Loading…
Residual cardiovascular risk reduction guided by lifetime benefit estimation in patients with symptomatic atherosclerotic disease: effectiveness and cost-effectiveness
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-...
Saved in:
| Published in: | European journal of preventive cardiology 2022-03, Vol.29 (4), p.635-644 |
|---|---|
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c295t-d10e140e8ceea544139cc7a8c55864d6bee4259ed496566753bc33eed2aead283 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c295t-d10e140e8ceea544139cc7a8c55864d6bee4259ed496566753bc33eed2aead283 |
| container_end_page | 644 |
| container_issue | 4 |
| container_start_page | 635 |
| container_title | European journal of preventive cardiology |
| container_volume | 29 |
| creator | 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 |
| description | 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) |
| doi_str_mv | 10.1093/eurjpc/zwab028 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2528908039</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2528908039</sourcerecordid><originalsourceid>FETCH-LOGICAL-c295t-d10e140e8ceea544139cc7a8c55864d6bee4259ed496566753bc33eed2aead283</originalsourceid><addsrcrecordid>eNpVUU1PwzAMjRCIIdiVI8qRSyFN0i7lhia-pElICM5VmriQ0bUlTpnGH-JvkrExiRwcfzw_y36EnKbsImWFuITBz3tz-bXUFeNqjxxxJieJVCrd3_kTMSJjxDmLL2ecK3VIRkKy2M_FEfl-AnR20A012lvXfWo0Q6M99Q7fqQc7mOC6lr4OzoKl1Yo2robgFkAraKF2gQLGUP-iXEv76EEbkC5deKO4WvShW1cN1eENfIemiXYdW4egEa4o1DXEKZ-RD5Hq1lLTYUj-pU_IQa0bhPH2PyYvtzfP0_tk9nj3ML2eJYYXWUhsyiCVDJQB0JmUqSiMmWhlskzl0uYVgORZAVYWeZbnk0xURggAyzVoy5U4Jucb3t53H0NcrVw4NNA0uoVuwJJnXBVMMVFE6MUGauJW6KEuex8P4Vdlysq1PuVGn3KrT2w423IP1QLsDv6nhvgBdCOUeA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2528908039</pqid></control><display><type>article</type><title>Residual cardiovascular risk reduction guided by lifetime benefit estimation in patients with symptomatic atherosclerotic disease: effectiveness and cost-effectiveness</title><source>Oxford Journals Online</source><creator>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</creator><creatorcontrib>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 ; UCC-SMART Study Group ; the UCC-SMART Study Group</creatorcontrib><description>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) < 1.8 mmol/L, systolic blood pressure <140 mmHg, and antithrombotic medication. Outcomes were evaluated for the total cohort using a microsimulation model. Effectiveness was evaluated as total gain in CVD-free life and events avoided, cost-effectiveness as incremental cost-effectivity ratio (ICER). In comparison to baseline treatment, treatment according to lifetime benefit would lead to an increase of 24 243 CVD-free life years [95% confidence interval (CI) 19 980-29 909] and would avoid 940 (95% CI 742-1140) events in the next 10 years. For risk-factor based treatment, this would be an increase of 18 564 CVD-free life years (95% CI 14 225-20 456) and decrease of 857 (95% CI 661-1057) events. The ICER of lifetime benefit-based treatment with a treatment threshold of ≥1 year additional CVD-free life per therapy was €15 092/QALY gained and of risk factor-based treatment €9933/QALY gained. In a direct comparison, lifetime benefit-based treatment compared to risk factor-based treatment results in 1871 additional QALYs for the price of €36 538/QALY gained.
