Differences in Statin Eligible Patients across Guidelines

Recent ACC/AHA guidelines recommend consideration of statin therapy among patients with a 7.5% 10-year risk of atherosclerotic cardiovascular disease (CVD).  In this study, the authors examined implications of these new guidelines as compared with previous European Society of Cardiology (ESC) and Adult Treatment Panel III (ATP III) guidelines in a Dutch population-based prospective cohort of 4,854 healthy participants over 55 years of age. In this cohort,  96.4% men and 65.8% women would be recommended statinsunder the new ACC/AHA guidelines. In contrast, 66.1% of men and 39.1% of women would be recommended statins under ESC guidelines and 52.0% of men and 35.5% of women would be recommended statins by ATP III guidelines.  Subgroup analyses demonstrated under ACC/AHA guidelines nearly all women age 65 or older would be recommended statin therapy.

Conclusion: Application of the new ACC/AHA CVD prevention guidelines to a Dutch cohort found that nearly all men age 55 or older and women age 65 or older were candidates for statin therapy.  This was a dramatic increase in statin eligible patients relative to prior ESC and ATP III guidelines. Given the near uniform statin recommendation at these age cutoffs, these findings raise questions as to the utility of the new ACC/AHA CVD risk prediction model in guiding treatment decisions.

 Summarized by Supriya Shore and Steven M. Bradley

  • Kavousi M, Leening MJ, Nanchen D, et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines for cardiovascular disease prevention in a European cohort. JAMA. 2014;311(14):1416-1423.