Eligibility for lipid-lowering therapy when applying systemic coronary risk estimation 2 according to guidelines on apparently healthy middle-Aged individuals
(2024) In European Journal of Preventive Cardiology 31(15). p.1890-1897- Abstract
Aims: To estimate the proportion eligible for lipid-lowering therapy (LLT) when using the systemic coronary risk estimation 2 (SCORE2) on apparently healthy individuals. Methods and results: Individuals aged 50-64 years were randomly invited to The Swedish Cardiopulmonary Bioimage Study (n = 30 154). Participants with previous atherosclerotic cardiovascular disease (CVD), diabetes mellitus, or chronic kidney disease were excluded. The 10-year risk of CVD was estimated using the SCORE2 equation and the multicell chart. Eligibility for LLT was estimated according to the 2021 European Society of Cardiology CVD prevention guidelines. Presence of coronary atherosclerosis was determined using coronary computed tomography angiography (CCTA).... (More)
Aims: To estimate the proportion eligible for lipid-lowering therapy (LLT) when using the systemic coronary risk estimation 2 (SCORE2) on apparently healthy individuals. Methods and results: Individuals aged 50-64 years were randomly invited to The Swedish Cardiopulmonary Bioimage Study (n = 30 154). Participants with previous atherosclerotic cardiovascular disease (CVD), diabetes mellitus, or chronic kidney disease were excluded. The 10-year risk of CVD was estimated using the SCORE2 equation and the multicell chart. Eligibility for LLT was estimated according to the 2021 European Society of Cardiology CVD prevention guidelines. Presence of coronary atherosclerosis was determined using coronary computed tomography angiography (CCTA). Among 26 570 apparently healthy individuals, 32% had high and 4% had very high 10-year CVD risk, according to the SCORE2 equation. Among high-and very-high-risk individuals, 99% had low-density lipoprotein cholesterol levels above guideline goals making 35% of the total population eligible for LLT. Of those eligible, undergoing imaging, 38% had no signs of coronary atherosclerosis according to CCTA. Using the SCORE2 chart, 52% of the population were eligible for LLT, of which 44% had no signs of coronary atherosclerosis. In those with high or very high risk, ongoing LLT was reported in 7% and another 11% received LLT within 6 months after study participation. Conclusion: Nearly all apparently healthy individuals with high and very high CVD risk, or 35% of the total population, were eligible for LLT according to guidelines, and a large proportion had no signs of atherosclerosis. Compared with the SCORE2 equation, the SCORE2 chart resulted in more individuals being eligible for LLT.
(Less)
- author
- Yari, Ali ; Ueda, Peter ; Lundman, Pia ; Alfredsson, Joakim ; Ravn-Fischer, Annica ; Söderberg, Stefan ; Yndigegn, Troels LU ; Hagström, Emil and Jernberg, Tomas
- organization
- publishing date
- 2024-10-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiovascular disease, Guidelines, Lipid-lowering therapy, Primary prevention, Risk prediction, SCORE2
- in
- European Journal of Preventive Cardiology
- volume
- 31
- issue
- 15
- pages
- 8 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:38842486
- scopus:85208772094
- ISSN
- 2047-4873
- DOI
- 10.1093/eurjpc/zwae190
- language
- English
- LU publication?
- yes
- id
- 293f9310-d7f8-42d4-9dea-b7c0ee1e7e24
- date added to LUP
- 2025-01-20 14:57:46
- date last changed
- 2025-06-10 01:35:24
@article{293f9310-d7f8-42d4-9dea-b7c0ee1e7e24,
abstract = {{<p>Aims: To estimate the proportion eligible for lipid-lowering therapy (LLT) when using the systemic coronary risk estimation 2 (SCORE2) on apparently healthy individuals. Methods and results: Individuals aged 50-64 years were randomly invited to The Swedish Cardiopulmonary Bioimage Study (n = 30 154). Participants with previous atherosclerotic cardiovascular disease (CVD), diabetes mellitus, or chronic kidney disease were excluded. The 10-year risk of CVD was estimated using the SCORE2 equation and the multicell chart. Eligibility for LLT was estimated according to the 2021 European Society of Cardiology CVD prevention guidelines. Presence of coronary atherosclerosis was determined using coronary computed tomography angiography (CCTA). Among 26 570 apparently healthy individuals, 32% had high and 4% had very high 10-year CVD risk, according to the SCORE2 equation. Among high-and very-high-risk individuals, 99% had low-density lipoprotein cholesterol levels above guideline goals making 35% of the total population eligible for LLT. Of those eligible, undergoing imaging, 38% had no signs of coronary atherosclerosis according to CCTA. Using the SCORE2 chart, 52% of the population were eligible for LLT, of which 44% had no signs of coronary atherosclerosis. In those with high or very high risk, ongoing LLT was reported in 7% and another 11% received LLT within 6 months after study participation. Conclusion: Nearly all apparently healthy individuals with high and very high CVD risk, or 35% of the total population, were eligible for LLT according to guidelines, and a large proportion had no signs of atherosclerosis. Compared with the SCORE2 equation, the SCORE2 chart resulted in more individuals being eligible for LLT.</p>}},
author = {{Yari, Ali and Ueda, Peter and Lundman, Pia and Alfredsson, Joakim and Ravn-Fischer, Annica and Söderberg, Stefan and Yndigegn, Troels and Hagström, Emil and Jernberg, Tomas}},
issn = {{2047-4873}},
keywords = {{Cardiovascular disease; Guidelines; Lipid-lowering therapy; Primary prevention; Risk prediction; SCORE2}},
language = {{eng}},
month = {{10}},
number = {{15}},
pages = {{1890--1897}},
publisher = {{Oxford University Press}},
series = {{European Journal of Preventive Cardiology}},
title = {{Eligibility for lipid-lowering therapy when applying systemic coronary risk estimation 2 according to guidelines on apparently healthy middle-Aged individuals}},
url = {{http://dx.doi.org/10.1093/eurjpc/zwae190}},
doi = {{10.1093/eurjpc/zwae190}},
volume = {{31}},
year = {{2024}},
}