CoChat
Sign Up
Cited by 569Lipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and LipoproteinsCoronary Interventions and Diagnostics

2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk

Open access
Lloyd-Jones, Donald M., Morris, Pamela B., Ballantyne, Christie M., Birtcher, Kim K., Covington, Ashleigh M., DePalma, Sondra M., Minissian, Margo B., Orringer, Carl E. +3 more·2022·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2022.07.006
Open this paper in CoChat — free account

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.jacc.2022.07.006

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The lack of studies deploying physiological targets as an outcome measure might be explained by the shifting LDL-C targets through time, which makes it challenging for researchers to use the attainment of targets as a reliable endpoint.

    “This might be explained by the shifting LDL-C targets through time, which makes it challenging for researchers to use the attainment of targets as a reliable endpoint.69, 70, 71, 72, 73”

    From Interventions to improve adherence to lipid-lowering drugs: a systematic review and meta-analysis (2025) · cites this paper as [71]

    The Introduction describes changes to cholesterol-guideline recommendations, and the Pathway Summary Graphic recommends a lower LDL-C threshold of 55 mg/dL than the 70 mg/dL threshold described for the 2018 guideline. These passages support that thresholds have changed, but the paper does not say that changing thresholds make target attainment an unreliable research endpoint or explain a lack of studies using it. (LLM, conf=0.81)

    Experimental — accuracy not yet measured

  • The American College of Cardiology 2022 Consensus recommends inclisiran may be used in place of PCSK9 monoclonal antibodies when the patient has poor adherence to this medication.

    “The American College of Cardiology 2022 Consensus also recommends inclisiran may be used in place of PCSK9 Monoclonal antibodies when the patient has poor adherence to this medication”

    From Small Interfering RNA for LDL-Cholesterol Reduction (2026) · cites this paper as [4]

  • The American College of Cardiology 2022 Consensus identifies inclisiran as an important nonstatin option.

    “identifies inclisiran as an important nonstatin option”

    From Small Interfering RNA for LDL-Cholesterol Reduction (2026) · cites this paper as [4]

  • Inclisiran has been suggested as an alternative to monoclonal antibodies to enhance medication adherence.

    “The inclusion of emerging evidence on inclisiran is valuable since it has been suggested as an alternative to moAbs, to enhance medication adherence.14”

    From Adherence to PCSK9 Inhibitors in Clinical Practice (2026) · cites this paper as [14]

  • Current guidelines recommend intensifying therapy in patients who remain above LDL-C thresholds despite maximally tolerated statin treatment, typically with ezetimibe and, when greater additional lowering is required, with PCSK9-directed therapy.

    “Current guidelines recommend intensifying therapy in patients who remain above LDL-C thresholds despite maximally tolerated statin treatment, typically with ezetimibe and, when greater additional lowering is required, with PCSK9-directed therapy [1].”

    From Oral PCSK9 inhibitors for elevated LDL-C: A systematic review and meta-analysis of randomized trials (2026) · cites this paper as [1]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 76

