Application of New Guidelines for the Primary Prevention of Atherosclerotic Cardiovascular Disease in a Korean Population

作者：Kim Nan Hee; So Min Suk; Kang Jeong Gyu; Cho Dong Sik; Byrne Christopher D; Lee Sang Jong; Sung Ki Chul^*

来源：Journal of Atherosclerosis and Thrombosis, 2015, 22(3): 293-303.

DOI：10.5551/jat.26682

• Guidelines
• Coronary artery calcium
• Statin
• Risk factor

Aim: We investigated the proportion of people who would qualify for statin treatment with an atherosclerotic cardiovascular disease (ASCVD) 10-year risk of >= 7.5% and who exhibit an LDL cholesterol (LDL-C) of 70 to 189 mg/dL according to the new ACC/AHA guidelines for the treatment of increased cardiovascular risk.
Methods: The study population (8,742 subjects) included individuals who underwent health examinations at Kangbuk Samsung Hospital in South Korea in 2010. We also evaluated the data obtained from the 2008-2010 Korea National Health and Nutrition Examination Survey (KNHANES) of 16,892 adults.
Results: Approximately 90% of men >= 60 years of age and women >= 70 years of age had an ASCVD 10-year risk of >= 7.5% and LDL-C level of >= 70 mg/dL. The proportions of subjects with a Framingham 10-year risk of >= 10%, coronary artery calcium score of > 20 and > 100 and fatty liver each increased in association with an increasing ASCVD 10-year risk quartile in both sexes. Furthermore, age was significantly associated with the ASCVD 10-year risk in both sexes (all p-value < 0.001). The KNHANES data also showed that over 85.0% of men >= 60 years of age and 95.0% of women >= 70 years of age had an ASCVD 10-year risk of >= 7.5% and an LDL-C level of >= 70 mg/dL.
Conclusions: Adopting the new ASCVD prevention guidelines would result in the treatment of almost all Korean men and women (>= 60 years and >= 70 years of age, respectively) without evidence of cardiovascular disease. Therefore, Asian-specific guidelines are needed to avoid unnecessary over treatment in an aging global population.

• 出版日期2015