CVD Risk Prediction Tool Could Guide Statin Therapy

Cardiovascular disease (CVD) remains one of the leading causes of morbidity and mortality, making accurate risk assessment essential for guiding preventive therapy. Existing tools, such as the Pooled Cohort Equations (PCEs), are widely used, but their thresholds for treatment recommendations may not fully capture patient risk. Now, researchers have developed a new predictive model to refine decision-making, particularly around the use of statin therapy for primary prevention.

Researchers at Northwestern Medicine (Chicago, IL, USA) have created the PREVENT (Predicting Risk of cardiovascular disease EVENTs) risk equations, initially developed for the American Heart Association in 2023. These equations aim to more accurately estimate CVD risk compared with prior models. The tool provides updated thresholds for when clinicians should consider prescribing statins, supporting shared decision-making between patients and healthcare providers.

In the latest study, the researchers conducted a cross-sectional analysis of more than 5,200 U.S. adults aged 40 to 75 from the National Health and Nutrition Examination Surveys. Representing 133 million adults, the study showed that 28.1 million were already on statins and 15.2 million were eligible due to existing high-risk conditions. Of the remaining population, PREVENT identified 11.8 million additional individuals who would benefit from statin therapy with a 10-year CVD risk of 5 percent or greater.

The findings, published in JAMA Cardiology, demonstrated that PREVENT not only detects risk more accurately but also identifies a “sweet spot” at 3 to 5 percent 10-year risk, where the greatest benefit from lipid-lowering medication occurs. This could reshape treatment recommendations by ensuring patients most likely to benefit are prioritized, while lower-risk individuals receive more personalized discussions. Future work will focus on improving risk communication strategies to support patient understanding and adherence.

“If a clinician can have a conversation with their patient explaining that there is a certain threshold after which intervention is recommended because the benefit of starting the intervention is greater than any potential harm, this is often a concept patients understand and can help make them more confident in the decision to adhere to their providers’ recommendations,” said Sadiya Khan, MD, MSc, lead author of the study.

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