Key result
PREVENT-ASCVD estimates ~5% lower absolute statin eligibility than the Pooled Cohort Equation.
Why the study?
To compare the PREVENT-ASCVD risk equation with the Pooled Cohort Equation for estimating statin eligibility across demographic subgroups and by Polysocial Risk Score.
Does the PREVENT-ASCVD risk equation alter estimated statin eligibility compared to the Pooled Cohort Equation in a primary prevention population?
Observational (n=25,188)
Does the PREVENT-ASCVD risk equation alter estimated statin eligibility compared to the Pooled Cohort Equation in a primary prevention population?
Answers are grounded in this paper and cite their sources.
The PREVENT-ASCVD risk equation estimates significantly lower statin eligibility compared to the Pooled Cohort Equation in primary prevention populations, particularly among Black adults and those aged 60-69 years.
We compared the PREVENT-ASCVD risk equation with the Pooled Cohort Equation (PCE) for estimating statin eligibility across demographic subgroups in the All of Us Research Program in patients without atherosclerotic cardiovascular disease (ASCVD), heart failure, diabetes, or lipid-lowering therapy. Statin eligibility was defined as a 10-year ASCVD risk for PREVENT-ASCVD ≥5% and PCE ≥7.5%. Eligibility estimates were compared across age, sex, and race / ethnicity, and by quintile of Polysocial Risk Score (PsRS). Among 25,188 participants, overall statin eligibility was 23.1% under PREVENT-ASCVD compared with 28.0% under PCE (Δ = 4.9%, p < 0.001). The largest differences were among participants aged 60-69 years and among Black participants. Among those with PsRS data (n=6,213), PREVENT-ASCVD estimated lower statin eligibility than PCE across all quintiles (p <0.05). Differences in statin eligibility between PREVENT-ASCVD and PCE persist even when applying guideline-recommended thresholds, highlighting the importance of incorporating additional risk-enhancing factors beyond those included in either equation to better inform primary prevention decisions.
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Young et al. (2026) conducted an observational in Primary prevention of ASCVD (n=25,188). PREVENT-ASCVD risk equation vs. Pooled Cohort Equation (PCE) was evaluated on Statin eligibility (10-year ASCVD risk for PREVENT-ASCVD ≥5% and PCE ≥7.5%) (Δ = 4.9%, p=< 0.001). The PREVENT-ASCVD risk equation estimated lower overall statin eligibility compared with the Pooled Cohort Equation (23.1% vs 28.0%, p < 0.001).
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