Author + information
- Jeffrey L. Anderson,
- Viet T. Le,
- Heidi May,
- Kevin Johnson,
- Shanelle Cripps,
- Lesley Schwab,
- Shelbi Braun,
- Fidela L. Moreno,
- Donald Lappe,
- Kirk Knowlton and
- J. Brent Muhlestein
Severe hyperlipidemia (LDL-C >=190mg/dL) is an indication for statin therapy, with LDL-C >=160mg/dL a treatment enhancing factor (2018 AHA/ACC Cholesterol Treatment Guideline).
The CorCal Vanguard Trial randomly invited 3770 Intermountain patients of age >=50yo without ASCVD or statin use to achieve 601 consenting patients, who were randomized to risk stratification and statin treatment guided by the Pooled Cohort Equation (PCE) or by coronary artery calcium scoring (CACS). The proportions of patients with baseline LDL-C>=190 and >=160mg/dL were determined and assessed by age, sex, PCE risk category (see Table) and (when obtained) CACS.
Patient age averaged 60.2y, and 65.0% were women. 41 (1.1%) of these untreated patients had LDL-C>=190 (Table). An increased but still small percentage (1.8%, P<=0.05) achieved a high-risk PCE classification, but no differences were noted by age or sex. 292 (8.1%) had LDL-C >=160mg/dL; no differences were noted by PCE risk category or age, but a higher percentage were women (9.5% vs 5.5%, p<0.0001). Among the 302 randomized to CACS, coronary calcium was detected in 49.4%, with the difference by LDL category not reaching significance (p=0.12).
A small but important percentage of primary prevention patients with very high LDL-C remain untreated. Given their known high ASCVD risk, these patients should be targeted for increased efforts at identification, refined risk stratification, and treatment.
Posters Hall_Hall A
Sunday, March 29, 2020, 12:30 p.m.-1:15 p.m.
Session Title: Prevention: Clinical 5
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1313-104
- 2020 American College of Cardiology Foundation