As a result of recent evidence regarding proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors and ezetimibe in some patients, the ACC has released the 2017 Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk. Read More >>>
Since the publication of the 2016 expect consensus decision pathway, additional evidence and perspectives have emerged from randomized clinical trials and other sources, particularly considering the longer-term efficacy and safety of PCSK9 inhibitors in secondary prevention of atherosclerotic cardiovascular disease (ASCVD), as well as evidence on the types of patients most likely to benefit from the use of ezetimibe in addition to statin therapy after acute coronary syndrome. Due to these findings, revised recommendations are provided for patients with clinical ASCVD with or without comorbidities on statin therapy for secondary prevention, indicating more clearly when ezetimibe or a PCSK9 inhibitor may be considered.
The writing committee judged that the new data did not warrant changes to the decision pathways and algorithms regarding the use of ezetimibe or PCSK9 inhibitors in primary prevention patients LDL-C <190 mg/dl with or without diabetes or patients without ASCVD and LDL-C <190 mg/dl not due to secondary causes. Also provided in the focused update is new information on diagnostic categories of heterozygous and homozygous familial hypercholesterolemia, based on clinical criteria with and without genetic testing.
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