new cholesterol treatment guidelines recommend consideration of statin treatment for a larger proportion of population for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). It is important to assess the population impact of statin treatment under these new guidelines. Hypothesis: We assessed the hypothesis that increased statin use for the primary prevention of ASCVD might be accompanied by adverse effects among population. Methods: We used 2010 US Census, Multiple Cause Mortality, Third National Health and Nutrition Examination Survey Linked Mortality File (NHANES III 1988-2006, n=7095) and NHANES 2005-2010 (n=3178) participants 40-75 years of age to estimate prevalence of statin use, annual ASCVD deaths prevented and excess adverse effects by age, sex, and race/ethnicity if everyone followed updated guidelines. Results: Among 33.0 million adults aged 40-75 years meeting new guidelines for primary prevention of ASCVD (12.4 million with diabetes and 20.6 without diabetes but with a predicted 10-year ASCVD risk ≥7.5% and 70 ≤ low-density lipoprotein (LDL) ≤189 mg/dL), 26.9% (8.8 million) were on statins, indicating an additional 24.2 million potentially eligible for statin treatment (7.7 million with diabetes and 16.5 million without). Among the 7.7 million with diabetes, assuming 100% statin use, expected annual ASCVD deaths prevented were 2,514 (95% CI 592-4,142) and number-needed-to-treat (NNT) was 3,063 (1,860-13,017). The additional cases of myopathy based on estimates from randomized clinical trials (RCT) was 482 (0-2239) and number-needed-to-harm (NNH) was 15,992 (3,440-∞), and was 11,801 (9,251-14,916) and NNH 653 (516-833) based on estimates from population-based studies. Among 16.5 million without diabetes, ASCVD deaths prevented were 5,425 (1,276-8,935) with NNT 3,039 (1,845-12,914). The additional diabetes cases were 16,406 (4,922-26,250) with NNH 1,005 (628-3,349). Additional cases of myopathy was 1,030 (0-4,791) with NNH 15,996 3,441-∞) based on RCT estimates, and 24,302 (19,363-30,292) with NNH 678 (544-851) for population-based studies. ASCVD deaths prevented increased with age and >70% of ASCVD deaths prevented would occur among adults aged ≥60 years. Conclusions: Under ACC/AHA new guidelines for primary prevention of ASCVD by statin, assuming all those eligible took a statin, up to 12.6% of annual ASCVD deaths could be prevented, but could be accompanied by additional cases of diabetes and myopathy.

scholarly journals Statin Use for Atherosclerotic Cardiovascular Disease Prevention Among Sexual Minority Adults

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Yi Guo ◽  
Christopher W. Wheldon ◽  
Hui Shao ◽  
Carl J. Pepine ◽  
Eileen M. Handberg ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Sexual Orientation ◽  
Primary Prevention ◽  
Disease Prevention ◽  
Sexual Minority ◽  
Online Survey ◽  
Cardiovascular Disease Prevention ◽  
Atherosclerotic Cardiovascular Disease ◽  
Increased Risk ◽  
Statin Use

Background Sexual minority, or lesbian, gay, and bisexual (LGB), individuals are at increased risk for cardiovascular disease attributable to elevated rates of health risk factors. However, although there is clear evidence that statin use can prevent cardiovscular disease in certain adult populations, no studies have examined how statins are being used among the LGB population. This study aimed to examine the prevalence and predictors of statin use among LGB and non‐LGB individuals using Facebook‐delivered online surveys. Methods and Results We conducted a cross‐sectional online survey about statin use in adults ≥40 years of age between September and December 2019 using Facebook advertising (n=1531). We calculated the prevalence of statin use by age, sexual orientation, and statin benefit populations. We used multivariable logistic regression to examine whether statin use differed by sexual orientation, adjusting for covariates. We observed a significantly lower rate of statin use in the LGB versus non‐LGB respondents (20.8% versus 43.8%; P <0.001) in the primary prevention population. However, the prevalence of statin use was not statistically different in the LGB versus non‐LGB respondents in the secondary prevention population. Adjusting for the covariates, the LGB participants were less likely to use statins than the non‐LGB respondents in the primary prevention population (odds ratio, 0.37; 95% CI, 0.19–0.70). Conclusions Our results are the first to emphasize the urgent need for tailored, evidence‐based cardiovascular disease prevention programs that aim to promote statin use, and thus healthy aging, in the LGB population.

