%0 Journal Article
%A Vallejo-Vaz, Antonio J
%A Bray, Sarah
%A Villa, Guillermo
%A Brandts, Julia
%A Kiru, Gaia
%A Murphy, Jennifer
%A Banach, Maciej
%A De-Servi, Stefano
%A Gaita, Dan
%A Gouni-Berthold, Ioanna
%A Kees-Hovingh, G
%A Jozwiak, Jacek J
%A Jukema, J Wouter
%A Gabor-Kiss, Robert
%A Kownator, Serge
%A Iversen, Helle K
%A Maher, Vincent
%A Masana, Luis
%A Parkhomenko, Alexander
%A Peeters, Andre
%A Clifford, Piers
%A Raslova, Katarina
%A Siostrzonek, Peter
%A Romeo, Stefano
%A Tousoulis, Dimitrios
%A Vlachopoulos, Charalambos
%A Vrablik, Michal
%A Catapano, Alberico L
%A Poulter, Neil R
%A Ray, Kausik K
%T Implications of ACC/AHA Versus ESC/EAS LDL-C Recommendations for Residual Risk Reduction in ASCVD: A Simulation Study From DA VINCI.
%D 2023
%U http://hdl.handle.net/10668/20496
%X PurposeLow-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.MethodsDA 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.ResultsOf 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. ConclusionIn ASCVD patients , achieving ESC/EAS LDL-C goals could result in a 2% additional ARR over 10 years versus the ACC/AHA approach
%K Atherosclerotic cardiovascular disease
%K Cardiovascular disease prevention
%K Cardiovascular risk
%K LDL-C
%K Lipid-lowering
%K Statins
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