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Identify secondary prevention ASCVD patients at very high risk to determine their recommended LDL-C level

More than 90% of patients who’ve had a myocardial infarction (MI), stroke, or have been diagnosed with symptomatic PAD are at very high risk.1,*

Reviewing the history of major CV events and the presence of high risk conditions determines if your secondary prevention patients are at very high risk.2

Examples of very high risk ASCVD patients

Susan: an ASCVD patient at very high risk

Susan

Major CV event:

  • Prior MI 3 years ago

High risk conditions:

  • Diabetes
  • Smoker
Barney: an ASCVD patient at very high risk

Barney

Major CV event:

  • Symptomatic PAD

High risk conditions:

  • Diabetes
  • Hypertension
Kenneth: an ASCVD patient at very high risk

Kenneth

Multiple major CV events:

  • History of ischemic stroke
  • Recent ACS (within the past
    year)

*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.1,3

Very high risk ASCVD definition per the 2018 AHA/ACC/Multi-society guideline2

Multiple major events icon

MULTIPLE MAJOR EVENTS

Hypothetical male with multiple major events

TWo or More of these:

Symptomatic PAD

Myocardial infarction

Stroke

Recent ACS
(within 12 months)

1 major event + multiple high-risk condition icon

1 Major EVENT + multiple
HIGH RISK CONDITIONS

Hypothetical Female with 1 major event + multiple high-risk conditions

One of these:

Symptomatic PAD

Myocardial infarction

Stroke

Recent ACS
(within 12 months)

And two or more of these:

Age 65+

Diabetes

Hypertension

History of CABG or PCI
(outside of the major ASCVD event)

Current smoker

CKD
(eGFR 15-59 mL/min/1.73 m2)

HeFH

History of CHF

Persistently elevated LDL-C (≥ 100 mg/dL)
despite maximally tolerated statin and ezetimibe

Testing Icon
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Did you know that LDL-C is not being tested in more than 75% of patients with ASCVD who are at very high risk after a recent MI?4,†

ACS = acute coronary syndrome; ASCVD = atherosclerotic cardiovascular disease; CABG = coronary artery bypass graft; CHF = congestive heart failure; CKD = chronic kidney disease; eGFR = estimated glomerular filtration rate; HeFH = heterozygous familial hypercholesterolemia; PAD = peripheral artery disease; PCI = percutaneous coronary intervention.

Based on a retrospective study using IQVIA claims (Longitudinal Access and Adjudication data; LAAD) and Quest Diagnostics lab databases. Study period was from January 2018 to December 2022, which included 16,406,925 patients with very high risk (VHR) ASCVD, of which 5,366,785 met criteria for VHR ASCVD and experienced an MI. VHR ASCVD 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.4

  • References

    1. 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.
    2. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCN A 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. American Heart Association (AHA). News Release; August 23, 2023.
    4. Data on file, Amgen; 2023.