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Effectiveness of Statins as Primary Prevention in People With Different Cardiovascular Risk: A Population-Based Cohort Study

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DOI

  • Maria Garcia-Gil, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Catalonia, Spain; ISV Research Group, Research Unit in Primary Care, Catalonia, Spain.
  • ,
  • Marc Comas-Cufí, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Catalonia, Spain; ISV Research Group, Research Unit in Primary Care, Catalonia, Spain.
  • ,
  • Jordi Blanch, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Catalonia, Spain; ISV Research Group, Research Unit in Primary Care, Catalonia, Spain.
  • ,
  • Ruth Martí, Biomedical Research Institute, Girona (IdIBGi), ICS, Catalonia, Spain.
  • ,
  • Anna Ponjoan, Biomedical Research Institute, Girona (IdIBGi), ICS, Catalonia, Spain.
  • ,
  • Lia Alves-Cabratosa, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Catalonia, Spain; ISV Research Group, Research Unit in Primary Care, Catalonia, Spain.
  • ,
  • Irene Petersen
  • Jaume Marrugat, CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.
  • ,
  • Roberto Elosua, CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.
  • ,
  • María Grau, CIBER Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain.
  • ,
  • Rafel Ramos, Department of Medical Sciences, School of Medicine, University of Girona, Spain.

The purpose was to analyze statin effectiveness in a general population with differing levels of coronary heart disease (CHD) risk. Patients (35-74 years) without previous cardiovascular disease were included and stratified according to 10-year CHD risk (<5%, 5-7.4%, 7.5-9.9%, and 10-19.9%). New users were categorized according to their medical possession ratio (MPR). The main outcome was atherosclerotic cardiovascular disease (ASCVD) (myocardial infarction and ischemic stroke). In adherent patients (MPR 70%), statin treatment decreased ASCVD risk across the range of coronary risk (from 16-30%). The 5-year number needed to treat (NNT) was 470 and 204 in the risk categories <5% and 5-7.4%, respectively, and 75 and 62 in the 7.5-9.9% category than in the 10-19.9% category, respectively. Statin therapy should remain a priority in patients at high 10-year CHD risk (10-19.9%). Most patients with intermediate risk could benefit from statin treatment, but the treatment decision should focus on the net benefit, safety, and patient preference, given the higher NNT.

Original languageEnglish
JournalClinical Pharmacology and Therapeutics
Volume104
Issue4
Pages (from-to)719-732
Number of pages14
ISSN0009-9236
DOIs
Publication statusPublished - Oct 2018

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