Mortensen MB, et al. - According to findings, approximately 90% of individuals recommended statins by guidelines have randomized controlled trial (RCT) evidence supporting efficacy. Allocating statins based on guideline-criteria is better than RCT criteria. Guideline-recommended use of risk calculators is strongly supported by findings.

• From the Copenhagen General Population Study, a total of 79,171 individuals free of ASCVD and statin use at baseline were included to ascertain the extent to which guideline-based statin recommendations are supported by available evidence from RCTs.

• The guidelines included were: American College of Cardiology/American Heart Association(ACC/AHA), Canadian Cardiovascular Society(CCS), UK National Institute for Health and Care Excellence(NICE), and European Society of Cardiology/European Atherosclerosis Society(ESC/EAS).

• Direct RCT evidence of statin efficacy was present in 86%, 88%, 88% and 84% of individuals eligible for statin therapy with the ACC/AHA, CCS, NICE and ESC/EAS guidelines, respectively (guideline-positive&RCT-positive).

• The ASCVD events per 1000 person-years were reported to be 11.4–12.7 (guideline-positive&RCT-positive), 6.3–8.0 (guideline-positive&RCT-negative), 4.2–5.2 (guideline-negative&RCT-positive), and 2.3–2.5 (guideline-negative&RCT-negative), respectively.

• The corresponding NNT (number needed to treat) to avert one event in 10 years employing high-intensity statin were noted to be 19–21, 30–32, 48–60, and 105–125, respectively.