Free LDL-C testing is available for your patients

Within 1 Year
of an MI
Nearly
PATIENTS have
another CV event 1,*
*CV event = composite of ischemic stroke, recurrent myocardial
infarction, or all-cause death.
plaque build up

High LDL-C is a major cause of CV events and one of the most modifiable risk factors2,3

You may be actively managing patients with ASCVD and several risk factors for a CV event, but reducing LDL-C is critical. It’s a main driver of ASCVD.2,3
ascvd-desktop
ascvd-mobile

Lower LDL-C is better for your secondary prevention ASCVD patients4,5

Treatment guidelines for patients with ASCVD have evolved over time, recommending more intensive LDL-C lowering to reduce the risk of CV events. Studies have suggested no meaningful association between low levels of LDL-C and safety outcomes.6-8 Your secondary prevention patients at very high risk are Living in the Red if their LDL-C is not < 55 mg/dL.9

More than 90% of patients who’ve had a myocardial infarction (MI), stroke, or have been diagnosed with symptomatic PAD are at very high risk10,†

Identifying each patient’s risk status helps you tailor your treatment
plan to achieve their recommended level of LDL-C.2

2018 AHA/ACC/Multi-society guideline definition of
very high risk ASCVD2

Major Event + Multiple High-Risk Conditions Icon
1 Major EVENT + multiple
HIGH RISK CONDITIONS
(such as: age ≥ 65 years, diabetes, hypertension)
Multiple Major Events Ic
Multiple major
events
(including: prior history of myocardial infarction, prior stroke, symptomatic PAD, acute coronary syndrome within 12 months)

Based on a retrospective cohort study of 16,344 patients aged 19 years or older with a history of major ASCVD event using data from the MarketScan database. This included 7,572 patients with MI (other than recent ACS), 3,551 patients with ischemic stroke, and 5,919 patients with symptomatic PAD as their history of a major ASCVD event. Patients were followed from January 1, 2016 through December 31, 2017 for recurrent ASCVD events. Very high risk was defined according to the 2018 AHA/ACC/Multi-society guidelines. Major ASCVD events included recent ACS, history of MI other than a recent ACS, history of ischemic stroke, and symptomatic PAD.10

Despite treatment with a high-intensity statin ± ezetimibe, most secondary prevention patients at very high risk have an LDL-C at or above 55 mg/dL.11,‡

Data included patients diagnosed with ASCVD between August 2018 to August 2023. This consisted of over 16 million patients with very high risk (VHR) ASCVD. 626,193 VHR ASCVD patients had an ASCVD event between August 2018 and August 2022 and valid LDL-C value within 12 months following most recent event. Measures on treatment based on LDL-C levels included patients with an ASCVD event between November 2018 and May 2023. Those identified as treated did not receive any additional nonstatin LLTs other than ezetimibe. The patient’s prescription activity and LDL-C levels were monitored for 3 months prior to and 3 months following their most recent event, respectively. Very high risk was defined in alignment with the 2018 AHA/ACC/Multi-society guidelines; however, persistently elevated LDL-C ≥ 100 mg/dL was not included due to data availability.11

javascript:void(0);

Based on the 2022 ACC ECDP recommendation for patients with ASCVD at very high risk9

Consider initiating nonstatin therapies to achieve LDL-C below 55mg/dL and/or greater than or equal to 50%

§After evaluating the optimization of lifestyle, adherence to guideline-recommended statin therapy, risk-factor control, statin-associated side effects, and escalating to high-intensity statin if not already taken.

Identify your patients Icon
scan_mobile
Identify your secondary prevention ASCVD patients who are at very high risk

AHA/ACC = American Heart Association/American College of Cardiology; ASCVD = atherosclerotic cardiovascular disease; ECDP = Expert Consensus Decision Pathway; MI = myocardial infarction; PAD = peripheral artery disease.

  • References

    1. Spertus J, Bhandary D, Fonseca E, et al. Contemporary incidence of recurrent cardiovascular events 1 to 3 years after myocardial infarction: longitudinal US analysis from NCDR registries linked with all-payer claims database. J Am Coll Cardiol. 2018;71:24.
    2. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73:3168-3209.
    3. Grundy SM and Feingold KR. Guidelines for the management of high blood cholesterol. NCBI Bookshelf. Available at: www.ncbi.nlm.nih.gov/books/NBK305897/?report=printable. Accessed 6/29/23.
    4. Cholesterol Treatment Trialists’ (CTT) Collaboration; Baigent C, Blackwell L, Emberson J et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376:1670-1681.
    5. Raymond C, Cho L, Rocco M, Hazen SL. New guidelines for reduction of blood cholesterol: worth the wait? Cleve Clin J Med. 2014;81:11-19.
    6. Wilkinson MJ, Lepor NE, Michos ED. Evolving management of low-density lipoprotein cholesterol: a personalized approach to preventing atherosclerotic cardiovascular disease across the risk continuum. J Am Heart Assoc. 2023;12:1-22.
    7. Sabouret P, Angoulvant D, Cannon CP, Banach M. Low levels of low-density lipoprotein cholesterol, intracerebral haemorrhage, and other safety issues: is there still a matter of debate? Eur Heart J Open. 2022;2:1-5.
    8. Masana L, Girona J, Ibarretxe D, et al. Clinical and pathophysiological evidence supporting the safety of extremely low LDL levels—the zero-LDL hypothesis. J Clin Lipidol. 2018;12:292-299.
    9. Lloyd-Jones DM, Morris PB, Ballantyne CM, et al. 2022 ACC Expert Consensus Decision Pathway on the role of nonstatin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2022;80:1366-1418.
    10. Muntner P, Orroth KK, Mues KE, et al. Evaluating a simple approach to identify adults meeting the 2018 AHA/ACC cholesterol guideline definition of very high risk for atherosclerotic cardiovascular disease. Cardiovasc Drugs Ther. 2022;36:475-481.
    11. Data on file, Amgen; 2024.

High LDL-C (bad cholesterol) can lead to serious cardiovascular events, like heart attack or stroke, especially if you have cardiovascular disease. Know more about your risk by getting your cholesterol tested. Learn how to