Study: ACC/AHA Guidelines Best Option for ASCVD Prevention

A recent head-to-head comparison has found that the 2013 cholesterol treatment guidelines from the American College of Cardiology and American Heart Association is superior to trial-based and hybrid approaches to preventing atherosclerotic cardiovascular disease (ASCVD).

Recently, trial-based and hybrid alternatives to the guideline’s approach of primary prevention using statins have been suggested. In order to compare the alternatives, researchers used data from the Copenhagen General Population Study including 37,892 individuals between 40 and 75 years old. All participants were free of ASCVD, diabetes, and statin use at baseline.
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Of the population, 42% were eligible for statin therapy based on the 2013 guidelines, versus 56% with the trial-based approach and 21% with the hybrid approach.

Among these individuals, the rate per 1000 person-years of ASCVD was 9.8 for the guidelines, 6.8 for the trial-based approach, and 1.2 for the hybrid approach.

“The clinical performance of the ACC/AHA risk-based approach for primary prevention of ASCVD with statins was superior to the trial-based and hybrid approaches,” researchers concluded.

“Our results indicate that the ACC/AHA guidelines will prevent more ASCVD events than the trial-based and hybrid approaches, while treating fewer people compared with the trial-based approach.”

—Michael Potts

Reference:

Mortensen MB, Afzal S, Nordestgaard BG et al. ACC/AHA risk-based approach versus trial-based approaches to guide statin therapy. JACC. 2015;66(24):2699-2709.