Statin Eligibility Varies Significantly Between Guidelines

The number of individuals eligible for statins under various sets of guidelines from various major organizations varies significantly, with some covering more than twice the number of patients as others, according to a recent review. 

The ACC/AHA, NICE, CCS, USPSTF, and ESC/EAS have all released guidelines for the use of statins for the prevention of atherosclerotic cardiovascular disease (ASCVD) since 2013.
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In order to compare the utility of these guidelines, researchers conducted an observational study of ASCVD events during 10 years in 45,750 Danish participants, aged 40 to 75 years, from the Copenhagen General Population Study, followed by a modeling study estimating the effectiveness of the guidelines.

Overall, the percentage of participants eligible for statin use was 44% under the CCS guidelines, 42% under the ACC/AHA guidelines, 40% under the NICE guidelines, 31% under the USPSTF guidelines, and 13% for the ESC/EAS guidelines.

The estimated percentage of ASCVD events that could have been prevented by using statins for 10 years was 34% for CCS, 34% for ACC/AHA, 32% for NICE, 27% for USPSTF, and 13% for ESC/EAS.

“Guidelines recommending that more persons use statins for primary prevention of ASCVD should prevent more events than guidelines recommending use by fewer persons,” the researchers concluded.

—Michael Potts

Reference:

Mortensen MB, Nordestgaard BG. Comparison of five major guidelines for statin use in primary prevention in a contemporary general population [published online January 2, 2018]. Ann Intern Med. doi:10.7326/M17-0681.