  1. [1]1. Januzzi J.L. Jr., Ahmad T., Binder L.G., et al. 2019 methodology for creating expert consensus decision pathways: a report of the American College of Cardiology. J Am Coll Cardiol 2019;74:1138-1150. Go to Citation Crossref PubMed Google Scholar
  2. [2]2. Stone N.J., Robinson J.G., Lichtenstein A.H., et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2889-2934. Crossref PubMed Google Scholar a [...] cholesterol guideline in this document) b [...] cholesterol guideline (see
  3. [4]4. Lloyd-Jones D.M., Morris P.B., Ballantyne C.M., et al. 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: a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 2016;68:92-125. Go to Citation Crossref PubMed Google Scholar
  4. [6]6. Lloyd-Jones D.M., Morris P.B., Ballantyne C.M., et al. 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: a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol 2017;70:1785-1822. Crossref PubMed Google Scholar a [...] antibodies (mAbs) into clinical practice. b [...] of ezetimibe, evolocumab, and alirocumab. c [...] provided in the 2017 ACC nonstatin ECDP, d [...] AHA/ACC/multisociety cholesterol guideline.
  5. [10]10. Thompson P.D., Rubino J., Janik M.J., et al. Use of ETC-1002 to treat hypercholesterolemia in patients with statin intolerance. J Clin Lipidol 2015;9:295-304. Go to Citation Crossref PubMed Google Scholar
  6. [12]12. Laufs U., Banach M., Mancini G.B.J., et al. Efficacy and safety of bempedoic acid in patients with hypercholesterolemia and statin intolerance. J Am Heart Assoc 2019;8:e011662. Go to Citation Crossref PubMed Google Scholar
  7. [13]13. Paruchuri K., Finneran P., Marston N.A., et al. Outcomes of a smartphone-based application with live health-coaching post-percutaneous coronary intervention. EBioMedicine 2021;72:103593. Crossref PubMed Google Scholar a [...] approximately 24.5% compared with placebo. b [...] additional 15% to 17.8% reduction in LDL-C.
  8. [15]15. Goldberg A.C., Leiter L.A., Stroes E.S.G., et al. Effect of bempedoic acid vs placebo added to maximally tolerated statins on low-density lipoprotein cholesterol in patients with high risk for cardiovascular disease: the CLEAR wisdom randomized clinical trial. JAMA 2019;322:1780-1788. Go to Citation Crossref PubMed Google Scholar
  9. [16]16. Ballantyne C.M., Laufs U., Ray K.K., et al. Bempedoic acid plus ezetimibe fixed-dose combination in patients with hypercholesterolemia and high CVD risk treated with maximally tolerated statin therapy. Eur J Prev Cardiol 2020;27:593-603. Go to Citation Crossref PubMed Google Scholar
  10. [19]19. Laufs U., Parhofer K.G., Ginsberg H.N., et al. Clinical review on triglycerides. Eur Heart J 2020;41:99-109c. Go to Citation Crossref PubMed Google Scholar
  11. [20]20. Raal F.J., Rosenson R.S., Reeskamp L.F., et al. Evinacumab for homozygous familial hypercholesterolemia. N Engl J Med 2020;383:711-720. Crossref PubMed Google Scholar a [...] may have absent or defective LDL receptors. b [...] treatment period in any of the patients. c [...] without ezetimibe and PCSK9 inhibitors (see d [...] without ezetimibe and PCSK9 inhibitors (see
  12. [23]23. Ahmad Z., Pordy R., Rader D.J., et al. Inhibition of angiopoietin-like protein 3 with evinacumab in subjects with high and severe hypertriglyceridemia. J Am Coll Cardiol 2021;78:193-195. Go to Citation Crossref PubMed Google Scholar
  13. [25]25. Ray K.K., Landmesser U., Leiter L.A., et al. Inclisiran in patients at high cardiovascular risk with elevated LDL cholesterol. N Engl J Med 2017;376:1430-1440. Crossref PubMed Google Scholar a [...] was otherwise similar in both groups. b [...] been excluded from studies with inclisiran
  14. [27]27. Warden B.A., Duell P.B. Inclisiran: a novel agent for lowering apolipoprotein B-containing lipoproteins. J Cardiovasc Pharmacol 2021;78:e157-e174. Go to Citation Crossref PubMed Google Scholar
  15. [29]29. Lichtenstein A.H., Appel L.J., Vadiveloo M., et al. 2021 dietary guidance to improve cardiovascular health: a scientific statement from the American Heart Association. Circulation 2021;144:e472-e487. Go to Citation Crossref PubMed Google Scholar
