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<h5 class="section-title" id="d3608304e235">Background:</h5>
<p id="P1">Residual atherosclerotic cardiovascular disease (ASCVD) risk in statin-treated
U.S.
adults without known ASCVD is not well-described.
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<h5 class="section-title" id="d3608304e240">Objective:</h5>
<p id="P2">To quantitate residual ASCVD risk and its predictors in statin-treated
adults.</p>
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<h5 class="section-title" id="d3608304e245">Methods:</h5>
<p id="P3">We studied 1,014 statin-treated adults (53.3% female, mean 66.0 years)
free of clinical
ASCVD in the Multiethnic Study of Atherosclerosis. We examined ASCVD event rates by
National Lipid Association risk groups over 11-year follow-up and the relation of
standard risk factors, biomarkers and subclinical atherosclerosis measures with residual
ASCVD event risk.
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<h5 class="section-title" id="d3608304e250">Results:</h5>
<p id="P4">Overall, 5.3% of participants were at low, 12.2% at moderate, 60.3% at
high, and 22.2%
at very high baseline risk. Despite statin therapy, age-and-race standardized ASCVD
rates per 1000 person years for men and women were both 4.9 for low/moderate risk,
19.1 and 14.2 for high risk and 35.6 and 26.7 for very high risk, respectively. Specific
independent predictors of residual risk included current smoking, family history,
diabetes, high sensitivity C-reactive protein, LDL-particle number, carotid intimal
medial thickness, and especially coronary artery calcium score. Those on moderate
or high intensity statins at baseline (compared to low intensity) had 39% lower risks,
and those who increased statin intensity 62% lower ASCVD event risks (p<0.01).
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<h5 class="section-title" id="d3608304e255">Conclusion:</h5>
<p id="P5">Residual risk of ASCVD remains high despite statin treatment and is predicted
by specific
risk factors and subclinical atherosclerosis. These findings may be helpful for identifying
those at highest risk needing more aggressive treatment.
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