The American Heart Association and American College of Cardiology recently released updated clinical practice guidelines on cholesterol management. According to the guidelines, personalized risk assessment for statin therapy should now include "risk-enhancing factors" in addition to conventional risk factors like smoking and hypertension. Risk-enhancing factors include a family history of premature atherosclerotic cardiovascular disease, low-density lipoprotein (LDL) persistently at or above 160 mg/dL, chronic kidney disease, and history of preeclampsia, etc.
The guidelines advise clinicians to consider adding ezetimibe to a therapeutic regimen of patients who've had one or more atherosclerotic cardiovascular disease events and whose LDL remains at or above 70 mg/dL despite optimal statin therapy. If LDL still remains elevated, it is rational to add evolocumab or alirocumab.…
