- Among 5 options, 3 sets of guidelines capture the most patients for statin treatment who later develop atherosclerotic cardiovascular disease (ASCVD).
- Numbers needed to treat (NNTs) to prevent 1 event are similar among the guidelines.
Why this matters
- For primary prevention, these authors give preference to the National Institute for Health and Care Excellence (NICE), Canadian Cardiovascular Society (CCS), and American College of Cardiology/American Heart Association (ACC/AHA) guidelines more than those from US Preventive Services Task Force (USPSTF) and European Society of Cardiology/European Atherosclerosis Society (ESC/EAS).
- By guidelines, sensitivity values for ASCVD events:
- CCS: 68%;
- ACC/AHA: 70%;
- NICE: 68%;
- USPSTF: 57%; and
- ESC/EAS: 24%.
- Specificity values by guidelines:
- CCS: 59%;
- ACC/AHA: 60%;
- NICE: 63%;
- USPSTF: 72%; and
- ESC/EAS: 86%.
- NNT to prevent 1 event under moderate- or high-intensity therapy by guidelines:
- CCS: 32 and 21;
- ACC/AHA: 30 and 20;
- NICE: 30 and 20;
- USPSTF: 27 and 18; and
- ESC/EAS: 29 and 20.
- Highest capture for statin eligibility was with CCS (44%); lowest was with ESC/EAS (15%).
- Population-based cohort study, Denmark, with 45,750 people ages 40-75 years, 2003-2009, with no baseline ASCVD; mean follow-up, 10.9 years.
- Funding: Aarhus University; others.
- Included only people of European ancestry in a single country.