  16. [30]30. Arnett D.K., Blumenthal R.S., Albert M.A., et al. 2019 ACC/AHA guideline on primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019;74:e177-e232. Go to Citation Crossref PubMed Google Scholar
  17. [33]33. Gupta A., Thompson D., Whitehouse A., et al. Adverse events associated with unblinded, but not with blinded, statin therapy in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm (ASCOT-LLA): a randomised double-blind placebo-controlled trial and its non-randomised non-blind extension phase. Lancet 2017;389:2473-2481. Go to Citation Crossref PubMed Google Scholar
  18. [35]35. Baigent C., Landray M.J., Reith C., et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet 2011;377:2181-2192. Crossref PubMed Google Scholar a [...] The median follow-up was 6 years); SHARP b [...] patients with CKD (3,023 on dialysis)
  19. [38]38. Janik M.J., Urbach D.V., van Nieuwenhuizen E., et al. Alirocumab treatment and neurocognitive function according to the CANTAB scale in patients at increased cardiovascular risk: a prospective, randomized, placebo-controlled study. Atherosclerosis 2021;331:20-27. Go to Citation Crossref PubMed Google Scholar
  20. [39]39. Giugliano R.P., Mach F., Zavitz K., et al. Design and rationale of the EBBINGHAUS trial: A phase 3, double-blind, placebo-controlled, multicenter study to assess the effect of evolocumab on cognitive function in patients with clinically evident cardiovascular disease and receiving statin background lipid-lowering therapy-A cognitive study of patients enrolled in the FOURIER trial. Clin Cardiol 2017;40:59-65. Go to Citation Crossref PubMed Google Scholar
  21. [46]46. Superko H.R., Greenland P., Manchester R.A., et al. Effectiveness of low-dose colestipol therapy in patients with moderate hypercholesterolemia. Am J Cardiol 1992;70:135-140. Go to Citation Crossref PubMed Google Scholar
  22. [49]49. Sajja A., Li H.F., Spinelli K.J., et al. Discordance between standard equations for determination of LDL cholesterol in patients with atherosclerosis. J Am Coll Cardiol 2022;79:530-541. Go to Citation Crossref PubMed Google Scholar
  23. [50]50. Mora S., Rifai N., Buring J.E., et al. Comparison of LDL cholesterol concentrations by Friedewald calculation and direct measurement in relation to cardiovascular events in 27,331 women. Clin Chem 2009;55:888-894. Go to Citation Crossref PubMed Google Scholar
  24. [52]52. Sampson M., Ling C., Sun Q., et al. A new equation for calculation of low-density lipoprotein cholesterol in patients with normolipidemia and/or hypertriglyceridemia. JAMA Cardiol 2020;5:540-548. Crossref PubMed Google Scholar a [...] of LDL-C or with hypertriglyceridemia. b [...] but additional validation is needed.
  25. [53]53. Martin S.S., Blaha M.J., Elshazly M.B., et al. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA 2013;310:2061-2068. Go to Citation Crossref PubMed Google Scholar
  26. [54]54. Navar A.M., Mulder H.M., Wojdyla D.M., et al. Have the major cardiovascular outcomes trials impacted payer approval rates for PCSK9 inhibitors?. Circ Cardiovasc Qual Outcomes 2020;13:e006019. Go to Citation Crossref PubMed Google Scholar
  27. [57]57. Raber L., Ueki Y., Otsuka T., et al. Effect of alirocumab added to high-intensity statin therapy on coronary atherosclerosis in patients With acute myocardial infarction: The PACMAN-AMI randomized clinical trial. JAMA 2022;327:18: 1771-1781. Crossref PubMed Google Scholar a [...] ezetimibe and PCSK9 mAbs may be considered. b [...] with or without ezetimibe and a PCSK9 mAb.
  28. [58]58. Koskinas K.C., Windecker S., Pedrazzini G., et al. Evolocumab for early reduction of LDL cholesterol levels in patients with acute coronary syndromes (EVOPACS). J Am Coll Cardiol 2019;74:2452-2462. Crossref PubMed Google Scholar a [...] ezetimibe and PCSK9 mAbs may be considered. b [...] with or without ezetimibe and a PCSK9 mAb.
