Vallejo-Vaz, Antonio JBray, SarahVilla, GuillermoBrandts, JuliaKiru, GaiaMurphy, JenniferBanach, MaciejDe-Servi, StefanoGaita, DanGouni-Berthold, IoannaKees-Hovingh, GJozwiak, Jacek JJukema, J WouterGabor-Kiss, RobertKownator, SergeIversen, Helle KMaher, VincentMasana, LuisParkhomenko, AlexanderPeeters, AndreClifford, PiersRaslova, KatarinaSiostrzonek, PeterRomeo, StefanoTousoulis, DimitriosVlachopoulos, CharalambosVrablik, MichalCatapano, Alberico LPoulter, Neil RRay, Kausik K2023-05-032023-05-032023-10Vallejo-Vaz AJ, Bray S, Villa G, Brandts J, Kiru G, Murphy J, et al. 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. 2023 Oct;37(5):941-953.http://hdl.handle.net/10668/20496PurposeLow-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 approachenAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Atherosclerotic cardiovascular diseaseCardiovascular disease preventionCardiovascular riskLDL-CLipid-loweringStatinsHumanslipoprotein cholesterolCardiovascular DiseasesRisk FactorsAtherosclerosisCardiologyHeart Disease Risk Factorsresearch article35567726open accessPacientesCardiologíaLipoproteínasEnfermedades cardiovascularesColesterolLípidosAterosclerosisEstudio observacional10.1007/s10557-022-07343-x1573-7241https://link.springer.com/content/pdf/10.1007/s10557-022-07343-x.pdf