Comparison of ACC/AHA and ESC Guideline Recommendations Following Trial Evidence for Statin Use in Primary Prevention of Cardiovascular Disease

Pavlović, Jelena; Greenland, Philip; Deckers, Jaap W.; Brugts, Jasper J.; Kavousi, Maryam; Dhana, Klodian; Ikram, M. Arfan; Hofman, Albert; Stricker, Bruno H. Ch.; Franco, Oscar H.; Leening, Maarten J.G.

doi:10.1001/jamacardio.2016.1577

Cited by 25 publications

(27 citation statements)

References 34 publications

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“…Similar recommendations have been issued by the European Atherosclerotic Society (EAS), European Society of Cardiology (ESC) [53], and the European Association for the Study of Diabetes (EASD) [54]. Based on a recent European population study, ACC/AHA and ESC prevention guidelines often do not align at the individual level [55]. …”

Section: Current Treatment Guidelinesmentioning

confidence: 99%

Treatment of Dyslipidemias to Prevent Cardiovascular Disease in Patients with Type 2 Diabetes

et al. 2017

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Purpose of Review Current preventive and treatment guidelines for type 2 diabetes have failed to decrease the incidence of comorbidities, such as dyslipidemia and ultimately heart disease. The goal of this review is to describe the physiological and metabolic lipid alterations that develop in patients with type 2 diabetes mellitus. Questions addressed include the differences in lipid and lipoprotein metabolism that characterize the dyslipidemia of insulin resistance and type 2 diabetes mellitus. We also examine the relevance of the new AHA/ADA treatment guidelines to dyslipidemic individuals. Recent Findings In this review, we provide an update on the pathophysiology of diabetic dyslipidemia, including the role of several apolipoproteins such as apoC-III. We also point to new studies and new agents for the treatment of individuals with type 2 diabetes mellitus who need lipid therapies. Summary Type 2 diabetes mellitus causes cardiovascular disease via several pathways, including dyslipidemia characterized by increased plasma levels of apoB-lipoproteins and triglycerides, and low plasma concentrations of HDL cholesterol. Treatments to normalize the dyslipidemia and reduce the risk for cardiovascular events include the following: lifestyle and medication, particularly statins, and if necessary, ezetimibe, to significantly lower LDL cholesterol. Other treatments, more focused on triglycerides and HDL cholesterol, are less well supported by randomized clinical trials and should be used on an individual basis. Newer agents, particularly the PCSK9 inhibitors, show a great promise for even greater lowering of LDL cholesterol, but we await the results of ongoing clinical trials.

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Section: Current Treatment Guidelinesmentioning

confidence: 99%

Treatment of Dyslipidemias to Prevent Cardiovascular Disease in Patients with Type 2 Diabetes

et al. 2017

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“…22 The Rotterdam Population study showed that there was little alignment between different guidelines, including US and European guidelines, when estimating global risk for CVD but over three quarters would be recommended a statin based on recent primary prevention trial based approaches. 23 However, most of the participants in these population based studies were of white European origin.…”

Section: Discussionmentioning

confidence: 99%

Statin Use in Primary Prevention: A Simple Trial-Based Approach Compared With Guideline-Recommended Risk Algorithms for Selection of Eligible Patients

Khunti

Jung

Dans

et al. 2019

Canadian Journal of Cardiology

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The Heart Outcomes Prevention Evaluation (HOPE) 3 study utilised a simple pragmatic risk factor approach to identify individuals that may benefit primary prevention therapy. Comparing outcomes using the Framingham risk score and the 2013 American College of Cardiology / American Heart Association (ACC/AHA) algorithm to outcomes seen in the HOPE-3 trial, showed similar risk reductions in cardiovascular events. However, these risk tools did not identify all participants that were eligible as when using a simple pragmatic approach.

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“…However, there is small group of patients (0.8%) at very high risk who are eligible by ESC, but not ACC/AHA guidelines. Those are patients with chronic kidney disease and significantly reduced renal function, as well as patients with heart failure who are not mentioned in US guidelines at all (14).…”

Section: Consequences Of Different Risk Calculation Modelsmentioning

confidence: 99%

Primary prevention of cardiovascular diseases: Differences between European and United States guidelines

Petrović¹

2017

Med gl Spec Bol Zlatibor

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European Society of Cardiology guidelines on primary prevention of cardiovascular diseases were published in 2016. Those guidelines are to some extent different from current set of American College of Cardiology/ American Heart Association guidelines dealing with primary prevention. Both United States and European guidelines agree that primary prevention of cardiovascular diseases is essential. Guidelines ask for individual risk calculation and agree that LDL-cholesterol is directly related to cardiovascular disease morbidity and mortality and should be adequately treated. However, there is substantial difference in risk estimation and treatment strategies in patients without established cardiovascular disease. The purpose of this short review is to underline similarities and especially difference between current primary prevention guidelines in United States and Europe, and to address advantages and disadvantages of each of these strategies.

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Comparison of ACC/AHA and ESC Guideline Recommendations Following Trial Evidence for Statin Use in Primary Prevention of Cardiovascular Disease

Cited by 25 publications

References 34 publications

Treatment of Dyslipidemias to Prevent Cardiovascular Disease in Patients with Type 2 Diabetes

Treatment of Dyslipidemias to Prevent Cardiovascular Disease in Patients with Type 2 Diabetes

Statin Use in Primary Prevention: A Simple Trial-Based Approach Compared With Guideline-Recommended Risk Algorithms for Selection of Eligible Patients

Primary prevention of cardiovascular diseases: Differences between European and United States guidelines

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