TY - JOUR
T1 - The Projected Impact of Population-Wide Achievement of LDL Cholesterol <70 mg/dL on the Number of Recurrent Events Among US Adults with ASCVD
AU - McKinley, Emily C.
AU - Bittner, Vera A.
AU - Brown, Todd M.
AU - Chen, Ligong
AU - Exter, Jason
AU - Farkouh, Michael E.
AU - Huang, Lei
AU - Jackson, Elizabeth A.
AU - Levitan, Emily B.
AU - Orroth, Kate K.
AU - Reading, Stephanie R.
AU - Rosenson, Robert S.
AU - Safford, Monika M.
AU - Woodward, Mark
AU - Muntner, Paul
AU - Colantonio, Lisandro D.
N1 - Funding Information:
The design and conduct of the study, interpretation of the results, and preparation of the manuscript were supported through a research grant from Amgen, Inc. (Thousand Oaks, CA). The academic authors conducted all analyses and maintained the rights to publish this article. The REGARDS study is supported by a cooperative agreement U01 NS041588 co-funded by the National Institute of Neurological Disorders and Stroke and the National Institute on Aging, National Institutes of Health, Department of Health and Human Service. Representatives of the funding agency have been involved in the review of the manuscript but not directly involved in the collection, management, analysis, or interpretation of the data. Additional support was provided by grants R01 HL080477 and K24 HL111154 from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke or the National Institutes of Health. The authors thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions and further information about the study can be found at http://www.regardsstudy.org .
Funding Information:
ECM receives research support from Amgen, Inc. VAB receives research support from Amgen, Inc.; serves on the executive steering committee of the ODYSSEY OUTCOMES trial (Sanofi); as National Coordinator for STRENGTH (Astra Zeneca), DalGene (Dalcor), and CLEAR (Esperion); and as local site investigator for ORION IV (Novartis). She served as a consultant to Sanofi in 2018 and is currently consulting for Pfizer. TMB receives research support from Amgen, Inc. and served as the local site investigator for STRENGTH (Astra Zeneca). EAJ receives research support from Amgen, Inc. and NIH; consulting fees from the American College of Cardiology and McKesson; expert witness for DeBlase Brown Everly, LLP; royalties from UpToDate, Inc.; and editor for the American Heart Association. MEF receives research support from Amgen, Inc., Novo Nordisk, and Novartis. EBL receives research support from Amgen, Inc. and consulting fees from Novartis. RSR receives research support from Amgen, Inc., Astra Zeneca, Novartis, and Regeneron; consulting fees from Amgen, Inc., Amryt, C5, CVS Caremark, Novartis, Regeneron, and 89 Bio; honoraria from Amgen, Inc., Kowa, and Regeneron; and royalties from Wolters Kluwer (UpToDate, Inc.) and has stock in MediMergent, LLC. MMS receives research support from Amgen, Inc. MW serves as a consultant for Amgen, Inc., Freeline, and Kyowa Kirin. JE, KKO, and SRR are employees of and have stock in Amgen, Inc. PM receives research support and consulting fees from Amgen, Inc. LDC receives research support from Amgen, Inc. No other disclosures were reported.
Funding Information:
This work was funded by Amgen Inc., Thousand Oaks, CA.
Publisher Copyright:
© 2021, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/2
Y1 - 2023/2
N2 - Purpose: Adults with atherosclerotic cardiovascular disease (ASCVD) are recommended high-intensity statins, with those at very high risk for recurrent events recommended adding ezetimibe and/or a proprotein convertase subtilisin/kexin type 9 inhibitor if their low-density lipoprotein cholesterol (LDL-C) is ≥70 mg/dL. We estimated the number of recurrent ASCVD events potentially averted if all adults in the United States (US) ≥45 years of age with ASCVD achieved an LDL-C <70 mg/dL. Methods: The number of US adults with ASCVD and LDL-C ≥70 mg/dL was estimated from the National Health and Nutrition Examination Survey 2009–2016 (n = 596). The 10-year cumulative incidence of recurrent ASCVD events was estimated from the REasons for Geographic And Racial Differences in Stroke study (n = 5390), weighted to the US population by age, race, and sex. The ASCVD risk reduction by achieving an LDL-C <70 mg/dL was estimated from meta-analyses of lipid-lowering treatment trials. Results: Overall, 14.7 (95% CI, 13.7–15.8) million US adults had ASCVD, of whom 11.6 (95% CI, 10.6–12.5) million had LDL-C ≥70 mg/dL. The 10-year cumulative incidence of ASCVD events was 24.3% (95% CI, 23.2–25.6%). We projected that 2.823 (95% CI, 2.543–3.091) million ASCVD events would occur over 10 years among US adults with ASCVD and LDL-C ≥70 mg/dL. Overall, 0.634 (95% CI, 0.542–0.737) million ASCVD events could potentially be averted if all US adults with ASCVD achieved and maintained LDL-C <70 mg/dL. Conclusion: A substantial number of recurrent ASCVD events could be averted over 10 years if all US adults with ASCVD achieved, and maintained, an LDL-C <70 mg/dL.
AB - Purpose: Adults with atherosclerotic cardiovascular disease (ASCVD) are recommended high-intensity statins, with those at very high risk for recurrent events recommended adding ezetimibe and/or a proprotein convertase subtilisin/kexin type 9 inhibitor if their low-density lipoprotein cholesterol (LDL-C) is ≥70 mg/dL. We estimated the number of recurrent ASCVD events potentially averted if all adults in the United States (US) ≥45 years of age with ASCVD achieved an LDL-C <70 mg/dL. Methods: The number of US adults with ASCVD and LDL-C ≥70 mg/dL was estimated from the National Health and Nutrition Examination Survey 2009–2016 (n = 596). The 10-year cumulative incidence of recurrent ASCVD events was estimated from the REasons for Geographic And Racial Differences in Stroke study (n = 5390), weighted to the US population by age, race, and sex. The ASCVD risk reduction by achieving an LDL-C <70 mg/dL was estimated from meta-analyses of lipid-lowering treatment trials. Results: Overall, 14.7 (95% CI, 13.7–15.8) million US adults had ASCVD, of whom 11.6 (95% CI, 10.6–12.5) million had LDL-C ≥70 mg/dL. The 10-year cumulative incidence of ASCVD events was 24.3% (95% CI, 23.2–25.6%). We projected that 2.823 (95% CI, 2.543–3.091) million ASCVD events would occur over 10 years among US adults with ASCVD and LDL-C ≥70 mg/dL. Overall, 0.634 (95% CI, 0.542–0.737) million ASCVD events could potentially be averted if all US adults with ASCVD achieved and maintained LDL-C <70 mg/dL. Conclusion: A substantial number of recurrent ASCVD events could be averted over 10 years if all US adults with ASCVD achieved, and maintained, an LDL-C <70 mg/dL.
KW - Atherosclerotic cardiovascular disease
KW - Low-density lipoprotein cholesterol
KW - Population attributable risk
KW - Secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85116303846&partnerID=8YFLogxK
U2 - 10.1007/s10557-021-07268-x
DO - 10.1007/s10557-021-07268-x
M3 - Article
AN - SCOPUS:85116303846
SN - 0920-3206
VL - 37
SP - 107
EP - 116
JO - Cardiovascular Drugs and Therapy
JF - Cardiovascular Drugs and Therapy
IS - 1
ER -