  29. [59]59. Leucker T.M., Blaha M.J., Jones S.R., et al. Effect of evolocumab on atherogenic lipoproteins during the peri- and early postinfarction period: a placebo-controlled, randomized trial. Circulation 2020;142:419-421. Crossref PubMed Google Scholar a [...] ezetimibe and PCSK9 mAbs may be considered. b [...] with or without ezetimibe and a PCSK9 mAb.
  30. [60]60. Baigent C., Blackwell L., Emberson J., et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 2010;376:1670-1681. Crossref PubMed Google Scholar a [...] associated with ASCVD risk reduction. b [...] if baseline LDL is <77 mg/dL (2 mmol/L).
  31. [62]62. Giugliano R.P., Pedersen T.R., Park J.G., et al. Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. Lancet 2017;390:1962-1971. Go to Citation Crossref PubMed Google Scholar
  32. [64]64. Bohula E.A., Morrow D.A., Giugliano R.P., et al. Atherothrombotic risk stratification and ezetimibe for secondary prevention. J Am Coll Cardiol 2017;69:911-921. Crossref PubMed Google Scholar a [...] ezetimibe to statin therapy following ACS. b [...] ezetimibe to statin therapy following ACS. c [...] experiencing >25% reduction in LDL-C.
  33. [65]65. Descamps O., Tomassini J.E., Lin J., et al. Variability of the LDL-C lowering response to ezetimibe and ezetimibe + statin therapy in hypercholesterolemic patients. Atherosclerosis 2015;240:482-489. Crossref PubMed Google Scholar a [...] experiencing >20% reduction in LDL-C. b [...] experiencing >25% reduction in LDL-C.
  34. [66]66. Kazi D.S., Moran A.E., Coxson P.G., et al. Cost-effectiveness of PCSK9 inhibitor therapy in patients with heterozygous familial hypercholesterolemia or atherosclerotic cardiovascular disease. JAMA 2016;316:743-753. Go to Citation Crossref PubMed Google Scholar
  35. [67]67. Smith A., Johnson D., Banks J., et al. Trends in PCSK9 Inhibitor prescriptions before and after the price reduction in patients with atherosclerotic cardiovascular disease. J Clin Med 2021;10:17: 3828. Go to Citation Crossref PubMed Google Scholar
  36. [68]68. Patel J. Managed care pharmacist updates for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. Am J Manag Care 2021;27:S76-S82. Go to Citation Crossref PubMed Google Scholar
  37. [69]69. LaRosa J.C., Grundy S.M., Waters D.D., et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005;352:1425-1435. Go to Citation Crossref PubMed Google Scholar
  38. [70]70. Heart Protection Study Collaborative G. Randomized trial of the effects of cholesterol-lowering with simvastatin on peripheral vascular and other major vascular outcomes in 20,536 people with peripheral arterial disease and other high-risk conditions. J Vasc Surg 2007;45:645-654. Go to Citation Crossref PubMed Google Scholar
  39. [71]71. Bangalore S., Fayyad R., Kastelein J.J., et al. 2013 Cholesterol guidelines revisited: Percent LDL cholesterol reduction or attained LDL cholesterol level or both for prognosis?. Am J Med 2016;129:384-391. Go to Citation Crossref PubMed Google Scholar
  40. [73]73. Aggarwal S., Loomba R.S., Arora R.R. Efficacy of colesevelam on lowering glycemia and lipids. J Cardiovasc Pharmacol 2012;59:198-205. Crossref PubMed Google Scholar a [...] the presence of other ASCVD risk factors. b [...] and patients with HoFH or severe HeFH.
  41. [74]74. Goldberg A.C., Hopkins P.N., Toth P.P., et al. Familial hypercholesterolemia: screening, diagnosis and management of pediatric and adult patients: clinical guidance from the National Lipid Association Expert Panel on Familial Hypercholesterolemia. J Clin Lipidol 2011;5:S1-S8. Crossref PubMed Google Scholar a [...] the presence of other ASCVD risk factors. b [...] and patients with HoFH or severe HeFH. c [...] and Goldberg et al
  42. [75]75. Perak A.M., Ning H., de Ferranti S.D., et al. Long-term risk of atherosclerotic cardiovascular disease in US adults with the familial hypercholesterolemia phenotype. Circulation 2016;134:9-19. Go to Citation Crossref PubMed Google Scholar
  43. [76]76. Khera A.V., Won H.H., Peloso G.M., et al. Diagnostic yield and clinical utility of sequencing familial hypercholesterolemia genes in patients with severe hypercholesterolemia. J Am Coll Cardiol 2016;67:2578-2589. Go to Citation Crossref PubMed Google Scholar