Statin Use in Older Adults with Stable Atherosclerotic Cardiovascular Disease

2021 ◽  
Author(s):  
Gabriela Spencer‐Bonilla ◽  
Sukyung Chung ◽  
Ashish Sarraju ◽  
Paul Heidenreich ◽  
Latha Palaniappan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Atherosclerotic Cardiovascular Disease ◽  
Statin Use

Role of coronary artery calcium score in the primary prevention of cardiovascular disease

BMJ ◽  
2021 ◽  
pp. n776
Author(s):  
Khurram Nasir ◽  
Miguel Cainzos-Achirica
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Primary Prevention ◽  
Coronary Artery Calcium ◽  
Calcium Score ◽  
Coronary Plaque ◽  
Preventive Therapy ◽  
Atherosclerotic Cardiovascular Disease ◽  
International Studies

Abstract First developed in 1990, the Agatston coronary artery calcium (CAC) score is an international guideline-endorsed decision aid for further risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease. This review discusses key international studies that have informed this 30 year journey, from an initial coronary plaque screening paradigm to its current role informing personalized shared decision making. Special attention is paid to the prognostic value of a CAC score of zero (the so called “power of zero”), which, in a context of low estimated risk thresholds for the consideration of preventive therapy with statins in current guidelines, may be used to de-risk individuals and thereby inform the safe delay or avoidance of certain preventive therapies. We also evaluate current recommendations for CAC scoring in clinical practice guidelines around the world, and past and prevailing barriers for its use in routine patient care. Finally, we discuss emerging approaches in this field, with a focus on the potential role of CAC informing not only the personalized allocation of statins and aspirin in the general population, but also of other risk-reduction therapies in special populations, such as individuals with diabetes and people with severe hypercholesterolemia.

Baseline Lipid Profiles and Statin Use among Patients with Atherosclerotic Cardiovascular Disease

2015 ◽  
Vol 9 (3) ◽  
pp. 441
Author(s):  
Peter P. Toth ◽  
Xuehua Ke ◽  
Zhenxiang Zhao ◽  
Nicole Bonine ◽  
Mark Cziraky ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lipid Profiles ◽  
Atherosclerotic Cardiovascular Disease ◽  
Statin Use

scholarly journals Aspirin for Primary Prevention of Atherosclerotic Cardiovascular Disease: Challenges to Appropriate Use

2017 ◽  
Vol 4 (3) ◽  
pp. 159
Author(s):  
JoAnn Sperl-Hillen ◽  
Patrick O'Connor ◽  
Jay Desai ◽  
Karen Margolis ◽  
Heidi Ekstrom ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Atherosclerotic Cardiovascular Disease ◽  
Appropriate Use

The Association of Atherosclerotic Cardiovascular Disease and Statin Use With Inflammation and Treatment Outcomes in Tuberculosis

2021 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Jennie Ruelas Castillo ◽  
Amudha Kumar ◽  
Justin Wei ◽  
Siqing Wang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Linear Regression Analysis ◽  
Elevated Serum ◽  
University Hospital ◽  
Sputum Smear ◽  
Atherosclerotic Cardiovascular Disease ◽  
All Cause Mortality ◽  
Multivariable Linear Regression Analysis ◽  
Related Mortality ◽  
Statin Use

Abstract Objective: Tuberculosis (TB) and atherosclerotic cardiovascular disease (ASCVD) have a close epidemiological and pathogenetic overlap. Thus, it becomes essential to understand the relationship between ASCVD and TB outcomes.Methods:From our retrospective cohort on drug-susceptible TB patients at the National Taiwan University Hospital, we assessed the association of pre-existing ASCVD (coronary artery disease (CAD) and atherothrombotic stroke (ATS)) with 9-month all-cause and infection-related mortality and the extent of mediation by systemic inflammatory markers. We determined the effect of pre-existing ASCVD on 2-month sputum microbiological status. Among ASCVD patients, we assessed the association of statin use on mortality.Results:Nine-month all-cause mortality was higher in CAD patients with prior acute myocardial infarction (CAD+AMI+) (adjusted HR 2.01, 95%CI 1.38-3.00) and ATS patients (aHR 2.79, 95%CI 1.92-4.07) and similarly, for infection-related mortality was higher in CAD+AMI+ (aHR 1.95, 95%CI 1.17-3.24) and ATS (aHR 2.04, 95%CI 1.19-3.46) after adjusting for confounding factors. Pre-existing CAD (AMI- or AMI+) or ATS did not change sputum culture conversion or sputum smear AFB positivity at 2 months. The CAD+AMI+ group had significantly higher levels of CRP at TB diagnosis in the multivariable linear regression analysis (Adjusted B(SE) 1.24(0.62)). CRP mediated 66% (p=0.048) and 25% (p=0.033) of the association all-cause mortality with CAD+AMI- and CAD+AMI+, respectively. ConclusionsIn summary, patients with ASCVD have higher hazards of 9-month all-cause and infection-related mortality, with elevated serum inflammation mediating one to three-quarters of this association when adjusted for confounders. Statin use was associated with lower all-cause mortality among patients with ASCVD.

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