01 Jul 2013 ACC/AHA Cholesterol Guidelines Increase Number Of Adults Eligible For Statin Therapy
Medical Research: What is the background for this study? What are the main findings?
Response: The applicability and potential clinical effects of the 2013 ACC/AHA cholesterol guidelines on major cardiovascular outcomes in the “real-world” population remains uncertain and also should also be evaluated in multiple groups of various ethnic backgrounds. We determined the proportions of adult persons eligible for statin therapy by changes of 2013 ACC/AHA cholesterol guidelines using a nationally representative sample from an Asian country (South Korea) and also we evaluated the potential clinical effects of this cholesterol guideline on future cardiovascular outcomes using an external validation cohort from the Korean National Health Examination.
Similar to findings from the United States and the European cohort, our study showed that the 2013 ACC/AHA guidelines would substantially increase the number of adults who would be potentially eligible for statin therapy in Korean population. In addition, the 2013 ACC/AHA guidelines would have identified more cases with higher events of cardiovascular disease (CVD) for statin treatment than the ATP-III guidelines.
Medical Research: What should clinicians and patients take away from your report?
Response: The applicability of 2013 cholesterol guidelines in Asian populations, who account for more than 60% of the world population, and the potential clinical effects of these guidelines on future CVD events remains unclear given considerable differences in the risks of coronary heart disease (CHD) and the rates of cardiovascular events in an Asian population. The present study might provide valuable clinical information to the physicians for the treatment of cholesterol targeting Asian populations and also suggest the related effects of 2013 cholesterol guidelines on CVD outcomes.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: In our study, given lower basal event rates in the Korean population compared with the US population, the pooled cohort equations tended to overestimate atherosclerotic cardiovascular disease (ASCVD) risk when applied to adults in Korea, particularly among adults at the highest levels of predicted risk. Therefore, further researches regarding implementing a country- or ethnic-specific risk equation and setting appropriate population-wide thresholds are required to facilitate better clinical decision-making in the Asian population.
Duk-Woo Park, MD, PhD., & Professor, Division of Cardiology (2015). 2013 ACC/AHA Cholesterol Guidelines Increase Number Of Adults Eligible For Statin Therapy