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@article{Wu:2024:10.3399/BJGP.2023.0198,
author = {Wu, R and Williams, C and Zhou, J and Schlackow, I and Emberson, J and Reith, C and Keech, A and Robson, J and Armitage, J and Gray, A and Simes, J and Baigent, C and Mihaylova, B and CTT, Collaboration secretariat and Armitage, J and Baigent, C and Barnes, E and Blackwell, L and Collins, R and Davies, K and Emberson, J and Fulcher, J and Halls, H and Herrington, WG and Holland, L and Keech, A and Kirby, A and Mihaylova, B and O'Connell, R and Preiss, D and Reith, C and Simes, J and Wilson, K and CTT, Collaboration trialists A to Z trial phase Z and Blazing, M and Braunwald, E and Lemos, JD and Murphy, S and Pedersen, TR and Pfeffer, M and White, H and Wiviott, S and AFCAPSTEXCAPS, AirForceTexas Coronary Atherosclerosis Prevention Study and Clearfield, M and Downs, JR and Gotto, A and Weis, S and ALERT, Assessment of Lescol in Renal Transplantation and Fellström, B and Holdaas, H and Jardine, A and Pedersen, TR and ALLHAT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart },
doi = {10.3399/BJGP.2023.0198},
journal = {Br J Gen Pract},
pages = {e189--e198},
title = {Long-term cardiovascular risks and the impact of statin treatment on socioeconomic inequalities: a microsimulation model.},
url = {http://dx.doi.org/10.3399/BJGP.2023.0198},
volume = {74},
year = {2024}
}

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TY  - JOUR
AB  - BACKGROUND: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist. AIM: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in the UK. DESIGN AND SETTING: A lifetime microsimulation model was developed using 117 896 participants in 16 statin trials, 501 854 UK Biobank (UKB) participants, and quality-of-life data from national health surveys. METHOD: A CVD microsimulation model was developed using risk equations for myocardial infarction, stroke, coronary revascularisation, cancer, and vascular and non-vascular death, estimated using trial data. The authors calibrated and further developed this model in the UKB cohort, including further characteristics and a diabetes risk equation, and validated the model in UKB and Whitehall II cohorts. The model was used to predict CVD incidence, life expectancy, quality-adjusted life years (QALYs), and the impact of UK guideline-recommended statin treatment across socioeconomic deprivation quintiles. RESULTS: Age, sex, socioeconomic deprivation, smoking, hypertension, diabetes, and cardiovascular events were key CVD risk determinants. Model-predicted event rates corresponded well to observed rates across participant categories. The model projected strong gradients in remaining life expectancy, with 4-5-year (5-8 QALYs) gaps between the least and most socioeconomically deprived quintiles. Guideline-recommended statin treatment was projected to increase QALYs, with larger gains in quintiles of higher deprivation. CONCLUSION: The study demonstrated the potential of guideline-recommended statin treatment to reduce socioeconomic inequalities. This CVD model is a novel resource for individualised long-term projections of health outcomes of CVD treatments.
AU  - Wu,R
AU  - Williams,C
AU  - Zhou,J
AU  - Schlackow,I
AU  - Emberson,J
AU  - Reith,C
AU  - Keech,A
AU  - Robson,J
AU  - Armitage,J
AU  - Gray,A
AU  - Simes,J
AU  - Baigent,C
AU  - Mihaylova,B
AU  - CTT,Collaboration secretariat
AU  - Armitage,J
AU  - Baigent,C
AU  - Barnes,E
AU  - Blackwell,L
AU  - Collins,R
AU  - Davies,K
AU  - Emberson,J
AU  - Fulcher,J
AU  - Halls,H
AU  - Herrington,WG
AU  - Holland,L
AU  - Keech,A
AU  - Kirby,A
AU  - Mihaylova,B
AU  - O'Connell,R
AU  - Preiss,D
AU  - Reith,C
AU  - Simes,J
AU  - Wilson,K
AU  - CTT,Collaboration trialists A to Z trial phase Z
AU  - Blazing,M
AU  - Braunwald,E
AU  - Lemos,JD
AU  - Murphy,S
AU  - Pedersen,TR
AU  - Pfeffer,M
AU  - White,H
AU  - Wiviott,S
AU  - AFCAPSTEXCAPS,AirForceTexas Coronary Atherosclerosis Prevention Study
AU  - Clearfield,M
AU  - Downs,JR
AU  - Gotto,A
AU  - Weis,S
AU  - ALERT,Assessment of Lescol in Renal Transplantation
AU  - Fellström,B
AU  - Holdaas,H
AU  - Jardine,A
AU  - Pedersen,TR
AU  - ALLHAT,Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
AU  - Gordon,D
AU  - Davis,B
AU  - Furberg,C
AU  - Grimm,R
AU  - Pressel,S
AU  - Probstfield,JL
AU  - Rahman,M
AU  - Simpson,L
AU  - ALLIANCE,Aggressive Lipid-Lowering Initiation Abates New Cardiac Events
AU  - Koren,M
AU  - ASCOT,Anglo-Scandinavian Cardiac Outcomes Trial
AU  - Dahlöf,B
AU  - Gupta,A
AU  - Poulter,N
AU  - Sever,P
AU  - Wedel,H
AU  - ASPEN,Atorvastatin Study for the Prevention of Coronary Heart Disease Endpoints in Non-Insulin Dependent Diabetes Mellitus
AU  - Knopp,RH
AU  - AURORA,A study to evaluate the Use of Rosuvastatin in subjects On Regular haemodialysis an Assessment of survival and cardiovascular events
AU  - Cobbe,S
AU  - Fellström,B
AU  - Holdaas,H
AU  - Jardine,A
AU  - Schmieder,R
AU  - Zannad,F
AU  - CARDS,Collaborative Atorvastatin Diabetes Study
AU  - Betteridge,DJ
AU  - Colhoun,HM
AU  - Durrington,PN
AU  - Fuller,J
AU  - Hitman,GA
AU  - Neil,A
AU  - CARE,Cholesterol And Recurrent Events Study
AU  - Braunwald,E
AU  - Davis,B
AU  - Hawkins,CM
AU  - Moyé,L
AU  - Pfeffer,M
AU  - Sacks,F
AU  - CORONA,Controlled Rosuvastatin Multinational Trial in Heart Failure
AU  - Kjekshus,J
AU  - Wedel,H
AU  - Wikstrand,J
AU  - 4D,Die Deutsche Diabetes Dialyse Studie
AU  - Wanner,C
AU  - Krane,V
AU  - GISSI,Gruppo Italiano per lo Studio della Sopravvivenza nellInfarto miocardico Heart Failure and Prevention trials
AU  - Franzosi,MG
AU  - Latini,R
AU  - Lucci,D
AU  - Magg
DO  - 10.3399/BJGP.2023.0198
EP  - 198
PY  - 2024///
SP  - 189
TI  - Long-term cardiovascular risks and the impact of statin treatment on socioeconomic inequalities: a microsimulation model.
T2  - Br J Gen Pract
UR  - http://dx.doi.org/10.3399/BJGP.2023.0198
UR  - https://www.ncbi.nlm.nih.gov/pubmed/38373851
VL  - 74
ER  -

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