New Guidelines from AACE/ACE Emphasize LDL-C Targets
New guidelines from the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) emphasize the treatment of low-density lipoprotein cholesterol (LDL-C) levels in some individuals to lower targets than those found in previous recommendations.
The guidelines also support the measurement of coronary artery calcium scores and inflammatory markers for the stratification of risk, and introduce a new “extreme-risk” category of patients, who are recommended an LDL-C level of less than 55 mg/dL.
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In contrast with 2013 guidelines from the American Heart Association and the American College of Cardiology, the AACE/ACE guidelines recommend LDL-C goals of <55 mg/dL, <70 mg/dL, <100 mg/dL, and <130 mg/dL for individuals at extreme, very high, high/moderate, and low risk for cardiovascular events, respectively, citing evidence that suggests that lowering LDL-C levels, regardless of starting point, is beneficial.
Overall, the guidelines include 87 recommendations (45 of which are Grade A), including sections on the cost-effectiveness of the treatment of dyslipidemia and prevention of atherosclerotic cardiovascular disease, which screening tests to use for the detection of cardiovascular risk, and treatment recommendations for individuals with dyslipidemia and atherosclerotic cardiovascular disease risk.
AACE 2017 guidelines American Association of Clinical Endocrinologists and American College of Endocrinology guidelines for management of dyslipidemia and prevention of cardiovascular disease. Endocrine Practice. 2017;23(Suppl 2). https://www.aace.com/files/lipid-guidelines.pdf.