What is the cardiac risk cutoff to recommend statin treatment?
Determining the cardiac risk cutoff to recommend statin treatment is a simplified strategy to most closely resemble the risk profiles of those included in the trials which demonstrated reduction in CV risk. While no studies used CV risk scores as part of the inclusion criteria, the studied populations had a high prevalence of CV risk factors, and some studies showed an increasing absolute benefit of statins with increased baseline CV risk. The 12% threshold we chose most closely resembles the lower limit of risk of populations in the clinical trials for which the benefits clearly outweighed the risks. The major primary prevention trials showed an event rate between 6 7.5%. Since these trials lasted 2 to 6 years (roughly equivalent to 12 15% ten-year event rate), the Work Group chose a 12% ten-year risk threshold to match the available data. There are no clinical trials that specifically address the <6% risk category, which would be represented by a control group event rate of approximately 3%.