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Implementing the 2013 cholesterol management guidelines into clinical practice
Insights
New guidelines shift cholesterol management focus from LDL targets to potent statin therapy for high-risk patients. Utilize the ASCVD pooled cohort calculator to identify individuals needing intensive treatment for atherosclerotic cardiovascular disease prevention.
Area of Science:
- Cardiology
- Public Health
- Clinical Practice Guidelines
Background:
- Cholesterol management aims to reduce atherosclerotic cardiovascular disease (ASCVD) events.
- Recent guidelines signal a shift in managing high-risk patients.
Purpose of the Study:
- To outline the updated approach to cholesterol management in high-risk patients.
- To guide clinicians in implementing current American Heart Association (AHA)/American College of Cardiology (ACC) guidelines.
Main Methods:
- The article reviews the revised recommendations for statin therapy.
- It introduces the ASCVD pooled cohort calculator as a risk assessment tool.
Main Results:
- The focus is now on potent statin therapy for highest ASCVD risk, not specific low-density lipoprotein (LDL) targets.
- Statin therapy cessation and routine adverse event monitoring are re-evaluated.
Conclusions:
- Clinicians should adopt a risk-based strategy using the ASCVD calculator.
- Prioritize potent statin therapy for individuals identified as high-risk for ASCVD events.
Abstract:
Although a reduction in atherosclerotic cardiovascular disease (ASCVD) events remains the ultimate goal in cholesterol management, there has been a change in recommended cholesterol management in patients with increased risk. The objective in cholesterol management is no longer reducing low-density lipoprotein (LDL) to a particular target value, but ensuring that patients with the highest ASCVD risk are treated with the most potent statin therapy. The previous practice of statin therapy cessation and routine monitoring for adverse events has also been scrutinized by the recent American Heart Association (AHA)/American College of Cardiology (ACC) guidelines. Identifying patients who are at risk now requires the utilization of a novel tool called the ASCVD pooled cohort calculator. The following article will guide the clinician on implementing the current AHA/ACC guidelines into clinical practice.
