Risk factors in the treatment of atherosclerotic cardiovascular disease

The vast majority of patients with atherosclerotic cardiovascular disease are at high and very high risk of recurrent events because control of risk factors (eg, high blood pressure, high cholesterol, smoking, etc.) is not optimized. In this study, the authors determined the potential for optimal treatment of risk factors over ten years and the lifetime risk of recurrent cardiovascular events, such as acute myocardial infarction, cardiac death, and heart bypass surgery, in patients after a coronary artery event.

This analysis combined data from the most relevant prevention studies in Europe. Patients over the age of 45 years and six months after a coronary artery bypass event were included. A risk assessment was used to estimate the risk of a 10-year cardiac event and the gains in years free of this cardiac event with optimal treatment of risk factors (lifestyle changes with the acquisition of healthy habits and use of medications to treat these risk factors).

3230 patients with atherosclerotic cardiovascular disease participated. The estimated risk of a cardiac event for ten years was 20% and for lifetime 54%. While 70% of patients used conventional medications, 82% had one or more modifiable risk factors outside of the recommended target, and 91% had one or more lifestyle risk factors that were out of control.

The analysis showed that properly adjusting treatment and controlling risk factors was associated with a reduction in the risk of cardiac events over a ten-year period from 20% to 6% and for a lifetime from 54% to 20%.

The authors concluded that among patients with atherosclerotic CVD, a guideline-based treatment modification, and increased control of risk factors, has a potential effect on reducing the risk of recurrent events and ensures clinically significant gains in non-event-free outcomes. rate throughout life.

Reference: Van Trier TJ et al. Untapped potential for risk factor treatment in patients with atherosclerotic cardiovascular disease. European Journal of Preventive Cardiology 2023; DOI: 101093/eurjpc/zwad038.