Abstract 15164: Exploring the Use of a 30-Year Cardiovascular Risk Prediction to Guide Statin Eligibility in Primary Care

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A15164-A15164
• Main Authors: Cesena, Fernando H, Laurinavicius, Antonio G, Valente, Viviane A, Conceição, Raquel D, Santos, Raul D, Bittencourt, Marcio S
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

IntroductionStatin eligibility based on long-term risk assessment has been suggested but it is not well known how this approach should be used and its impact in clinical practice. The goals of this study were to propose a strategy for statin eligibility based on the 30-year (y) cardiovascular (CV) risk and verify how this approach modifies the current ACC/AHA guideline recommendation.MethodsWe selected individuals aged 40-59 years, without clinical ASCVD or diabetes, with LDL-c 70-189 mg/dL, not on lipid-lowering drugs, who underwent a routine health screening from January, 2015 to December, 2016 in a single center in Brazil. The 10-y ASCVD risk was calculated by the pooled cohort equations. The 30-y risk of hard CV disease was estimated by the equations developed by the Framingham Heart Study. We determined the 30-y risk thresholds corresponding to the minimum 30-y risk observed in subjects with either 10-y risk ≥7.5% or ≥5%. Statin eligibility based on the 30-y risk was considered if it was equal to or greater than the 30-y risk threshold.ResultsThe study included 3813 subjects (47 ± 5 years, 65% men). The Figure shows the correlation between the 10-y and 30-y risks, the 30-y risk thresholds (blue) and the proportion of the population eligible or non-eligible for statins based on the 10-y and 30-y risk assessments (orange). Compared to non-eligible subjects by both the 10-y and 30-y risk scores, those with 10-y risk