The 2023 PREVENT equations identified only 2.9% of young adults with premature MI as eligible for statins (≥7.5% 10-year risk), compared to 21.8% using the 2013 Pooled Cohort Equations.
Cohort (n=1,149)
Yes
Does the 2023 PREVENT equation accurately identify increased cardiovascular risk for statin eligibility in young adults who experience premature myocardial infarction compared with the 2013 Pooled Cohort Equations?
The 2023 PREVENT equations may underestimate 10-year ASCVD risk in young adults who eventually experience an MI, suggesting that using 30-year risk estimates or lower thresholds may be necessary to prevent undertreatment.
Absolute Event Rate: 2.9% vs 21.8%
Background: Predicting cardiovascular risk in young adults remains challenging. The newly developed PREVENT equations offers several advantages for short and long-term cardiovascular risk prediction. Objective: To determine how often PREVENT equations identify increased cardiovascular risk among young adults who experience premature myocardial infarction compared with existing risk calculators. Methods: The YOUNG-MI registry is a retrospective cohort from two large academic centers, which included individuals who experienced an MI at age ≤ 50 years. Study physicians adjudicated diagnosis of Type 1 MI. Cardiovascular risk was estimated by pooled cohort equations and PREVENT equations based on data available prior to MI or at the time of presentation. Results: The study cohort included 1149 individuals with a median age of 45 years and 19 % women. The median 10-year ASCVD risk calculated by pooled cohort equations and 2023 PREVENT equations was 4.6 % and 2.3 %, respectively. Using the 10-year ASCVD risk estimates from the 2023 PREVENT equations, only 33 (3 %) individuals met the 7.5 % threshold while 93 (8 %) met the 5 % threshold and 333 (29 %) met the 3 % threshold. For 30-year ASCVD risk using PREVENT, 827 (72 %) met a threshold of ≥ 10 %. Conclusion: The PREVENT equations may lead to undertreatment of young adults who experienced an MI. Using the 30-year risk PREVENT equations may improve long-term risk assessment in this population.
Singh et al. (Sat,) conducted a cohort in Myocardial infarction at a young age (n=1,149). 2023 PREVENT equations vs. 2013 Pooled Cohort Equations (PCE) was evaluated on Proportion of individuals meeting the ≥ 7.5% threshold for 10-year ASCVD risk (statin eligibility). The 2023 PREVENT equations identified only 2.9% of young adults with premature MI as eligible for statins (≥7.5% 10-year risk), compared to 21.8% using the 2013 Pooled Cohort Equations.