Residual risk reduction guided by lifetime benefit estimation results in more CVD-free life years and more CVD events avoided compared to the conventional risk factor-based strategy. Lifetime benefit-based treatment is an effective and potentially cost-effective strategy for reducing residual CVD risk in patients with clinical manifest vascular disease.</description><identifier>ISSN: 2047-4873</identifier><identifier>EISSN: 2047-4881</identifier><identifier>DOI: 10.1093/eurjpc/zwab028</identifier><identifier>PMID: 34009323</identifier><language>eng</language><publisher>England</publisher><subject>Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Cost-Benefit Analysis ; Heart Disease Risk Factors ; Humans ; Quality-Adjusted Life Years ; Risk Factors</subject><ispartof>European journal of preventive cardiology, 2022-03, Vol.29 (4), p.635-644</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c295t-d10e140e8ceea544139cc7a8c55864d6bee4259ed496566753bc33eed2aead283</citedby><cites>FETCH-LOGICAL-c295t-d10e140e8ceea544139cc7a8c55864d6bee4259ed496566753bc33eed2aead283</cites><orcidid>0000-0003-2871-9810 ; 0000-0002-6906-2643 ; 0000-0002-1692-8669 ; 0000-0002-0190-8526 ; 0000-0001-5021-5227</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34009323$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hageman, Steven H J</creatorcontrib><creatorcontrib>Dorresteijn, Jannick A N</creatorcontrib><creatorcontrib>Bots, Michiel L</creatorcontrib><creatorcontrib>Asselbergs, Folkert W</creatorcontrib><creatorcontrib>Westerink, Jan</creatorcontrib><creatorcontrib>van der Meulen, Miriam P</creatorcontrib><creatorcontrib>Mosterd, Arend</creatorcontrib><creatorcontrib>Visseren, Frank L J</creatorcontrib><creatorcontrib>Asselbergs, F W</creatorcontrib><creatorcontrib>Nathoe, H M</creatorcontrib><creatorcontrib>de Borst, G J</creatorcontrib><creatorcontrib>Bots, M L</creatorcontrib><creatorcontrib>Geerlings, M I</creatorcontrib><creatorcontrib>Emmelot, M H</creatorcontrib><creatorcontrib>de Jong, P A</creatorcontrib><creatorcontrib>Leiner, T</creatorcontrib><creatorcontrib>Lely, A T</creatorcontrib><creatorcontrib>van der Kaaij, N P</creatorcontrib><creatorcontrib>Kappelle, L J</creatorcontrib><creatorcontrib>Ruigrok, Y M</creatorcontrib><creatorcontrib>Verhaar, M C</creatorcontrib><creatorcontrib>Visseren, F L J</creatorcontrib><creatorcontrib>Westerink, J</creatorcontrib><creatorcontrib>UCC-SMART Study Group</creatorcontrib><creatorcontrib>the UCC-SMART Study Group</creatorcontrib><title>Residual cardiovascular risk reduction guided by lifetime benefit estimation in patients with symptomatic atherosclerotic disease: effectiveness and cost-effectiveness</title><title>European journal of preventive cardiology</title><addtitle>Eur J Prev Cardiol</addtitle><description>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) < 1.8 mmol/L, systolic blood pressure <140 mmHg, and antithrombotic medication. Outcomes were evaluated for the total cohort using a microsimulation model. Effectiveness was evaluated as total gain in CVD-free life and events avoided, cost-effectiveness as incremental cost-effectivity ratio (ICER). In comparison to baseline treatment, treatment according to lifetime benefit would lead to an increase of 24 243 CVD-free life years [95% confidence interval (CI) 19 980-29 909] and would avoid 940 (95% CI 742-1140) events in the next 10 years. For risk-factor based treatment, this would be an increase of 18 564 CVD-free life years (95% CI 14 225-20 456) and decrease of 857 (95% CI 661-1057) events. The ICER of lifetime benefit-based treatment with a treatment threshold of ≥1 year additional CVD-free life per therapy was €15 092/QALY gained and of risk factor-based treatment €9933/QALY gained. In a direct comparison, lifetime benefit-based treatment compared to risk factor-based treatment results in 1871 additional QALYs for the price of €36 538/QALY gained.
