The American College of Cardiology (ACC) released an Expert Consensus Decision Pathway (ECDP) in 2022 that outlined their Low-Density Lipoprotein Cholesterol (LDL-C) thresholds for patients at risk for Atherosclerotic Cardiovascular Disease (ASCVD).

^a2022 ACC Expert Consensus Decision Pathway defines LDL-C goals as <55 mg/dL, <70 mg/dL, and <100 mg/dL depending on patient risk level.¹

^bIn addition to the specified LDL-C goal, ≥50% LDL-C reduction is also recommended¹

^cIn addition to the specified LDL-C goal, ≥ 30-49% LDL-C reduction is also recommended¹

^dPatients with diabetes and 10-year risk < 7.5% and no additional high-risk factors¹

^ePatients with high risk for ASCVD include individuals who have a ≥20% 10-year estimated ASCVD risk. Patients with intermediate risk for ASCVD include individuals who have a ≥7.5% to <20% 10-year estimated ASCVD risk. Patients with borderline risk for ASCVD include individuals who have a 5% to <7.5% 10-year estimated ASCVD risk.¹

^fRisk enhancers include: Family history of premature ASCVD (men <55 years, women <65 years), primary hypercholesterolemia (LDL-C 160-189 mg/dL), metabolic syndrome, chronic kidney disease (eGFR 15-59 mL/min/1.73 m² with or without albuminuria, not treated with dialysis or kidney transplant), chronic inflammatory conditions, history of premature menopause (before 40 years) and history of pregnancy-associated conditions that later raise ASCVD risk, high-risk races/ethnicities, and lipids/biomarkers associated with increased ASCVD risk.¹

^gVery high risk includes a history of multiple major ASCVD events (recent acute coronary syndrome [ACS] [within the past 12 months], history of myocardial infarction [other than recent ACS], history of ischemic stroke, symptomatic peripheral artery disease) or 1 major ASCVD event and multiple high-risk conditions (Age ≥65 years, heterozygous familial hypercholesterolemia, history of prior coronary artery bypass surgery or percutaneous coronary intervention outside of the major ASCVD event(s), diabetes, hypertension, chronic kidney disease (eGFR 15-59 mL/min/1.73 m²), current smoking, persistently elevated LDL-C ≥100 mg/dL despite conventional management, history of congestive heart failure).¹