Past ASCVD events are risk factors for future events. The existence of high-risk conditions as well.
From the AHA/ACC 2018 cholesterol guidelines.
Clinical ASCVD
Clinical ASCVD consists of the following conditions of atherosclerotic origin.
- ACS,
- history of MI,
- stable or unstable angina or coronary other arterial revascularization,
- stroke,
- transient ischemic attack (TIA), or
- peripheral artery disease (PAD)
- aortic aneurysm,
Very High-Risk* of Future ASCVD Events
“Very high-risk includes a history of multiple major ASCVD events or 1 major ASCVD event and multiple high-risk conditions.” AHA/ACC 2018
Major ASCVD Events
- Recent ACS (within the past 12 mo)
- History of MI (other than recent ACS event listed above)
- History of ischemic stroke
- Symptomatic peripheral arterial disease (history of claudication with ABI <0.85, or previous revascularization or amputation)
People w/ established ASCVD are at high risk for a CVD event.
High-Risk Conditions
Also, treat the following patients as seriously as patients w/ established ASCVD.
- Age ≥65 y
- Heterozygous familial hypercholesterolemia
- History of prior coronary artery bypass surgery or percutaneous coronary intervention outside of the major ASCVD event(s)
- Diabetes mellitus
- Hypertension
- CKD (eGFR 15-59 mL/min/1.73 m2 )
- Current smoking
- Persistently elevated LDL-C (LDL-C ≥100 mg/dL [≥2.6 mmol/L]) despite maximally tolerated statin therapy and ezetimibe History of congestive HF
- Need for revascularization while on a statin.
- Recurrent ASCVD event risk while on statin treatment.
See more ASCVD risk factors here.
* Per AHA/ACC 2018 Guidelines, “Very high risk includes a history of multiple major ASCVD events or 1 major ASCVD event and multiple high-risk conditions”
Source
AHA/ACC 2018 Cholesterol Guidelines. https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000625