Current Guidelines for Management of ASCVD Risk
National and international evidence-based guidelines for primary and secondary prevention of ASCVD are available (49-52). These guidelines are all moving toward the same direction in order to tackle ASCVD with strong emphasis on secondary prevention and LDL-C reduction. Although international guidelines are based on trials of a predominantly white population, the LATAM population is represented.
Several international guidelines, including those for LATAM, were updated in 2018 and 2019 as a result of new evidence from RCTs and genetic studies that support the causal relationship between LDL-C and ApoB in relation to ASCVD. Currently, these guidelines recognize that treatment decision making is based on risk stratification, which is divided into low, moderate, high, and very high. Some subgroups of patients with very high risk should be recognized in order to identify those who need an aggressive treatment approach (Table 3).
Table 3. Risk Stratification of Very High Risk ASCVD Patients