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1/31/2013
»Modeling Tool Uses Lab Results to Predict Patients' Benefit From Statins

By Lori Solomon, Editor, Diagnostics Testing & Technology Report

A web-based tool that incorporates routine laboratory test results into a calculation can predict gains in life expectancy from starting statin therapy in asymptomatic patients, according to a study published online Dec. 27 in PLoS Medicine. The prediction of individualized long-term benefits may aid physicians in personalizing preventative care.

While cardiovascular disease is a leading cause of death, it is largely preventable. Through risk assessments physicians can recommend lifestyle changes and medications in asymptomatic patients. However, patients often desire more tangible, personalized data to evaluate the drug's benefits in light of a medication's potential side effects and cost as part of informed decision-making.

"Most decision tools for cardiovascular disease prevention in asymptomatic individuals predict the individual's risk over a time period ranging from 5 years to 10 years without calculating potential treatment benefits. If treatment benefits are presented, they are usually calculated as absolute risk reductions without taking into account competing risks," write the authors, led by Bart S. Ferket, a Ph.D., candidate at Erasmus Medical Center in the Netherlands, in noting the benefits of their model. "Once the underlying model has been independently validated, these tools can be used for communication of the expected lifetime benefits of statin therapy in persons aged 55 years and older."

The web-based calculator relies on laboratory results including lipids, glucose, and creatinine measures as well as other patient characteristics including age, sex, smoking, blood pressure, hypertension, diabetes, body mass index, and waist-to-hip ratio.

The microsimulation model was developed based on 5-year follow-up data from 2,428 participants in the Rotterdam Study, a population-based cohort of individuals aged 55 years and older and was validated using in-sample 10-year follow-up data. While the findings suggest that statin therapy can lead on average to small gains in total life expectancy (0.3 years) and slightly larger gains in CVD-free life expectancy (0.7 years) among healthy individuals, if independently validated it can enhance the ability to of physicians to offer more personalized decision-making.

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