The Particulars: The ACC and American Heart Association (AHA) have developed pooled cohort risk equations to estimate atherosclerotic cardiovascular disease (CVD) risk and guide statin initiation. Researchers have yet to assess calibration and discrimination of the pooled cohort risk equations in a contemporary Unites States population.

Data Breakdown: Participants in the Reasons for Geographic and Racial Differences in Stroke aged 45 to 79 were studied if their atherosclerotic CVD risk may have triggered a discussion of statin initiation. Incidence of CVD as predicted using the pooled cohort risk equations was compared with observed incidence as follows:

 

10-year predicted atherosclerotic CVD risk 5-year atherosclerotic CVD incidence per 1,000 person-years
Observed Predicted
< 5.0% 1.9 1.9
5.0% to 7.5% 4.8 4.8
7.5% to < 10.0% 6.1 6.9
≥ 10.% 12.0 15.1

 

Take Home Pearls: When statin initiation is considered based on ACC/AHA pooled cohort risk equations to estimate atherosclerotic CVD risk, observed and predicted 5-year atherosclerotic CVD risks appear to be similar. The equations appear to be well calibrated in the population for which they were designed to be used.