Residual risk reduction guided by lifetime benefit estimation results in more CVD-free life years and more CVD events avoided compared to the conventional risk factor-based strategy. Lifetime benefit-based treatment is an effective and potentially cost-effective strategy for reducing residual CVD risk in patients with clinical manifest vascular disease.</description><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Cost-Benefit Analysis</subject><subject>Heart Disease Risk Factors</subject><subject>Humans</subject><subject>Quality-Adjusted Life Years</subject><subject>Risk Factors</subject><issn>2047-4873</issn><issn>2047-4881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpVUU1PwzAMjRCIIdiVI8qRSyFN0i7lhia-pElICM5VmriQ0bUlTpnGH-JvkrExiRwcfzw_y36EnKbsImWFuITBz3tz-bXUFeNqjxxxJieJVCrd3_kTMSJjxDmLL2ecK3VIRkKy2M_FEfl-AnR20A012lvXfWo0Q6M99Q7fqQc7mOC6lr4OzoKl1Yo2robgFkAraKF2gQLGUP-iXEv76EEbkC5deKO4WvShW1cN1eENfIemiXYdW4egEa4o1DXEKZ-RD5Hq1lLTYUj-pU_IQa0bhPH2PyYvtzfP0_tk9nj3ML2eJYYXWUhsyiCVDJQB0JmUqSiMmWhlskzl0uYVgORZAVYWeZbnk0xURggAyzVoy5U4Jucb3t53H0NcrVw4NNA0uoVuwJJnXBVMMVFE6MUGauJW6KEuex8P4Vdlysq1PuVGn3KrT2w423IP1QLsDv6nhvgBdCOUeA</recordid><startdate>20220330</startdate><enddate>20220330</enddate><creator>Hageman, Steven H J</creator><creator>Dorresteijn, Jannick A N</creator><creator>Bots, Michiel L</creator><creator>Asselbergs, Folkert W</creator><creator>Westerink, Jan</creator><creator>van der Meulen, Miriam P</creator><creator>Mosterd, Arend</creator><creator>Visseren, Frank L J</creator><creator>Asselbergs, F W</creator><creator>Nathoe, H M</creator><creator>de Borst, G J</creator><creator>Bots, M L</creator><creator>Geerlings, M I</creator><creator>Emmelot, M H</creator><creator>de Jong, P A</creator><creator>Leiner, T</creator><creator>Lely, A T</creator><creator>van der Kaaij, N P</creator><creator>Kappelle, L J</creator><creator>Ruigrok, Y M</creator><creator>Verhaar, M C</creator><creator>Visseren, F L J</creator><creator>Westerink, J</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2871-9810</orcidid><orcidid>https://orcid.org/0000-0002-6906-2643</orcidid><orcidid>https://orcid.org/0000-0002-1692-8669</orcidid><orcidid>https://orcid.org/0000-0002-0190-8526</orcidid><orcidid>https://orcid.org/0000-0001-5021-5227</orcidid></search><sort><creationdate>20220330</creationdate><title>Residual cardiovascular risk reduction guided by lifetime benefit estimation in patients with symptomatic atherosclerotic disease: effectiveness and cost-effectiveness</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c295t-d10e140e8ceea544139cc7a8c55864d6bee4259ed496566753bc33eed2aead283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Cost-Benefit Analysis</topic><topic>Heart Disease Risk Factors</topic><topic>Humans</topic><topic>Quality-Adjusted Life Years</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hageman, Steven H J</creatorcontrib><creatorcontrib>Dorresteijn, Jannick A N</creatorcontrib><creatorcontrib>Bots, Michiel L</creatorcontrib><creatorcontrib>Asselbergs, Folkert W</creatorcontrib><creatorcontrib>Westerink, Jan</creatorcontrib><creatorcontrib>van der Meulen, Miriam P</creatorcontrib><creatorcontrib>Mosterd, Arend</creatorcontrib><creatorcontrib>Visseren, Frank L J</creatorcontrib><creatorcontrib>Asselbergs, F W</creatorcontrib><creatorcontrib>Nathoe, H M</creatorcontrib><creatorcontrib>de Borst, G J</creatorcontrib><creatorcontrib>Bots, M L</creatorcontrib><creatorcontrib>Geerlings, M I</creatorcontrib><creatorcontrib>Emmelot, M H</creatorcontrib><creatorcontrib>de Jong, P A</creatorcontrib><creatorcontrib>Leiner, T</creatorcontrib><creatorcontrib>Lely, A T</creatorcontrib><creatorcontrib>van der Kaaij, N P</creatorcontrib><creatorcontrib>Kappelle, L J</creatorcontrib><creatorcontrib>Ruigrok, Y M</creatorcontrib><creatorcontrib>Verhaar, M C</creatorcontrib><creatorcontrib>Visseren, F L J</creatorcontrib><creatorcontrib>Westerink, J</creatorcontrib><creatorcontrib>UCC-SMART Study Group</creatorcontrib><creatorcontrib>the UCC-SMART Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of preventive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hageman, Steven H J</au><au>Dorresteijn, Jannick A N</au><au>Bots, Michiel L</au><au>Asselbergs, Folkert