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Predicting risk of cardiovascular disease events (PREVENT) equations could greatly decrease the number of patients suitable for primary prevention statin treatment, refining treatment suggestions.
Notable differences in the eligibility for primary prevention statin therapy when using the newly introduced PREVENT equations have been uncovered in a cross-sectional study after analyzing data from the National Health and Nutrition Examination Survey in adults (aged 40 to 75 years). As suggested, fewer adults in the U.S. would qualify for statin treatment under the PREVENT model, yet a considerable proportion of those who are qualified based on these equations are not currently using statins.
The PREVENT equations, developed by the American Heart Association (AHA) in 2023, provide an updated approach to approximating the ten-year risk for atherosclerotic cardiovascular disease (ASCVD). As a modern alternative to the 2013 Pooled Cohort Equations (PCEs), it incorporates variables such as kidney function and statin usage, while removing race as a factor. In this study, the risk estimates for ASCVD in adults using both the PREVENT and PCE equations were compared, and eligible individuals for primary prevention statin therapy were evaluated according to both models.
People with a 10-year ASCVD risk of 10% or higher were eligible for statin interventions keeping in view the 2019 AHA/ACC recommendations. The PREVENT equations estimated an expressively lower risk of ASCVD than PCEs. On average, the 10-year risk was calculated at 8.0% using the PCEs, compared to merely 4.3% with the PREVENT model. This shift in risk estimation led to a dramatic decrease in the number of adults qualifying for statin therapy—from 45.4 million to 28.3 million.
In total, 17.3 million adults who were recommended statins under the PCEs no longer met the criteria with the PREVENT equations, including 4.1 million individuals already on statins. Despite the alteration in eligibility, a substantial portion of adults eligible for primary prevention statins according to the PREVENT equations were not currently taking statins. Among eligible adults, 44.1% were using statins, leaving 15.8 million adults who could profit from statin therapy but were not on treatment.
JAMA Internal Medicine
Atherosclerotic Cardiovascular Disease Risk Estimates Using the Predicting Risk of Cardiovascular Disease Events Equations
Timothy S. Anderson et al.
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