Clinical takeaway
LDL-C remains central, while Lp(a), ApoB, coronary calcium, and residual-risk assessment help refine who needs more intensive prevention.
A broader risk picture
- Measure lipoprotein(a) at least once in a lifetime.
- Use PREVENT-ASCVD for contemporary risk estimation.
- Consider ApoB when particle burden may be underestimated by LDL-C.
- Use coronary artery calcium selectively when the treatment decision remains uncertain.
Risk-based treatment
The review emphasizes progressively lower LDL-C goals as cardiovascular risk rises, alongside statin initiation or intensification and long-term lifestyle intervention.
Residual risk still matters
Elevated triglycerides, inflammation, and metabolic health can continue to drive events even after LDL-C improves. Reassess the whole risk profile over time.
References
- Blumenthal RS, et al. Circulation. 2026;153:e1154-e1276.
Educational summary from Medeasy Review Issue 01. Verify recommendations against current guidelines, local approvals, product information, and the individual patient's circumstances.
