| Title: |
Eligibility for statin therapy in primary prevention: discrepancies using different guidelines in a population-based study in Switzerland |
| Authors: |
Nanchen, David; Chiolero, Arnaud; Cornuz, Jacques; Firmann, Mathieu; Marques-Vidal Pedro, Manuel; Mooser, Vincent; Paccaud, Fred; Waeber, Gérard; Vollenweider, Peter; Rodondi, Nicolas |
| Publication Year: |
2008 |
| Collection: |
Université de Lausanne (UNIL): Serval - Serveur académique lausannois |
| Description: |
Introduction: Recommendations for statin use for primary prevention of coronary heart disease (CHD) are based on estimation of the 10-year CHD risk. We compared the 10-year CHD risk assessments and eligibility percentages for statin therapy using three scoring algorithms currently used in Switzerland. Methods: We studied 5683 women and men, aged 35-75, without overt cardiovascular disease (CVD), in a population-based study in Lausanne, Switzerland. We compared the 10-year CHD risk using three scoring schemes, i.e., the Framingham risk score (FRS) from the U.S. National Cholesterol Education Program's Adult Treatment Panel III (ATP III), the PROCAM scoring scheme from the International Atherosclerosis Society (IAS), and the European risk SCORE for low-risk countries, without and with extrapolation to 60 years as recommended by the European Society of Cardiology guidelines (ESC). With FRS and PROCAM, high-risk was defined as a 10-year risk of fatal or non-fatal CHD >20% and a 10-year risk of fatal CVD >= 5% with SCORE. We compared the proportions of high-risk participants and eligibility for statin use according to these three schemes. For each guideline, we estimated the impact of increased statin use from current partial compliance to full compliance on potential CHD deaths averted over 10 years, using a success proportion of 27% for statins. Results: Participants classified at high-risk (both genders) were 5.8% according to FRS and 3.0% to the PROCAM, whereas the European risk SCORE classified 12.5% at high-risk (15.4% with extrapolation to 60 years). For the primary prevention of CHD, 18.5% of participants were eligible for statin therapy using ATP III, 16.6% using IAS, and 10.3% using ESC (13.0% with extrapolation) because ESC guidelines recommend statin therapy only in high-risk subjects. In comparison with IAS, agreement to identify eligible adults for statins was good with ATP III, but moderate with ESC (Figure). Using a population perspective, a full compliance with ATP III guidelines would reduce ... |
| Document Type: |
conference object |
| Language: |
English |
| Relation: |
Lausanne, Switzerland, 21-23 mai 2008; Swiss Medical Forum = Forum Médical Suisse; 76e Assemblée annuelle de la Société suisse de médecine interne (SGIM/SSMI); https://iris.unil.ch/handle/iris/95908; serval:BIB_194DD569B325 |
| Availability: |
https://iris.unil.ch/handle/iris/95908 |
| Accession Number: |
edsbas.99CA24DA |
| Database: |
BASE |