  44. [78]78. Gidding S.S., Champagne M.A., de Ferranti S.D., et al. The agenda for familial hypercholesterolemia: a scientific statement from the American Heart Association. Circulation 2015;132:2167-2192. Crossref PubMed Google Scholar a [...] with permission from Gidding et al. b [...] in this high-risk patient population.
  45. [79]79. Stone N.J., Robinson J.G., Lichtenstein A.H., et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2889-2934. Go to Citation Crossref PubMed Google Scholar
  46. [80]80. Ridker P.M., Lonn E., Paynter N.P., et al. Primary prevention with statin therapy in the elderly: new meta-analyses from the contemporary JUPITER and HOPE-3 randomized trials. Circulation 2017;135:1979-1981. Go to Citation Crossref PubMed Google Scholar
  47. [82]82. Carr J.J., Jacobs D.R. Jr., Terry J.G., et al. Association of coronary artery calcium in adults aged 32 to 46 years with incident coronary heart disease and death. JAMA Cardiol 2017;2:391-399. Go to Citation Crossref PubMed Google Scholar
  48. [83]83. Mihaylova B., Emberson J., Blackwell L., et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012;380:581-590. Go to Citation Crossref PubMed Google Scholar
  49. [84]84. Orringer C.E., Blaha M.J., Blankstein R., et al. The National Lipid Association scientific statement on coronary artery calcium scoring to guide preventive strategies for ASCVD risk reduction. J Clin Lipidol 2021;15:33-60. Go to Citation Crossref PubMed Google Scholar
  50. [86]86. Flueckiger P., Qureshi W., Michos E.D., et al. Guideline-based statin/lipid-lowering therapy eligibility for primary prevention and accuracy of coronary artery calcium and clinical cardiovascular events: the Multi-Ethnic Study of Atherosclerosis (MESA). Clin Cardiol 2017;40:163-169. Go to Citation Crossref PubMed Google Scholar
  51. [88]88. Peng A.W., Dardari Z.A., Blumenthal R.S., et al. Very high coronary artery calcium (≥ 1000) and association with cardiovascular disease events, non-cardiovascular disease outcomes, and mortality: results from MESA. Circulation 2021;143:1571-1583. Go to Citation Crossref PubMed Google Scholar
  52. [90]90. Munden R.F., Carter B.W., Chiles C., et al. Managing incidental findings on thoracic CT: mediastinal and cardiovascular findings. a white paper of the ACR Incidental Findings Committee. J Am Coll Radiol 2018;15:1087-1096. Go to Citation Crossref PubMed Google Scholar
  53. [91]91. Osei A.D., Mirbolouk M., Berman D., et al. Prognostic value of coronary artery calcium score, area, and density among individuals on statin therapy vs. non-users: the Coronary Artery Calcium Consortium. Atherosclerosis 2021;316:79-83. Go to Citation Crossref PubMed Google Scholar
  54. [92]92. Navarese E.P., Buffon A., Andreotti F., et al. Meta-analysis of impact of different types and doses of statins on new-onset diabetes mellitus. Am J Cardiol 2013;111:1123-1130. Go to Citation Crossref PubMed Google Scholar
  55. [93]93. Guyton J.R., Bays H.E., Grundy S.M., et al. An assessment by the Statin Intolerance Panel: 2014 update. J Clin Lipidol 2014;8:S72-S81. Crossref PubMed Google Scholar a [...] complete statin intolerance is uncommon. b [...] recurrence of muscle-related symptoms.
  56. [94]94. Ahmad Z. Statin intolerance. Am J Cardiol 2014;113:1765-1771. Go to Citation Crossref PubMed Google Scholar
  57. [95]95. Nazir S., Lohani S., Tachamo N., et al. Statin-associated autoimmune myopathy: a systematic review of 100 cases. J Clin Rheumatol 2017;23:149-154. Go to Citation Crossref PubMed Google Scholar
  58. [96]96. Zisa D., Goodman S.M. Perioperative management of rheumatic disease and therapies. Med Clin North Am 2021;105:273-284. Crossref PubMed Google Scholar a [...] statin-associated autoimmune myopathy. b [...] include PCSK9 inhibitors or ezetimibe (see
  59. [97]97. Tiniakou E. Statin-associated autoimmune myopathy: current perspectives. Ther Clin Risk Manag 2020;16:483-492. Go to Citation Crossref PubMed Google Scholar
