Non-Statin Therapy Use in a Patient With Clinical ASCVD and Very High LDL-C

Mr. Smith is a 32 year-old Caucasian male, who had a non-ST segment elevation myocardial infarction (NSTEMI) 3 months ago. He was not taking any medications prior to hospital admission. His LDL-C was measured within 24 hours of the NSTEMI, and it was 194 mg/dL. Secondary causes of very high LDL-C were ruled out. At the time of hospital discharge, he was given prescriptions for evidence-based therapies, including atorvastatin 80 mg PO daily.

Mr. Smith returned to clinic today. His LDL-C is 103 mg/dL. He states adherence with optimal lifestyle modifications and pharmacotherapy.

According to the 2016 ACC Expert Consensus Decision Pathway (ECDP) on non-statin therapies, which ONE of the following recommendations for non-statin therapy could be considered for this patient?

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