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Review
. 2022;37(2):34-41.
doi: 10.15605/jafes.037.02.16. Epub 2022 Sep 15.

A Comparison of Statin Treatment Algorithms Based on the ACC/AHA and Philippine Guidelines for Primary Prevention of Dyslipidemia in Statin-Naive Filipino Patients

Bayani Pocholo Maglinte  1 , Alex Junia  1   2 , Jeremyjones Robles  1   3
Affiliations
Review

A Comparison of Statin Treatment Algorithms Based on the ACC/AHA and Philippine Guidelines for Primary Prevention of Dyslipidemia in Statin-Naive Filipino Patients

Bayani Pocholo Maglinte et al. J ASEAN Fed Endocr Soc. 2022.

Abstract

Objectives: This cross-sectional study evaluates the degree of agreement between the 2018 American College of Cardiology/American Heart Association (ACC/AHA2018) and 2020 Philippine Guideline (PG2020) treatment algorithms for the primary prevention of dyslipidemia among Filipinos.

Methodology: This review included 159 charts of statin-naive Filipinos who are 45-79 years old. Using risk profile and lipid measurements, statin treatment recommendation was determined through the PG2020 algorithm and ACC/AHA-ASCVD Risk Estimator Plus web application. The degree of agreement was measured by Cohen's kappa statistic with the two algorithms as independent raters.

Results: A total of 159 patients were included in the final analysis. There was a slight agreement with a kappa coefficient of 0.209 or 4.4% (95% CI 0.078-0.340, p=0.003). Statin treatment was recommended in 69 out of 159 patients (43.4%) by the PG2020 overlapping with ACC/AHA2018 in 56 cases (81.2%). On the other hand, 109 cases (68.6%) were recommended for statin treatment by ACC/AHA2018 overlapping with PG2020 in only 51.4%.

Conclusions: The low degree of agreement between the two treatment algorithms highlights the key demographic and ethnic variations in dyslipidemia management necessitating outcome-based studies to translate these differences. Overestimation of ASCVD risk calculation in the ACC/AHA2018 and consideration of important, unique risk factors among Filipinos favors the applicability of the Philippine guideline.

Keywords: algorithms; dyslipidemia; hypercholesterolemia; primary prevention; statins.

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Conflict of interest statement

All the authors declared no conflict of interest.

Figures

Figure 1
Figure 1
Algorithm based on the 2020 Clinical Practice Guidelines for the management of dyslipidemia in the Philippines. LDLT is the LDL target as recommended by the guideline; LDLP is the patient’s LDL level on assessment of lipid profile.
See this image and copyright information in PMC

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