  60. [98]98. Toth P.P., Patti A.M., Giglio R.V., et al. Management of statin intolerance in 2018: still more questions than answers. Am J Cardiovasc Drugs 2018;18:157-173. Go to Citation Crossref PubMed Google Scholar
  61. [99]99. Thompson P.D., Clarkson P.M., Rosenson R.S., et al. An assessment of statin safety by muscle experts. Am J Cardiol 2006;97:69C-76C. Go to Citation Crossref PubMed Google Scholar
  62. [100]100. Nguyen K.A., Li L., Lu D., et al. A comprehensive review and meta-analysis of risk factors for statin-induced myopathy. Eur J Clin Pharmacol 2018;74:1099-1109. Go to Citation Crossref PubMed Google Scholar
  63. [104]104. Baigent C., Landray M.J., Reith C., et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet 2011;377:2181-2192. Crossref PubMed Google Scholar a [...] ) and have benefit from statin therapy. b [...] of Heart and Renal Protection) trial,
  64. [105]105. Fellstrom B.C., Jardine A.G., Schmieder R.E., et al. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med 2009;360:1395-1407. Go to Citation Crossref PubMed Google Scholar
  65. [106]106. Wanner C., Krane V., Marz W., et al. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med 2005;353:238-248. Go to Citation Crossref PubMed Google Scholar
  66. [108]108. Wright R.S., Collins M.G., Stoekenbroek R.M., et al. Effects of renal impairment on the pharmacokinetics, efficacy, and safety of inclisiran: an analysis of the ORION-7 and ORION-1 studies. Mayo Clin Proc 2020;95:77-89. Go to Citation Crossref PubMed Google Scholar
  67. [110]110. Jacobson T.A., Maki K.C., Orringer C.E., et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 2. J Clin Lipidol 2015;9:S1-S122.e1. Go to Citation Crossref PubMed Google Scholar
  68. [113]113. Bateman B.T., Hernandez-Diaz S., Fischer M.A., et al. Statins and congenital malformations: cohort study. BMJ 2015;350:h1035. Go to Citation Crossref PubMed Google Scholar
  69. [114]114. Costantine M.M., Cleary K., Hebert M.F., et al. Safety and pharmacokinetics of pravastatin used for the prevention of preeclampsia in high-risk pregnant women: a pilot randomized controlled trial. Am J Obstet Gynecol 2016;214:720.e1-720.e17. Go to Citation Crossref PubMed Google Scholar
  70. [115]115. Adam O., Laufs U. Antioxidative effects of statins. Arch Toxicol 2008;82:885-892. Go to Citation Crossref PubMed Google Scholar
  71. [116]116. Nakamura H., Arakawa K., Itakura H., et al. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. Lancet 2006;368:1155-1163. Go to Citation Crossref PubMed Google Scholar
  72. [117]117. Taguchi I., Iimuro S., Iwata H., et al. High-dose versus low-dose pitavastatin in Japanese patients with stable coronary artery disease (REAL-CAD): a randomized superiority trial. Circulation 2018;137:1997-2009. Go to Citation Crossref PubMed Google Scholar
  73. [118]118. Ferdinand K.C., Jacobson T.A., Koren A., et al. Alirocumab efficacy and safety by race and ethnicity: Analysis from 3 ODYSSEY phase 3 trials. J Clin Lipidol 2019;13:586-593.e5. Go to Citation Crossref PubMed Google Scholar
  74. [119]119. Daviglus M.L., Ferdinand K.C., Lopez J.A.G., et al. Effects of evolocumab on low-Density lipoprotein cholesterol, non-high density lipoprotein cholesterol, apolipoprotein B, and lipoprotein(a) by race and ethnicity: a meta-analysis of individual participant data From double-blind and open-label extension studies. J Am Heart Assoc 2021;10:e016839. Go to Citation Google Scholar
  75. [120]120. Warden B.A., Duell P.B. Management of dyslipidemia in adult solid organ transplant recipients. J Clin Lipidol 2019;13:231-245. Go to Citation Crossref PubMed Google Scholar
