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Real-life evaluation of European and American high-risk strategies for primary prevention of cardiovascular disease in patients with first myocardial infarction.

Mortensen MB, Falk E - BMJ Open (2014)

Bottom Line: In younger patients (age 40-60), 62% of men and 13% of women qualified for statin therapy by ACC/AHA criteria, compared with only 2% of men and no women using the ESC criteria recommended for most non-Eastern European countries.In those 60-75 years of age, the ACC/AHA guidelines captured all men and 85% of women, compared with 12% and 2%, respectively, using the new ESC guideline.The 2012 ESC guidelines differ substantially from the 2013 ACC/AHA and 2014 NICE/UK guidelines in ability to secure statin therapy to those destined for a first MI.

View Article: PubMed Central - PubMed

Affiliation: Atherosclerosis Research Unit, Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

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Eligibility for statin therapy by ACC/AHA versus NICE/UK. Predicted risk estimated by the pooled cohort equations (PCE) and the QRISK2-2013 risk equation correlated strongly (Spearman's r 0.94 in men and 0.97 in women; p<0.0001). Compared with PCE risk ≥7.5%, QRISK ≥20% (indication for statin therapy in the previous NICE guideline) identified much fewer patients with first myocardial infarction, whereas QRISK ≥10% (indication for statins in the 2014 NICE update) identified nearly the same patients, especially among women. For PCE <7.5%, y=0.6385*x+2.171 in men, and y=1.308*x+0.2708 in women.
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BMJOPEN2014005991F3: Eligibility for statin therapy by ACC/AHA versus NICE/UK. Predicted risk estimated by the pooled cohort equations (PCE) and the QRISK2-2013 risk equation correlated strongly (Spearman's r 0.94 in men and 0.97 in women; p<0.0001). Compared with PCE risk ≥7.5%, QRISK ≥20% (indication for statin therapy in the previous NICE guideline) identified much fewer patients with first myocardial infarction, whereas QRISK ≥10% (indication for statins in the 2014 NICE update) identified nearly the same patients, especially among women. For PCE <7.5%, y=0.6385*x+2.171 in men, and y=1.308*x+0.2708 in women.

Mentions: Ranking patients with first MI by predicted risk estimated by PCE and the QRISK risk calculator correlated strongly (figure 3). A PCE risk of 7.5% corresponded to a risk of 7% in men and 10.1% in women estimated by QRISK (table 3). Thus, with the 2014 NICE/UK recommendation to lower the QRISK-based threshold for statin therapy from 20% to 10%, the eligibility for primary prevention with statins is nearly similar in the USA and the UK (figures 2 and 3).


Real-life evaluation of European and American high-risk strategies for primary prevention of cardiovascular disease in patients with first myocardial infarction.

Mortensen MB, Falk E - BMJ Open (2014)

Eligibility for statin therapy by ACC/AHA versus NICE/UK. Predicted risk estimated by the pooled cohort equations (PCE) and the QRISK2-2013 risk equation correlated strongly (Spearman's r 0.94 in men and 0.97 in women; p<0.0001). Compared with PCE risk ≥7.5%, QRISK ≥20% (indication for statin therapy in the previous NICE guideline) identified much fewer patients with first myocardial infarction, whereas QRISK ≥10% (indication for statins in the 2014 NICE update) identified nearly the same patients, especially among women. For PCE <7.5%, y=0.6385*x+2.171 in men, and y=1.308*x+0.2708 in women.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4201996&req=5

BMJOPEN2014005991F3: Eligibility for statin therapy by ACC/AHA versus NICE/UK. Predicted risk estimated by the pooled cohort equations (PCE) and the QRISK2-2013 risk equation correlated strongly (Spearman's r 0.94 in men and 0.97 in women; p<0.0001). Compared with PCE risk ≥7.5%, QRISK ≥20% (indication for statin therapy in the previous NICE guideline) identified much fewer patients with first myocardial infarction, whereas QRISK ≥10% (indication for statins in the 2014 NICE update) identified nearly the same patients, especially among women. For PCE <7.5%, y=0.6385*x+2.171 in men, and y=1.308*x+0.2708 in women.
Mentions: Ranking patients with first MI by predicted risk estimated by PCE and the QRISK risk calculator correlated strongly (figure 3). A PCE risk of 7.5% corresponded to a risk of 7% in men and 10.1% in women estimated by QRISK (table 3). Thus, with the 2014 NICE/UK recommendation to lower the QRISK-based threshold for statin therapy from 20% to 10%, the eligibility for primary prevention with statins is nearly similar in the USA and the UK (figures 2 and 3).

Bottom Line: In younger patients (age 40-60), 62% of men and 13% of women qualified for statin therapy by ACC/AHA criteria, compared with only 2% of men and no women using the ESC criteria recommended for most non-Eastern European countries.In those 60-75 years of age, the ACC/AHA guidelines captured all men and 85% of women, compared with 12% and 2%, respectively, using the new ESC guideline.The 2012 ESC guidelines differ substantially from the 2013 ACC/AHA and 2014 NICE/UK guidelines in ability to secure statin therapy to those destined for a first MI.

View Article: PubMed Central - PubMed

Affiliation: Atherosclerosis Research Unit, Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

Show MeSH
Related in: MedlinePlus