TY - JOUR
T1 - Evaluating a Simple Approach to Identify Adults Meeting the 2018 AHA/ACC Cholesterol Guideline Definition of Very High Risk for Atherosclerotic Cardiovascular Disease
AU - Muntner, Paul
AU - Orroth, Kate K.
AU - Mues, Katherine E.
AU - Exter, Jason
AU - Shannon, Erin D.
AU - Zaha, Rebecca
AU - Rosenson, Robert S.
AU - Jackson, Elizabeth A.
N1 - Funding Information:
The design and conduct of the study, interpretation of the results, and preparation of the manuscript were supported through a grant from Amgen, Inc. (Thousand Oaks, CA).
Funding Information:
K.K.O., K.E.M., J.E., E.D.S., and R.Z. are employed by Amgen, Inc. K.K.O., K.E.M., and J.E. also have stock in Amgen, Inc. E.A.J., R.S.R., and P.M. receive research support from Amgen, Inc. R.S.R. also receives research support from the Medicines Company, Novartis, Novo Nordisk, and Regeneron; consulting fees from Amgen, C5, CVS Caremark and Corvidia; honoraria from Amgen, Kowa, Pfizer, Regeneron and 89bio; royalties from UpToDate, Inc.; and has stock ownership in MediMergent, LLC. E.A.J. receives royalties from UpToDate.
Publisher Copyright:
© 2021, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/6
Y1 - 2022/6
N2 - Purpose: The 2018 American Heart Association/American College of Cardiology (AHA/ACC) cholesterol guideline defines very high atherosclerotic cardiovascular disease (ASCVD) risk as a history of ≥ 2 major ASCVD events or 1 major ASCVD event and multiple high-risk conditions. We tested if a simplified approach, having a history of a major ASCVD event, would identify a high proportion of patients that meet the 2018 AHA/ACC cholesterol guideline criteria for very high risk. Methods: We analyzed data from US adults with health insurance in the MarketScan database who had experienced an acute coronary syndrome in the past year (recent ACS, n = 3626), a myocardial infarction (MI) other than a recent ACS (n = 7572), an ischemic stroke (n = 3551), or symptomatic peripheral artery disease (PAD, n = 5919). Patients were followed from January 1, 2016, through December 31, 2017, for recurrent ASCVD events. Results: Among 16,344 patients with a history of a major ASCVD event, 94.0% met the 2018 AHA/ACC cholesterol guideline definition for very high risk including 92.9%, 96.5%, 93.1%, and 96.2% with a recent ACS, history of MI, history of stroke, and symptomatic PAD, respectively. The incidence of ASCVD events per 1000 person-years was 50.4 (95% CI: 47.6–53.3) among all patients with a history of a major ASCVD event versus 53.1 (95% CI: 50.1–56.1) among patients who met the 2018 AHA/ACC cholesterol guideline definition of very high risk. Conclusion: The vast majority of patients with a recent ACS, history of MI, ischemic stroke, or symptomatic PAD meet the 2018 AHA/ACC cholesterol guideline definition of very high risk.
AB - Purpose: The 2018 American Heart Association/American College of Cardiology (AHA/ACC) cholesterol guideline defines very high atherosclerotic cardiovascular disease (ASCVD) risk as a history of ≥ 2 major ASCVD events or 1 major ASCVD event and multiple high-risk conditions. We tested if a simplified approach, having a history of a major ASCVD event, would identify a high proportion of patients that meet the 2018 AHA/ACC cholesterol guideline criteria for very high risk. Methods: We analyzed data from US adults with health insurance in the MarketScan database who had experienced an acute coronary syndrome in the past year (recent ACS, n = 3626), a myocardial infarction (MI) other than a recent ACS (n = 7572), an ischemic stroke (n = 3551), or symptomatic peripheral artery disease (PAD, n = 5919). Patients were followed from January 1, 2016, through December 31, 2017, for recurrent ASCVD events. Results: Among 16,344 patients with a history of a major ASCVD event, 94.0% met the 2018 AHA/ACC cholesterol guideline definition for very high risk including 92.9%, 96.5%, 93.1%, and 96.2% with a recent ACS, history of MI, history of stroke, and symptomatic PAD, respectively. The incidence of ASCVD events per 1000 person-years was 50.4 (95% CI: 47.6–53.3) among all patients with a history of a major ASCVD event versus 53.1 (95% CI: 50.1–56.1) among patients who met the 2018 AHA/ACC cholesterol guideline definition of very high risk. Conclusion: The vast majority of patients with a recent ACS, history of MI, ischemic stroke, or symptomatic PAD meet the 2018 AHA/ACC cholesterol guideline definition of very high risk.
KW - Cholesterol
KW - Guidelines
KW - Risk prediction
UR - http://www.scopus.com/inward/record.url?scp=85102050421&partnerID=8YFLogxK
U2 - 10.1007/s10557-021-07167-1
DO - 10.1007/s10557-021-07167-1
M3 - Article
C2 - 33661432
AN - SCOPUS:85102050421
VL - 36
SP - 475
EP - 481
JO - Cardiovascular Drugs and Therapy
JF - Cardiovascular Drugs and Therapy
SN - 0920-3206
IS - 3
ER -