Next steps in primary prevention of coronary heart disease rationale for and design of the ECAD Trial

Michael J. Domanski, Valentin Fuster, Francisco Diaz-Mitoma, Scott M Grundy, Donald Lloyd-Jones, Muhammad Mamdani, Robin Roberts, Kevin Thorpe, Judith Hall, Jacob A. Udell, Michael E. Farkouh

Research output: Contribution to journalArticle

30 Scopus citations

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)

Original languageEnglish (US)
Pages (from-to)1828-1836
Number of pages9
JournalJournal of the American College of Cardiology
Volume66
Issue number16
DOIs
StatePublished - Oct 20 2015

Keywords

  • atherosclerosis
  • atherosclerotic
  • cholesterol
  • hydroxymethylglutaryl-CoA reductase inhibitors
  • plaque
  • primary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Domanski, M. J., Fuster, V., Diaz-Mitoma, F., Grundy, S. M., Lloyd-Jones, D., Mamdani, M., Roberts, R., Thorpe, K., Hall, J., Udell, J. A., & Farkouh, M. E. (2015). Next steps in primary prevention of coronary heart disease rationale for and design of the ECAD Trial. Journal of the American College of Cardiology, 66(16), 1828-1836. https://doi.org/10.1016/j.jacc.2015.08.857