Abstract 12490: Class I Indications for Statin Therapy in Primary Prevention by Three Cholesterol Guidelines and Risk of Incident Cardiovascular Outcomes: Multi-ethnic Study of Atherosclerosis (MESA)

Introduction: The major societal guidelines on cholesterol treatment (2013 ACC/AHA, 2004 NCEP/ATP III, and the 2011 ESC/EAS) differ in identifying patients with a class 1 recommendation for statin therapy for atherosclerotic cardiovascular disease (ASCVD). ACC/AHA emphasizes a need for clinician-patient dialogue on the risks/benefits of statins in primary prevention of ASCVD. Limited data exist on the accuracy of statin-eligibility (Class I) for ASCVD events to inform this dialogue. We assessed the accuracy of class I statin eligibility with incident ASCVD events by ACC/AHA compared with NCEP/ATP III and ESC/EAS guidelines. Methods: We evaluated the sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) of class I recommendation for statin therapy by each guideline for respective 10 yr. adjudicated incident ASCVD outcomes [NCEP/ATP III- MI, CHD death; ACC/AHA- MI, CHD death, fatal/non-fatal strokes; ESC/EAS: ASCVD death] in participants of the Multi Ethnic Stu...