Personalized Prediction of Lifetime Benefits with Statin Therapy for Asymptomatic Individuals: A Modelling Study.


Guidelines currently recommend that asymptomatic individuals at high cardiovascular disease (CVD) risk be identified for statin therapy. For this purpose, risk assessment is performed using prediction models estimating short-term. Recall that the higher the predicted CVD risk, the stronger the recommendation is to initiate statin therapy.

Physicians are often expected to inform asymptomatic individuals about personalized outcomes of statin therapy for primary prevention of cardiovascular disease (CVD). Yet, current prediction models focus on short-term outcomes and ignore the competing risk of death due to other causes. The purpose of this study was therefore to predict the potential lifetime benefits with statin therapy, considering competing risks. This study was however done following a microsimulation model based on 5-y follow-up data from the Rotterdam Study.

The population that was used to estimate lifetime outcomes with and without statin therapy comprised of individuals aged 55 y and older living in the Ommoord district of Rotterdam, the Netherlands. Although tools were developed to predict personalized increases in total and CVD-free life expectancy with statin therapy, the predicted gains that were found were small.


AUTHOR:      Bart S. Ferket, Bob J. H. van Kempen, Jan Heeringa, Sandra Spronk, Kirsten E. Fleischmann, Rogier L. G. Nijhuis4, Albert Hofman, Ewout W. Steyerberg, M. G. Myriam Hunink
JOURNAL:    PLOS Medicine
URL:              http://journals.plos.org

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