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; Alex Junia; Jeremyjones Robles

doi:10.15605/jafes.037.02.16

Authors

Bayani Pocholo Maglinte Cebu Institute of Medicine, Cebu Velez General Hospital, Cebu City, Philippines https://orcid.org/0000-0001-6449-9646
Alex Junia Cebu Institute of Medicine, Cebu Velez General Hospital, Cebu City, Philippines https://orcid.org/0000-0001-8686-4309
Jeremyjones Robles Cebu Institute of Medicine, Cebu Velez General Hospital, Cebu City, Philippines https://orcid.org/0000-0001-6704-564X

DOI:

https://doi.org/10.15605/jafes.037.02.16

Keywords:

dyslipidemia, hypercholesterolemia, algorithms, statins, primary prevention

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 tatin-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.

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Author Biographies

Bayani Pocholo Maglinte, Cebu Institute of Medicine, Cebu Velez General Hospital, Cebu City, Philippines

Department of Internal Medicine

Alex Junia, Cebu Institute of Medicine, Cebu Velez General Hospital, Cebu City, Philippines

Section of Cardiology, Department of Internal Medicine

Jeremyjones Robles, Cebu Institute of Medicine, Cebu Velez General Hospital, Cebu City, Philippines

Section of Endocrinology, Department of Internal Medicine

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