Table 3.
Statin treatment according to NICE guidelines in the overall ASCVD and non-ASCVD cohorts and subgroups
| ASCVD cohort (n=91 497) |
Non-ASCVD cohort (n=92 086) |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Recent ACS | Other CHD | Ischaemic stroke/TIA | PAD | Total ASCVD | T2DM with CKD | T2DM without CKD | T1DM with CKD | T1DM without CKD | CKD alone | Total non-ASCVD | |
| Study cohort, % | |||||||||||
| Treated as per NICE guidelines* | 33.1 | 6.7 | 2.0 | 2.2 | 6.1 | 18.6 | 17.2 | 26.2 | 19.3 | 10.3 | 15.8 |
| Treated with statins of lower potency* | 54.0 | 75.1 | 71.2 | 70.5 | 73.0 | 52.5 | 49.3 | 47.3 | 42.7 | 38.6 | 46.6 |
| Treated with only non-statin LMT | 0.9 | 2.0 | 1.7 | 1.9 | 1.9 | 2.5 | 1.6 | 3.9 | 2.0 | 1.7 | 1.8 |
| Not treated by LMT | 12.1 | 16.2 | 25.1 | 25.4 | 19.0 | 26.4 | 31.9 | 22.7 | 35.9 | 49.4 | 35.8 |
| Adjusted extrapolation to the UK population, N | |||||||||||
| Treated as per NICE guidelines* | 34 085 | 147 215 | 15 653 | 4869 | 201 822 | 112 119 | 209 589 | 10 642 | 18 830 | 156 621 | 507 801 |
| Treated with statins of lower potency* | 55 615 | 1 639 122 | 550 930 | 158 966 | 2 404 633 | 316 269 | 600 916 | 19 220 | 41 649 | 586 243 | 1 564 297 |
| Treated with only non-statin LMT | 894 | 44 456 | 13 266 | 4318 | 62 934 | 15 311 | 19 897 | 1575 | 1994 | 26 006 | 64 783 |
| Not treated by LMT | 12 488 | 352 657 | 194 365 | 57 299 | 616 809 | 159 085 | 388 359 | 9230 | 35 017 | 749 786 | 1 341 477 |
ASCVD subgroups represent hierarchical categorisation. Non-ASCVD categorisations have been simplified by consideration of the qualifiers QRISK2 ≥10% and age >40 years as implicit in the definitions of T2DM and T1DM, respectively, with and without CKD, and of the qualifiers without T2DM + QRISK2 ≥10% or T1DM + age >40 as implicit in the definition of CKD alone.
*NICE 2014 guidelines recommend atorvastatin 80 mg and 20 mg, respectively, for the ASCVD and non-ASCVD populations in the table. We have included statins of equivalent or higher potency with ASCVD definition based on atorvastatin 80 mg, rosuvastatin 40 mg and non-ASCVD definition based on atorvastatin 20, 40 and 80 mg, rosuvastatin 10, 20 and 40 mg and simvastatin 80 mg. It should be noted that NICE guidelines allow for consideration of a lower dose based on clinical considerations and patient preference.
ACS, acute coronary syndrome; ASCVD, atherosclerotic cardiovascular disease; CHD, coronary heart disease; CKD, chronic kidney disease; LMT, lipid-modifying therapy; NICE, National Institute for Health and Care Excellence; PAD, peripheral arterial disease; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; TIA, transient ischaemic attack.