| Title: |
Eligibility for lipid-lowering therapy when applying systemic coronary risk estimation 2 according to guidelines on apparently healthy middle-aged individuals |
| Authors: |
Yari, Ali; Ueda, Peter; Lundman, Pia; Alfredsson, Joakim; Ravn-Fischer, Annica; Söderberg, Stefan; Yndigegn, Troels; Hagström, Emil; Jernberg, Tomas |
| Publisher Information: |
Uppsala universitet, Kardiologi; Karolinska Inst, Danderyd Hosp, Dept Clin Sci, S-18288 Stockholm, Sweden.; Karolinska Inst, Dept Med, Clin Epidemiol Div, Stockholm, Sweden.; Linköping Univ, Dept Hlth Med & Caring Sci, S-58183 Linköping, Sweden.;Linköping Univ Hosp, Dept Cardiol, S-58185 Linköping, Sweden.; Univ Gothenburg, Inst Med, Dept Mol & Clin Med, S-41385 Gothenburg, Sweden.; Umeå Univ, Dept Publ Hlth & Clin Med, S-90187 Umeå, Sweden.;Umeå Univ, Heart Ctr, S-90187 Umeå, Sweden.; Lund Univ, Dept Clin Sci, S-22184 Lund, Sweden. |
| Publication Year: |
2024 |
| Collection: |
Uppsala University: Publications (DiVA) |
| Subject Terms: |
Risk prediction; Cardiovascular disease; Primary prevention; Lipid-lowering therapy; Guidelines; SCORE2; Cardiology and Cardiovascular Disease; Kardiologi och kardiovaskulära sjukdomar |
| Description: |
Aims: To estimate the proportion eligible for lipid-lowering therapy (LLT) when using the systemic coronary risk estimation 2 (SCORE2) on apparently healthy individuals. Methods and results: Individuals aged 50-64 years were randomly invited to The Swedish Cardiopulmonary Bioimage Study (n = 30 154). Participants with previous atherosclerotic cardiovascular disease (CVD), diabetes mellitus, or chronic kidney disease were excluded. The 10-year risk of CVD was estimated using the SCORE2 equation and the multicell chart. Eligibility for LLT was estimated according to the 2021 European Society of Cardiology CVD prevention guidelines. Presence of coronary atherosclerosis was determined using coronary computed tomography angiography (CCTA). Among 26 570 apparently healthy individuals, 32% had high and 4% had very high 10-year CVD risk, according to the SCORE2 equation. Among high- and very-high-risk individuals, 99% had low-density lipoprotein cholesterol levels above guideline goals making 35% of the total population eligible for LLT. Of those eligible, undergoing imaging, 38% had no signs of coronary atherosclerosis according to CCTA. Using the SCORE2 chart, 52% of the population were eligible for LLT, of which 44% had no signs of coronary atherosclerosis. In those with high or very high risk, ongoing LLT was reported in 7% and another 11% received LLT within 6 months after study participation. Conclusion: Nearly all apparently healthy individuals with high and very high CVD risk, or 35% of the total population, were eligible for LLT according to guidelines, and a large proportion had no signs of atherosclerosis. Compared with the SCORE2 equation, the SCORE2 chart resulted in more individuals being eligible for LLT. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
European Journal of Preventive Cardiology, 2047-4873, 2024, 31:15, s. 1890-1897; PMID 38842486; ISI:001252838600001 |
| DOI: |
10.1093/eurjpc/zwae190 |
| Availability: |
http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-548376; https://doi.org/10.1093/eurjpc/zwae190 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.8463F9B4 |
| Database: |
BASE |