W</au><au>Westerink, Jan</au><au>van der Meulen, Miriam P</au><au>Mosterd, Arend</au><au>Visseren, Frank L J</au><au>Asselbergs, F W</au><au>Nathoe, H M</au><au>de Borst, G J</au><au>Bots, M L</au><au>Geerlings, M I</au><au>Emmelot, M H</au><au>de Jong, P A</au><au>Leiner, T</au><au>Lely, A T</au><au>van der Kaaij, N P</au><au>Kappelle, L J</au><au>Ruigrok, Y M</au><au>Verhaar, M C</au><au>Visseren, F L J</au><au>Westerink, J</au><aucorp>UCC-SMART Study Group</aucorp><aucorp>the UCC-SMART Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Residual cardiovascular risk reduction guided by lifetime benefit estimation in patients with symptomatic atherosclerotic disease: effectiveness and cost-effectiveness</atitle><jtitle>European journal of preventive cardiology</jtitle><addtitle>Eur J Prev Cardiol</addtitle><date>2022-03-30</date><risdate>2022</risdate><volume>29</volume><issue>4</issue><spage>635</spage><epage>644</epage><pages>635-644</pages><issn>2047-4873</issn><eissn>2047-4881</eissn><abstract>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) < 1.8 mmol/L, systolic blood pressure <140 mmHg, and antithrombotic medication. Outcomes were evaluated for the total cohort using a microsimulation model. Effectiveness was evaluated as total gain in CVD-free life and events avoided, cost-effectiveness as incremental cost-effectivity ratio (ICER). In comparison to baseline treatment, treatment according to lifetime benefit would lead to an increase of 24 243 CVD-free life years [95% confidence interval (CI) 19 980-29 909] and would avoid 940 (95% CI 742-1140) events in the next 10 years. For risk-factor based treatment, this would be an increase of 18 564 CVD-free life years (95% CI 14 225-20 456) and decrease of 857 (95% CI 661-1057) events. The ICER of lifetime benefit-based treatment with a treatment threshold of ≥1 year additional CVD-free life per therapy was €15 092/QALY gained and of risk factor-based treatment €9933/QALY gained. In a direct comparison, lifetime benefit-based treatment compared to risk factor-based treatment results in 1871 additional QALYs for the price of €36 538/QALY gained.
Residual risk reduction guided by lifetime benefit estimation results in more CVD-free life years and more CVD events avoided compared to the conventional risk factor-based strategy. Lifetime benefit-based treatment is an effective and potentially cost-effective strategy for reducing residual CVD risk in patients with clinical manifest vascular disease.</abstract><cop>England</cop><pmid>34009323</pmid><doi>10.1093/eurjpc/zwab028</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-2871-9810</orcidid><orcidid>https://orcid.org/0000-0002-6906-2643</orcidid><orcidid>https://orcid.org/0000-0002-1692-8669</orcidid><orcidid>https://orcid.org/0000-0002-0190-8526</orcidid><orcidid>https://orcid.org/0000-0001-5021-5227</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2047-4873 |
| ispartof | European journal of preventive cardiology, 2022-03, Vol.29 (4), p.635-644 |
| issn | 2047-4873 2047-4881 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2528908039 |
| source | Oxford Journals Online |
| 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 |
| title | Residual cardiovascular risk reduction guided by lifetime benefit estimation in patients with symptomatic atherosclerotic disease: effectiveness and cost-effectiveness |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T01%3A37%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Residual%20cardiovascular%20risk%20reduction%20guided%20by%20lifetime%20benefit%20estimation%20in%20patients%20with%20symptomatic%20atherosclerotic%20disease:%20effectiveness%20and%20cost-effectiveness&rft.jtitle=European%20journal%20of%20preventive%20cardiology&rft.au=Hageman,%20Steven%20H%20J&rft.aucorp=UCC-SMART%20Study%20Group&rft.date=2022-03-30&rft.volume=29&rft.issue=4&rft.spage=635&rft.epage=644&rft.pages=635-644&rft.issn=2047-4873&rft.eissn=2047-4881&rft_id=info:doi/10.1093/eurjpc/zwab028&rft_dat=%3Cproquest_cross%3E2528908039%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c295t-d10e140e8ceea544139cc7a8c55864d6bee4259ed496566753bc33eed2aead283%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2528908039&rft_id=info:pmid/34009323&rfr_iscdi=true |