Defining Potential Use of Nonstatin Therapies to Lower Blood Cholesterol Levels

The 2013 American College of Cardiology and American Heart Association (ACC/AHA) Guidelines on Treatment to Lower Blood Cholesterol recommend high-intensity statin therapy for patients with atherosclerotic cardiovascular disease (ASCVD), with a provision to use nonstatin therapies with proven clinical outcome benefit when the anticipated therapeutic response of at least 50% lowering of low-density lipoprotein cholesterol (LDL-C) level is not seen with high-intensity statin therapy, and further suggest an LDL-C level of at least 100 mg/dL with high-intensity therapy as criteria for adding nonstatin therapy with established clinical benefit. The 2016 ACC Expert Consensus Decision Pathway supports this approach.