Atherosclerotic cardiovascular risk and simulation of lipid-lowering therapy in China

Abstract Background Lipid-lowering therapy is a key strategy to reduce atherosclerotic cardiovascular disease (ASCVD) risk. However, little known about the burden of lipid-lowering in China. Purpose We aim simulate proportion individuals need different regimens reach diverse low-density lipoprotein cholesterol (LDL-C) goals based on ASCVD risk stratification. Methods used data from China PEACE Million Persons Project, national screening project covering 31 provinces The stratifications and LDL-C were 2016 Chinese Guideline for Management Dyslipidemia Adults. Stepwise (atorvastatin 20 mg, add-on ezetimibe evolocumab) was simulated by Monte Carlo model individual's level. Results included 2,876,272 participants (89.7% screened) who not receiving (mean age 55.8±9.9 years; 60.5% women). at low, moderate, high very 57.9%, 17.5%, 22.3% 2.3%, respectively. In low or moderate risk, 10.5% did goal LDL-C<3.4mmol/L; after statin simulation, 99.8% met goal. high-risk patients, 49.0% LDL-C<2.6mmol/L; monotherapy (82.7%), (10.6%) evolocumab (6.7%), 99.7% very-high-risk 72.2% LDL-C<1.8mmol/L; while 99.1% all patients received simulation: (76.5%), (13.0%) (10.5%). total 609,489 (21.2% overall participants) needing therapy, 88.5% required 11.5% additional non-statin (Figure). Conclusions Moderate-intensity pivotal China; nearly 10% therapy. Funding Acknowledgement Type funding sources: None.