PDF
ePub
Citation
Print
Abstract
The new 2013 ACC/AHA Guideline is quite different from the previous NCEP-ATP III or ESC/EAS guidelines. Although the guideline is simplified and aimed at prevention of ASCVD rather than control of lipid levels, it also raises many questions and debates. If Koreaadopts the new guideline, the number of people to be treated with statins will increase dramatically, which would pose a large costburden on the medical system. Young people with high lifetime ASCVD risk according to the Pooled Cohort Equation would be administered high- or moderate-intensity statins at an earlier stage, and the older generations would likely be overtreated. The equation should be validated in populations other than non-Hispanic whites and African-Americans before final approval as a valid tool for risk calculation. Studies of Korean populations, including several observational epidemiologic studies and RCTs, are required to validate the new guideline in Korea.
References
1. Stone NJ, Robinson J, Lichtenstein AH, Merz CN, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM, McBride P, Schwartz JS, Shero ST, Smith SC Jr, Watson K, Wilson PW. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2013 Nov 12 [Epub].http://dx.doi. org/10.1161/01.cir.0000437738.63853.7a.
2. Wenger NK. Prevention of cardiovascular disease: highlights for the clinician of the 2013 american college of cardiology/american heart association guidelines. Clin Cardiol. 2014; 37:239–51.
3. Tripolt NJ, Sourij H. New American College of Cardiology and American Heart Association cholesterol treatment guidelines: subjects with Type 2 diabetes are under treated with high-intensity statins. Diabet Med 2014 Feb 25 [Epub].http://dx.doi.org/10.1111/dme.12420.
4. Ray KK, Kastelein JJ, Matthijs Boekholdt S, Nicholls SJ, Khaw KT, Ballantyne CM, Catapano AL, Reiner Z, Lüscher TF. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011. Eur Heart J. 2014; 35:960–8.
5. The National Lipid Assciation Statement on the 2013 ACC/AHA Guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults [Internet]. Jacksonville: National Lipid Association;c2014. [cited 2014 Jan 25]. Available from:. http://www.lipid.org/nla/2013-accaha-guideline-treatment-blood-cholesterol-reduce-atheroscleotic-cardiovascularrisk.
6. The American Association of Clinical Endocrinologists. Press statement on 2013 ACC/AHA guidelines [Internet]. Jacksonville: American Association of Clinical Endocrinologists;c2014. [cited 2014 Jan 25]. Available from:. http://media.aace.com/press-release/press-statement.
7. Ridker PM, Cook NR. Statins: new American guidelines for prevention of cardiovascular disease. Lancet. 2013; 382:1762–5.
8. Kolata G. Risk calculator for cholesterol appears flawed [Internet]. New York: The New York Times Company;c2013. [cited 2014 Jan 25]. Available from:. http://www. nytimes.com/2013/11/18/health/risk-calculator-for-cholesterol-appears-flawed.html?_r=0.
9. Myerson M, Rosenson RS. 2013 ACC/AHA Guideline: A Guideline for the Population-Without Evidence from the Population. Cardiovasc Drugs Ther 2014 Mar 8 [Epub].http://dx.doi.org/10.1007/s10557-014–6513–1.
10. Robinson JG. 2013 ACC/AHA cholesterol guideline for reducing cardiovascular risk: what is so controversial? Curr Atheroscler Rep. 2014; 16:413.
XML Download