Next Steps in Primary Prevention of Coronary Heart Disease: Rationale for and Design of the ECAD Trial - PubMed (original) (raw)

Review

. 2015 Oct 20;66(16):1828-1836.

doi: 10.1016/j.jacc.2015.08.857.

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Review

Next Steps in Primary Prevention of Coronary Heart Disease: Rationale for and Design of the ECAD Trial

Michael J Domanski et al. J Am Coll Cardiol. 2015.

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Abstract

Atherosclerotic cardiovascular disease (ASCVD) events, including coronary heart disease and stroke, are the most frequent cause of death and major disability in the world. Current American College of Cardiology/American Heart Association primary prevention guidelines are mainly on the basis of randomized controlled trials of statin-based low-density lipoprotein cholesterol (LDL-C)-lowering therapy for primary prevention of ASCVD events. Despite the clear demonstration of statin-based LDL-C lowering, substantial 10-year and lifetime risks of incident ASCVD continue. Although the 10-year risk is low in young and middle-aged adults who would not be treated according to current guidelines, they ultimately account for most incident ASCVD. If statin-based LDL-C lowering were initiated in them at an age before complex coronary plaques are common in the population, a substantial reduction in lifetime risk of incident coronary heart disease might be achieved. We examine this hypothesis and introduce the design of a currently recruiting trial to address it. (Eliminate Coronary Artery Disease [ECAD]; NCT02245087).

Keywords: atherosclerosis; atherosclerotic; cholesterol; hydroxymethylglutaryl-CoA reductase inhibitors; plaque; primary prevention.

Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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