2013 ACC/AHA Cholesterol Guideline Versus 2004 NCEP ATP III Guideline in the Prediction of Coronary Artery Calcification Progression in a Korean Population

Cho, Yun Kyung; Jung, Chang Hee; Kang, Yu Mi; Hwang, Jenie Yoonoo; Kim, Eun Hee; Yang, Dong Hyun; Kang, Joon‐Won; Park, Joong‐Yeol; Kim, Hong‐Kyu; Lee, Woo Je

doi:10.1161/jaha.116.003410

Cited by 17 publications

(11 citation statements)

References 42 publications

(109 reference statements)

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“…40–42 The current approach also has an acceptable number-needed-to-treat to prevent a ASCVD event 43 and is cost-effective by current standards. 44 It is estimated that the 2013 ACC/AHA guideline approach to cholesterol reduction could reduce the number of ASCVD events in the United States by 475,000 in the next decade, compared with the ATP III guideline approach, most of which would occur in older individuals who are at highest risk for ASCVD.…”

Section: Rationalementioning

confidence: 99%

Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology

Lloyd‐Jones

Huffman

Karmali³

et al. 2017

Circulation

110

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The Million Hearts Initiative has a goal of preventing 1 million heart attacks and strokes—the leading causes of mortality—through several public health and healthcare strategies by 2017. The American Heart Association and American College of Cardiology support the program. The Cardiovascular Risk Reduction Model was developed by Million Hearts and the Center for Medicare & Medicaid Services as a strategy to asses a value-based payment approach toward reduction in 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) by implementing cardiovascular preventive strategies to manage the “ABCS” (aspirin therapy in appropriate patients, blood pressure control, cholesterol management, and smoking cessation). The purpose of this special report is to describe the development and intended use of the Million Hearts Longitudinal ASCVD Risk Assessment Tool. The Million Hearts Tool reinforces and builds on the “2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk” by allowing clinicians to estimate baseline and updated 10-year ASCVD risk estimates for primary prevention patients adhering to the appropriate ABCS over time, alone or in combination. The tool provides updated risk estimates based on evidence from high-quality systematic reviews and meta-analyses of the ABCS therapies. This novel approach to personalized estimation of benefits from risk-reducing therapies in primary prevention may help target therapies to those in whom they will provide the greatest benefit, and serves as the basis for a Center for Medicare & Medicaid Services program designed to evaluate the Million Hearts Cardiovascular Risk Reduction Model.

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Section: Rationalementioning

confidence: 99%

Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology

Lloyd‐Jones

Huffman

Karmali³

et al. 2017

Circulation

110

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“…Recently, Cho et al . 19 reported a higher proportion of eligible candidates for statin therapy according to the ACC/AHA guidelines compared to the ATP-III guidelines in a Korean population (55.0% vs 20.5%); this increase was more evident in people aged >60 years (84.5% vs 26.1%). Overall, it should be taken into account that the risk assessment tools of the two guidelines differ from each other and the ACC/AHA uses a pooled cohort equation to estimate both CHD and stroke events which their prevalence increases in the older population.…”

Section: Discussionmentioning

confidence: 95%

The Burden of Statin Therapy based on ACC/AHA and NCEP ATP-III Guidelines: An Iranian Survey of Non-Communicable Diseases Risk Factors

Asgari

Abdi

Hezaveh

et al. 2018

Sci Rep

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To compare the burden of statin therapy according to the Third Adult Treatment Panel (ATP-III) and the American College of Cardiology/American Heart Association (ACC/AHA) guidelines the Survey of Risk Factors of Non-Communicable Disease (SuRFNCD)−2011of Iran was used. A survey analysis associated with sex and age categorization was run. Of total 3496 persons (1322 men) aged 40–70 years, based on the ACC/AHA guidelines, about 46.5% were eligible to receive moderate- to high-intensity statin therapy. Based on the ATP-III guidelines, 17.0% were considered as needing statin drugs. Among adults aged <60 years, the proportion of those who were eligible for statin therapy was higher (38.3%) according to the ACC/AHA guidelines compared to the ATP-III guidelines (15.2%), a difference more prominent in adults aged ≥60 years (85.2% versus 25.0%). Agreement between the two guidelines was low (kappa: 0.32). Compared to the ATP-III guidelines, the ACC/AHA guidelines increase the number of adults eligible for statin therapy in an Iraninan population from 2.5 million to 7.0 million people according to the 2011 census, specifically in those aged ≥ 60 years, a finding in agreement with those of studies from different countries.

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“…24 Cholesterol cutoff for determining hyperlipidemia was greater than 200 mg/dL of total cholesterol based on the Adult Panel III guidelines. 25…”

Section: Methodsmentioning

confidence: 99%

Multimorbidity Trends in United States Adults, 1988–2014

2018

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Importance:The simultaneous presence of multiple conditions in one patient (multi-morbidity) is a key challenge facing primary care.Objective: The purpose of this study was to determine the prevalence of multi-morbidity and to document changes in prevalence during the last 25 years.Design/Setting: Cross-sectional study using multiple years (1988 -2014) Results: A total of 57,303 individuals were surveyed regarding the presence of multi-morbidity in separate surveys spanning 1988 -2014. The overall current prevalence in 2013-2014 of >2 morbidities was 59.6% (95% CI 58.1%-61.1%), 38.5% had 3 or more, and 22.7% had 4 or more morbidities, which was significantly higher than in 1988 (45.7%, 95% CI 43.5%-47.8%, with >2 morbidities). Among individuals with 2 or more morbidities, 54.1% have obesity compared to 41.9% in 1988. Among adults age >65, prevalence was 91.8% for 2 or more morbidities. Whites and Blacks had significantly higher prevalence (59.2% and 60.1%) than Hispanic or "other" race (45.0%, P < .0001). Women (58.4%) had more current multi-morbidities (>2) than men (55.9%, P ‫؍‬ .01). The simultaneous presence of multiple conditions in one patient (multimorbidity) is a key challenge in primary care. Multimorbidity adds to the complexity of care and threatens the quality, coordination, continuity, and safety of care in the United States health care system and elsewhere. Despite the seriousness and far-reaching impacts of this phenomenon, characterization of this population in recent studies has focused on older populations, include a limited number of chronic conditions, and often do not include obesity as a chronic condition. [1][2][3][4][5][6][7][8] The burden on patients with multimorbidity is considerable and is associated with increased mortality. Conclusions and9-12 A recent meta-analysis by Nunes and colleagues 10 included 5806 multimorbidity studies, and mortality (26 studies were included) demonstrated a hazard ratio of 1.73 (95% CI, 1.41-2.13) and 2.72 (95% CI, 1.81-4.08) for people with 2 or more and 3 or more morbidities, respectively. This article was externally peer reviewed.

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2013 ACC/AHA Cholesterol Guideline Versus 2004 NCEP ATP III Guideline in the Prediction of Coronary Artery Calcification Progression in a Korean Population

Cited by 17 publications

References 42 publications

Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology

Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology

The Burden of Statin Therapy based on ACC/AHA and NCEP ATP-III Guidelines: An Iranian Survey of Non-Communicable Diseases Risk Factors

Multimorbidity Trends in United States Adults, 1988–2014

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