This article is more than 5 years old. Information may no longer be current.
AHA/ACC lipid guidelines not cost-effective for atherosclerotic CVD
SAN FRANCISCO — The new American Heart Association and American College of Cardiology cholesterol guidelines on diabetes care and prevention are not cost-effective for patients with atherosclerotic CVD, according to data presented at the American Diabetes Association’s 74th Scientific Sessions.
“The new ACC/AHA’s cholesterol guidelines are a paradigm shift with respect to CVD primary prevention,” Xiaohui Zhuo, PhD, Division of Diabetes Translation at the CDC, said during a presentation here. “These will have large implications for diabetes care, particularly for CVD primary prevention care.”
The guidelines, introduced in November 2013, divide patients into four groups: those with CVD; those with LDL greater than 190 mg/dL; patients with diabetes aged 40 to 75 with LDL 70 mg/dL to 189 mg/dL; and patients without diabetes or CVD and an LDL of 70 mg/dL to 189 mg/dL, with an estimated risk for CVD >7.5%.
The researchers assessed the lifetime atherosclerotic CVD and diabetes outcomes, costs, and cost-effectiveness of the recommendations using a simulation model. Stratified data were based on data from the 2005-2010 National Health and Nutrition Examination Survey.
Data indicated that the recommended therapies reduced lifetime atherosclerotic CVD incidence, but increased diabetes risk among adults without diabetes. A $50,000 per quality adjusted life year was considered to be cost-effective, according to abstract data.
However, intensive statin use was not cost-effective in patients with diabetes if their atherosclerotic CVD risk was 7.5% to 10%.
In addition, moderate statin use was cost-effective only if atherosclerotic CVD risk was >10% in adults without diabetes. However, it was not cost-effective otherwise, particularly in patients with prediabetes.
“The cost-effectiveness of statin use for primary prevention is primarily determined by baseline atherosclerotic CVD risk. However, persons with relatively lower atherosclerotic CVD risk should be considered for statin use,” Zhuo said. — by Samantha Costa
Disclosure: Zhuo reports no relevant financial disclosures.
For more information: Zhuo X. Abstract 17-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.