Abstract 18387: Comparison of Application of the 2013 ACC/AHA Guidelines and Adult Treatment Panel III Guidelines for Cardiovascular Disease Prevention in Asian Population: Result From Korean Health Cohort
Introduction: The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for cholesterol management defined new eligibility criteria for statin therapy. Implications of the new guideline’s threshold and model have not been addressed in Asian populations or compared with previous guidelines.
Objective: To determine population-wide implications of the ACC/AHA and the Adult Treatment Panel III (ATP-III) using a cohort of Korean Health Examination aged between 40 and 75 years.
Methods: We included 338,332 individuals who underwent health check-up in 2009~2010 and followed them until December 2013. We calculated 10-year risks for hard ASCVD events (including fatal and nonfatal coronary heart disease [CHD] and stroke). We calculated proportions of individuals for whom statins would be recommended in each guidelines and determined calibration and discrimination of risk models.
Results: Current statin users were 20.4% (69,163). Among non-statin users, Statins would be recommended for 33.0% (n = 111,600) by the ACC/AHA and 14.8% (n = 50,023) by the ATP-III. Cumulative incidence of hard ASCVD events was 2.1% (n = 7,145) during mean follow up of 4.6 years. Participants who were statin eligible by ACC/AHA had increased hazard ratios for incident ASCVD compared with those eligible by ATP III: 1.28 (95% CI, 1.18-1.39) vs. 1.06 (95% CI, 0.99-1.14), respectively in multivariable analysis. Participants who were newly statin eligible (n = 65,806 [19.5%]) had an incident ACCVD rate of 3.0% increased hazard ratio (1.28, 95% CI, 1.17~1.40).
Conclusions: In this Asian population aged between 40~75 years, the ACC/AHA guidelines for determining statin eligibility, compared with the ATP III, were associated with better accuracy and efficiency in identifying increased risk of incident ASCVD.
Author Disclosures: S. Shin: None. H. Lim: None. D. Jeon: None.
- © 2016 by American Heart Association, Inc.