Increases in statin eligibility to reduce cardiovascular risk according to the 2013 ACC/AHA cholesterol guidelines in the Africa Middle East region: a sub-analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study.

Autor: Hamoui O; Cardiovascular Diseases, Clemenceau Medical Center, Beirut, Lebanon. ohamoui@gmail.com., Omar MI; Medical Department, Pfizer Gulf FZ LLC, Dubai, United Arab Emirates., Raal FJ; Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa., Rashed W; Cardiology Division, Mubarak Al-kabeer Hospital, Jabriya, Kuwait., Kane A; Department of Cardiology, Dakar University, Hopital General de Grand yoff, Dakar, Senegal., Alami M; Private Practice, Casablanca, Morocco., Abreu P; Pfizer Inc, New York, NY, USA., Mashhoud W; Pfizer Saudi Limited, Jeddah, KSA, Saudi Arabia., Alsheikh-Ali AA; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Jazyk: angličtina
Zdroj: BMC cardiovascular disorders [BMC Cardiovasc Disord] 2019 Mar 15; Vol. 19 (1), pp. 61. Date of Electronic Publication: 2019 Mar 15.
DOI: 10.1186/s12872-019-1034-2
Abstrakt: Background: With development of cholesterol management guidelines by the American College of Cardiology/American Heart Association (ACC/AHA), more individuals at risk of cardiovascular disease may be eligible for statin therapy. It is not known how this affects statin eligibility in the Africa and Middle East Region.
Methods: Data were used from the Africa Middle East Cardiovascular Epidemiological (ACE) study. The percentage of subjects eligible for statins per the ACC/AHA 2013 cholesterol guidelines and the 2002 National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) recommendations were compared. Analyses were carried out according to age, gender, community (urban/rural), and country income categories based on World Bank definitions.
Results: According to the ACC/AHA recommendations, 1695 out of 4378 subjects (39%; 95% confidence interval [CI], 37-40%) satisfied statin eligibility criteria vs. 1043/4378 (24%; 95% CI, 23-25%) per NCEP-ATP recommendations, representing a 63% increase in statin eligibility. Consistent increases in eligibility for statin therapy were seen according to the ACC/AHA vs. NCEP-ATP guidelines across sub-groups of age, gender, community, and country income. Notable increases for statin eligibility according to ACC/AHA vs. NCEP-ATP were seen, respectively, in subjects aged ≥65 years (86% vs. 39%), in males (46% vs. 25%), in low-income countries (28% vs. 14%), and rural communities (37% vs. 19%).
Conclusion: An increase in statin eligibility was seen applying ACC/AHA cholesterol guidelines compared with previous NCEP-ATP recommendations in the Africa Middle East region. The economic consequences of these guideline recommendations will need further research.
Trial Registration: The ACE trial is registered under NCT01243138 .
Databáze: MEDLINE
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