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Improvement of evaluation in Chinese patients with atherosclerotic cardiovascular disease using the very-high-risk

Sha Li1, Hui-Hui Liu1, Yuan-Lin Guo1

  • 1State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China.

The Lancet Regional Health. Western Pacific
|November 4, 2021
PubMed

Insights

Very-high-risk (VHR) patients with atherosclerotic cardiovascular disease (ASCVD) in China have a greater disease burden and higher cardiovascular event risk. Current statin use and low-density lipoprotein cholesterol (LDL-C) achievement are suboptimal in this population.

Area of Science:

  • Cardiology
  • Public Health
  • Clinical Medicine

Background:

  • Atherosclerotic cardiovascular disease (ASCVD) risk stratification is continuously refined, with recent definitions of very-high-risk (VHR) underutilized in China.
  • Understanding the characteristics and outcomes of VHR patients in China is crucial for improving cardiovascular care.

Purpose of the Study:

  • To identify patients at VHR according to the 2018 AHA/ACC guideline within a Chinese ASCVD population.
  • To evaluate the clinical characteristics, low-density lipoprotein cholesterol (LDL-C) management, and prognostic value of VHR status for cardiovascular events (CVEs).

Main Methods:

  • Enrolled 9944 patients with ASCVD.
  • Identified VHR patients using the 2018 AHA/ACC guideline.
  • Median follow-up of 36.4 months to assess clinical characteristics, LDL-C levels, and CVEs.

Main Results:

  • 26% of patients were classified as VHR, with higher prevalence in males, younger individuals (<45 years), and those from low-income regions.
  • VHR patients exhibited higher rates of risk factors, more severe coronary stenosis, and increased cardiovascular events compared to non-VHR patients.
  • Suboptimal management was observed, with only 3% on high-intensity statins and 13% achieving the LDL-C goal (<1.4 mmol/L).

Conclusions:

  • Patients identified as VHR in China carry a significant ASCVD burden, demonstrate poor LDL-C control, and face elevated risks of CVEs.
  • The findings suggest a need for refined ASCVD risk stratification and improved management strategies for VHR patients in China.
Abstract

Keywords:
ChineseVery-high-riskatherosclerotic cardiovascular disease

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