The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of cholesterol are more accurate and efficient in identifying increased risk of cardiovascular disease (CVD) events and the presence of subclinical coronary artery disease, when compared with 2004 guidelines, according to a study published in the July 14 issue of JAMA.
Udo Hoffmann, MD, MPH, and colleagues compared the 2013 guidelines against the National Cholesterol Education Program’s 2004 Updated Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) in 2,435 people who were not on lipid-lowering treatment. The researchers found that more study subjects were eligible for statin treatment when applying the 2013 ACC/AHA guidelines than ATP III guidelines (39% vs. 14%). With ATP III, 7% of those eligible for statin treatment developed incident CVD, compared with 2% of participants who were not eligible for statin therapy. According to the ACC/AHA guidelines, 6% of those eligible for statin treatment developed incident CVD, compared with 1% among those who were not eligible. Participants with coronary artery calcification were more likely to be eligible for statin treatment according to the ACC/AHA guidelines than per the ATP III guidelines.
The authors noted that the benefit of the ACC/AHA guidelines may be that they identify many more statin-eligible people who have a similarly high event rate as with the ATP III guidelines.