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To address the current gaps in expert guidance related to the recent development and commercial availability of newer nonstatin agents, the American College of Cardiology published today an expert consensus decision pathway on the role of nonstatin therapies for LDL-C lowering in the management of atherosclerotic cardiovascular disease (ASCVD) risk reduction.

The document provides guidance on clinical scenarios not covered in the “2018 AHA/ACC Guideline on the Management of Blood Cholesterol” and refines criteria for treating individuals determined by baseline LDL-C levels. The clinical policy focuses on individuals at very high-risk as well as not very high-risk of future ASCVD events, individuals currently with or without a clinical diagnosis of familial hypercholesterolemia, primary prevention for individuals with and without diabetes, what does metoprolol do to heart rate and individuals with statin-associated side effects. The writing committee also addresses factors to consider in the clinician-patient discussion reinforcing patient preference with regard to the addition of nonstatin therapies.

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