Residual cardiovascular risk reduction guided by lifetime benefit estimation in patients with symptomatic atherosclerotic disease: effectiveness and cost-effectiveness

• Published in: European journal of preventive cardiology 2022-03, Vol.29 (4), p.635-644
• Main Authors: Hageman, Steven H J, Dorresteijn, Jannick A N, Bots, Michiel L, Asselbergs, Folkert W, Westerink, Jan, van der Meulen, Miriam P, Mosterd, Arend, Visseren, Frank L J, Asselbergs, F W, Nathoe, H M, de Borst, G J, Bots, M L, Geerlings, M I, Emmelot, M H, de Jong, P A, Leiner, T, Lely, A T, van der Kaaij, N P, Kappelle, L J, Ruigrok, Y M, Verhaar, M C, Visseren, F L J, Westerink, J
• Format: Article
• Language: English
• Subjects: Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Cost-Benefit Analysis; Heart Disease Risk Factors; Humans; Quality-Adjusted Life Years; Risk Factors
• ISSN: 2047-4873; 2047-4881
• DOI: 10.1093/eurjpc/zwab028

To determine the (cost)-effectiveness of blood pressure lowering, lipid-lowering, and antithrombotic therapy guided by predicted lifetime benefit compared to risk factor levels in patients with symptomatic atherosclerotic disease. For all patients with symptomatic atherosclerotic disease in the UCC-SMART cohort (1996-2018; n = 7697) two treatment strategies were compared. The lifetime benefit-guided strategy was based on individual estimation of gain in cardiovascular disease (CVD)-free life with the SMART-REACH model. In the risk factor-based strategy, all patients were treated the following: low-density lipoprotein cholesterol (LDL-c)