Highlights
- •Applying the new ACC/AHA guideline increased the statin-eligible population from 18.7% to 21.7% as defined by ATP III in Korean health screening cohort.
- •Statin-eligible subjects as defined by ACC/AHA guideline manifested a higher proportion of subjects with CAC compared with those meeting ATP-III criteria for statin treatment.
- •ACC/AHA guideline demonstrated better prediction for CAC compared with ATP III guideline with higher odds ratio for cardiovascular disease.
Abstract
Objective
To investigate the statin eligibility and the predictabilities for cardiovascular
disease between AHA/ACC and ATPIII guidelines, comparing those results to concomitant
coronary artery calcium scores (CACS) in a large cohort of Korean individuals who
met statin-eligibility criteria.
Methods
Among 19,920 participants in a health screening program, eligibility for statin treatment
was assessed by the two guidelines. The presence and extent of coronary artery calcification
(CAC) was measured by multi-detector computed tomography and compared among the various
groups defined by the two guidelines.
Results
Applying the new ACC/AHA guideline to the health screening cohort increased the statin-eligible
population from 18.7% (as defined by ATP III) to 21.7%. Statin-eligible subjects as
defined only by ACC/AHA guideline manifested a higher proportion of subjects with
CAC compared with those meeting only ATP-III criteria even after adjustment for age
and sex (47.1 vs. 33.8%, p < 0.01). Statin-eligible subjects as defined by ACC/AHA
guideline showed higher odds ratio for the presence of CACS>0 compared with those meeting ATP-III criteria {3.493 (3.245∼3.759) vs. 2.865 (2.653∼3.094)}, which was attenuated after adjusted for age and sex.
Conclusions
In this large Korean cohort, more subjects would have qualified for statin initiation
under the new ACC/AHA guideline as compared with the proportion recommended for statin
treatment by ATP III guideline. Among statin-eligible Korean health screening subjects,
the new ACC/AHA guideline identified a greater extent of atherosclerosis as assessed
by CACS as compared to ATP III guideline assessment.
Keywords
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Article info
Publication history
Published online: March 07, 2015
Accepted:
March 5,
2015
Received in revised form:
March 4,
2015
Received:
January 2,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
