2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee

Salim S Virani, Pamela B Morris, Anandita Agarwala, et al.


J Am Coll Cardiol 2021 Aug 31;78(9):960-993

First published: August 31, 2021  DOI: 10.1016/j.jacc.2021.06.011



The 2018 AHA/ACC Guideline on the Management of Blood Cholesterol was published prior to the important results of REDUCE-IT trial, which demonstrated that the addition of high-dose icosapent ethyl to traditional statin therapy led to a significant reduction in risk of ASCVD events and CV mortality. As a result, this 2021 ACC Consensus statement is intended to provide healthcare professionals with the latest recommendations for lifestyle and/or pharmacological interventions of moderate- to high-risk patients with persistent hypertriglyceridemia.

In particular, this Consensus Statement covers the latest evidence on the safety and efficacy of triglyceride therapies (IPE, eicosapentaenoic acid plus docosahexaenoic acid, and selective peroxisome proliferator-activated receptor alpha agonists), and prescription grade omega-3 fatty acids in reducing LDL-C levels. The emphasis is on recommendations of lifestyle interventions and the use of statins and triglyceride risk-based non-statin therapies for ASCVD risk reduction in patients with hypertriglyceridemia, established ASCVD; and diabetes.

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