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