National Cholesterol Education Program Adult Treatment Panel III | Fasting lipid panel Calculation of non-HDL-C when TG >200 mg/dL | Primary target: LDL-C Secondary target: non-HDL-C | Identify number of CHD risk factors Framingham 10-y absolute CHD risk |
International Atherosclerosis Society | Fasting lipid panel with calculation of non-HDL-C | Non-HDL-C LDL-C is considered alternative target of therapy | Lifetimes risk of total ASCVD morbidity/mortality (by Framingham, CV Lifetime Risk pooling project, or QRisk) |
European Society of Cardiology/European Atherosclerosis Society | Fasting lipid panel with calculation of non-HDL-C and TC/HDL-C ratio ApoB or ApoB/apoA1 ration are considered alternative risk markers | Primary target: LDL-C Secondary targets: non-HDL or ApoB in patients with cardiometabolic risk | 10-y risk of total fatal ASCVD by the Systematic Coronary Risk Evaluation (SCORE) system |
Canadian Cardiovascular Society | European Society of Cardiology/European Atherosclerosis Society | Primary target: LDL-C Secondary targets: non-HDL-C and ApoB | 10-y risk of total ASCVD events by the Framingham Risk Score |
American Association of Clinical Endocrinologists | Fasting lipid panel Calculation of non-HDL-C is a more accurate risk assessment if TG is between 200 and 500 mg/dL, diabetes, insulin resistance, or established CAD | Primary targets: LDL-C Secondary targets: non-HDL-C in patients with cardiometabolic risk or established CAD ApoB recommended to assess success of LDL-C-lowering therapy | Men: Framingham Risk Score (10-y risk of coronary event) Women: Reynolds Risk Score (10-y risk of coronary event, stroke, or other major heart disease) |
American Diabetes Association/ American Heart Association Statement on Cardiometabolic Risk | Stronger risk discrimination provided by non-HDL-C, ApoB, LDL-P | Strong recommendation for ApoB and non-HDL-C as secondary targets | 30-y/lifetime global ASCVD risk |
American Diabetes Association: Standards of Medical Care in Diabetes | Fasting lipid panel | LDL-C | Not applicable in setting of diabetes (CHD risk equivalent) |
Kidney Disease: Improving Global Outcomes: Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease | Fasting lipid panel to screen for more severe forms of dyslipidemia and secondary causes of dyslipidemia | None: therapy guided by absolute risk of coronary event based on age, and stage of CKD or eGFR | CKD considered CHD risk equivalent Treatment with evidence-based statins/statin doses based on age, and stage of CKD or eGFR |
Secondary Prevention of Atherosclerotic Cardiovascular Disease in Older Adults: A Scientific Statement from the American Heart Association | Fasting lipid panel Calculation of non-HDL-C when TG >200 mg/dL | Primary target: LDL-C Secondary target: non-HDL-C | N/A |
National Lipid Association: Familial Hypercholesterolemia | Fasting lipid panel | LDL-C | Not applicable due to extremely high lifetime risk |
Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents | Fasting lipid panel with calculation of non-HDL-C | Primary target: LDL-C Secondary target: non-HDL-C | No risk algorithm, treatment based on the number of ASCVD risk factors |
AHA Women’s Cardiovascular Disease Prevention Guidelines | Fasting lipid panel Consider hs-CRP in women >60 y and CHD risk >10% | LDL-C | Updated Framingham risk profile (coronary, cerebrovascular, and peripheral arterial disease and heart failure events) |
| Reynolds Risk Score (10-y risk of coronary event, stroke, or other major heart disease) |
2013 American College of Cardiology/American Heart Association: Blood Cholesterol Guidelines for ASCVD Prevention | Fasting lipid panel to screen for more severe forms of dyslipidemia and secondary causes of dyslipidemia | LDL-C measured for assessment of therapeutic response and compliance Therapy guided by identification of 40 categories of patients who benefit from high- or moderate-dose statin therapy | CV Risk Calculator based on Pooled Risk Equations (10-y risk of total ASCVD events) Lifetime risk provided for individuals 20–59 y of age |
apoA1, apolipoprotein A1; ApoB, apolipoprotein B; ASCVD, atherosclerotic cardiovascular disease; CAD, coronary artery disease; CHD, coronary heart disease; CKD, chronic kidney disease; CV, cardiovascular; eGFR, estimated glomerular filtration rate; HDL-C, high-density lipoprotein cholesterol; hs-CRP, high-sensitivity C-reactive protein; LDL-C, low-density lipoprotein-cholesterol; LDL-P, low-density lipoprotein particle; TC, total cholesterol; TG, triglycerides. |