  76. [121]121. Wiggins B.S., Saseen J.J., Page R.L. 2nd, et al. Recommendations for management of clinically significant drug-drug interactions with statins and select agents in patients with cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2016;134:e468-e495. Go to Citation Crossref PubMed Google Scholar Podcast cover 2022 Acc Expert Consensus Decision Pathway On the Role of Nonstatin Therapies For Ldl-Cholesterol Lowering In the Management of Atherosclerotic Cardiovascular Disease Risk Valentin Fuster September 26, 2022 View full text|Download PDF Now Reading: 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Solution Set Oversight Committee Share PREVIOUS ARTICLE Myocarditis Following SARS-CoV2 mRNA Vaccination Against COVID-19 Previous NEXT ARTICLE Correction Next AP=acute pancreatitis; sHTG=severe hypertriglyceridemia. sHTG-induced AP can be devastating: mortality as high as 8%, irreversible organ damage, and prolonged hospitalization.3,4 Once AP occurs, the chance of recurrence is as high as 24%.5* Learn how TRYNGOLZA helps patients with their triglycerides and AP. See the data AP=acute pancreatitis. Prescribing Information IMPORTANT SAFETY INFORMATION & INDICATION CONTRAINDICATIONS TRYNGOLZA is contraindicated in patients with a history of serious hypersensitivity to TRYNGOLZA or any of the excipients in TRYNGOLZA. Hypersensitivity reactions requiring medical treatment have occurred. WARNINGS AND PRECAUTIONS Hypersensitivity Reactions Hypersensitivity reactions (including symptoms of bronchospasm, diffuse erythema, facial swelling, urticaria, chills, and myalgias) have been reported in patients treated with TRYNGOLZA. Advise patients on the signs and symptoms of hypersensitivity reactions and instruct patients to promptly seek medical attention and discontinue use of TRYNGOLZA if hypersensitivity reactions occur. ADVERSE REACTIONS Most common adverse reactions in patients with sHTG (incidence ≥2% higher than placebo) were injection site reactions and transaminases increased. INDICATION TRYNGOLZA (olezarsen) is indicated as an adjunct to diet to reduce triglyceride (TG) levels in adults with severe hypertriglyceridemia (TG ≥500 mg/dL, sHTG). Please see full Prescribing Information for TRYNGOLZA. * Within 1 year.5 References: 1. TRYNGOLZA. Prescribing information. Ionis Pharmaceuticals. 2. Kessler AS, Baum SJ, Kutrieb E, et al. Rates of acute pancreatitis and cardiovascular events among adults with severe or extreme hypertriglyceridemia in US clinical practice. Lipids Health Dis. 2025;24(1):252. 3. Nawaz H, Koutroumpakis E, Easler J, et al. Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis. Am J Gastroenterol. 2015;110(10):1497-1503. 4. Shemesh E, Zafrir B. Hypertriglyceridemia-related pancreatitis in patients with type 2 diabetes: links and risks. Diabetes Metab Syndr Obes. 2019;12:2041-2052. 5. Sanchez RJ, Ge W, Wei W, Ponda MP, Rosenson RS. The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis. Lipids Health Dis. 2021;20(1):72. ©2026 Ionis Pharmaceuticals, Inc. Ionis, TRYNGOLZA, and the TRYNGOLZA logo are registered trademarks of Ionis Pharmaceuticals, Inc. All rights reserved. US-OLZ-2600190 v1.0 07/2026 JACC THIS WEEK 2022 Acc Expert Consensus Decision Pathway On the Role of Nonstatin Therapies For Ldl-Cholesterol Lowering In the Management of Atherosclerotic Cardiovascular Disease Risk 00:00:00

Cited by

Sorted by citations

Authors
Lloyd-Jones, D. M., Morris, P. B., Ballantyne, C. M., Birtcher, K. K., Covington, A. M., DePalma, S. M., Minissian, M. B., Orringer, C. E., Smith, S. C., Waring, A. A., & Wilkins, J. T.
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2022-10
Volume
80
Issue
14
Pages
1366-1418
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2022.07.006
OpenAlex
W4293253252
Cited by
569
References
26
Citations by year
2026: 140 · 2025: 157 · 2024: 144 · 2023: 108 · 2022: 16 · 2017: 3 · 2016: 1
FWCI
101.79
Type
journal article
Language
en
Update notices
erratum (2023-01-03)
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
Keywords
LDL cholesterol lowering, atherosclerotic cardiovascular disease, cardiovascular risk management, hypercholesterolemia, LDL-C lowering therapy
MeSH terms
Ezetimibe, Anticholesteremic Agents, Cardiology, Cardiovascular Diseases, Humans, Cholesterol, LDL, United States, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Consensus

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review