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Does use of pooled cohort risk score overestimate the use of statin?: a retrospective cohort study in a primary care setting

Overview of attention for article published in BMC Primary Care, November 2014
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Title
Does use of pooled cohort risk score overestimate the use of statin?: a retrospective cohort study in a primary care setting
Published in
BMC Primary Care, November 2014
DOI 10.1186/s12875-014-0172-y
Pubmed ID
Authors

Yook Chin Chia, Hooi Min Lim, Siew Mooi Ching

Abstract

BackgroundInitiation of statin therapy as primary prevention particularly in those with mildly elevated cardiovascular disease risk factors is still being debated. The 2013 ACC/AHA blood cholesterol guideline recommends initiation of statin by estimating the 10-year atherosclerotic cardiovascular disease (ASCVD) risk using the new pooled cohort risk score. This paper examines the use of the pooled cohort risk score and compares it to actual use of statins in daily clinical practice in a primary care setting.MethodsWe examined the use of statins in a randomly selected sample of patients in a primary care clinic. The demographic data and cardiovascular risk parameters were captured from patient records in 1998. The pooled cohort risk score was calculated based on the parameters in 1998. The use of statins in 1998 and 2007, a 10-year interval, was recorded.ResultsA total of 847 patients were entered into the analysis. Mean age of the patients was 57.2¿±¿8.4 years and 33.1% were male. The use of statins in 1998 was only 10.2% (n¿=¿86) as compared to 67.5% (n¿=¿572) in 2007. For patients with LDL 70-189 mg/dl and estimated 10-year ASCVD risk ¿7.5% (n¿=¿190), 60% (n¿=¿114) of patients were on statin therapy by 2007. There were 124 patients in whom statin therapy was not recommended according to ACC/AHA guideline but were actually receiving statin therapy.ConclusionsAn extra 40% of patients need to be treated with statin if the 2013 ACC/AHA blood cholesterol guideline is used. However the absolute number of patients who needed to be treated based on the ACC/AHA guideline is lower than the number of patients actually receiving it in a daily clinical practice. The pooled cohort risk score does not increase the absolute number of patients who are actually treated with statins. However these findings and the use of the pooled cohort risk score need to be validated further.

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Mendeley readers

The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Malaysia 1 2%
Unknown 60 98%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 11 18%
Student > Ph. D. Student 8 13%
Student > Master 8 13%
Student > Postgraduate 6 10%
Other 5 8%
Other 13 21%
Unknown 10 16%
Readers by discipline Count As %
Medicine and Dentistry 26 43%
Pharmacology, Toxicology and Pharmaceutical Science 8 13%
Nursing and Health Professions 6 10%
Biochemistry, Genetics and Molecular Biology 4 7%
Psychology 2 3%
Other 4 7%
Unknown 11 18%