American College of Cardiology overview
Findings from the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV), which demonstrated a 36% reduction in major adverse cardiovascular events with pitavastatin among people living with HIV (PWH) with low-to-moderate atherosclerotic cardiovascular disease (ASCVD) risk, led the 2025 Focused Update of the 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) Guidelines for the Management of Dyslipidaemias to recommend statin therapy for all PWH ≥40 years of age regardless of calculated ASCVD risk, diverging from earlier frameworks and from US recommendations that continue to use ASCVD risk score-based thresholds.
The Pooled Cohort Equations, PREVENT (American Heart Association Predicting Risk of CVD Events), and SCORE2 (Systematic Coronary Risk Evaluation 2) risk-estimation models were developed and validated in American and European cohorts and may lack generalizability to PWH in low- and middle-income countries who disproportionately shoulder the global HIV burden, highlighting the need to develop and validate ASCVD risk estimators in higher-HIV-burden settings to support accurate risk stratification and context-appropriate prevention strategies.
Read the full overview here.
Source : American College of Cardiology
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