33
Panel B:
High-intensity statin assumptions
RRR for ASCVD: 45%; NND in 10 y: 33
120
100
80
60
40
20
0
10-y CVD Event Rate
0.0 5.0 10.0 15.0 20.0 25.0
NND
=33
At 10-y risk levels ≥7%,
more likely to prevent ASCVD
event than cause diabetes
with high-intensity statin
The points where the red curves and the horizontal black lines cross (blue circle; ~3% 10-year
event rates for moderate-intensity and ~7% for high-intensity statin) represent the points at
which the NNT-benefit and the NND are equal. Therefore, at risk levels higher than indicated
by the dashed lines, there is expected net clinical benefit (potential benefit>potential harm) for
initiation of LLT in primary prevention. Given that the PREVENT-ASCVD equations accurately
predict ASCVD risk, the threshold for consideration of LLT in primary prevention was set at a
PREVENT-ASCVD 10-year risk estimate of ≥3%.
ASCVD indicates atherosclerotic cardiovascular disease; CVD, cardiovascular disease; DM,
diabetes; LLT, lipid-lowering therapy; NND, number-needed-to-treat to cause 1 case of incident
diabetes in 10 years; NNT-benefit, number-needed-to-treat to prevent 1 ASCVD event; RCT,
randomized controlled trial; and RRR, relative risk reduction.
Adapted with permission from Khan et al. Copyright © 2024 American Heart Association, Inc.
