AACE Algorithm

When LDL goal is achieved, if TG>200mg/dL, consider fibrate therapy

Major independent risk factors are high LDL-C, polycystic ovary syndrome, cigarette smoking, hypertension (blood pressure ≥140/90 mm Hg or on hypertensive medication), low HDL-C (<40 mg/dL), family history of coronary artery disease (in male, first-degree relative younger than 55 years; in female, first-degree relative younger than 65 years), chronic renal disease (CKD) stage 3/4, evidence of coronary artery calcification and age (men ≥45; women ≥55 years). Subtract 1 risk factor if the person has high HDL-C.

ACC Primary Prevention:

Risk Enhancers:FMH premature ASCVD, persistently elevated LDL>160, CKD, metabolic syndrome,preeclampsia, premature menopause, inflammatory diseases(RA, PsA, HIV), Ethnicity (South Asian), persistently elevated Tg >175, hs-CRP>2.0mg/L, Lp(a)>50mg/dL or >125mmol/L, apoB>130mg/dL, ABI<0.9

ADA DM Statin Recommendations:

DM specific Risk enhancers independent of other risk factors: Long duration(>/=10y for T2DM, or >/=20y for T1DM), Albuminuria >=30mcg alb/mg cr, eGFR<60,retinopathy, neuropathy, ABI<0.9

ACC Secondary Prevention:

Very High Risk Definition:

Very high risk includes multiple major ASCVD events or 1 major event and multiple high risk conditions

Major independent risk factors are high LDL-C, polycystic ovary syndrome, cigarette smoking, hypertension (blood pressure ≥140/90 mm Hg or on hypertensive medication), low HDL-C (<40 mg/dL), family history of coronary artery disease (in male, first-degree relative younger than 55 years; in female, first-degree relative younger than 65 years), chronic renal disease (CKD) stage 3/4, evidence of coronary artery calcification and age (men ≥45; women ≥55 years). Subtract 1 risk factor if the person has high HDL-C.

ACC:

AACE Risk Factors

Major independent risk factors are high LDL-C, polycystic ovary syndrome, cigarette smoking, hypertension (blood pressure ≥140/90 mm Hg or on hypertensive medication), low HDL-C (<40 mg/dL), family history of coronary artery disease (in male, first-degree relative younger than 55 years; in female, first-degree relative younger than 65 years), chronic renal disease (CKD) stage 3/4, evidence of coronary artery calcification and age (men ≥45; women ≥55 years). Subtract 1 risk factor if the person has high HDL-C.

DM Specific:

DM specific Risk enhancers independent of other risk factors: Long duration(>/=10y for T2DM, or >/=20y for T1DM), Albuminuria >=30mcg alb/mg cr, eGFR<60,retinopathy, neuropathy, ABI<0.9