ASCVD Risk Estimator from AHA/ACC

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Clinical Use

Estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk in individuals with LDL-C < 190 mg/dL, without ASCVD, not on LDL-C lowering therapy

More Info

The ASCVD risk estimator was developed and released by ACC/AHA in 2013. The Expert Work Group used the available data from community based cohorts of adults, with adjudicated endpoints for cardiovascular death, nonfatal myocardial infarction, and fatal or nonfatal stroke.

Cohorts that included African-American or white participants with at least 12 years of follow-up were included. Data from other racial/ethnic groups were insufficient, precluding their inclusion in the final analyses.

The final pooled cohorts included participants from several large, racially and geographically diverse cohort studies, including the ARIC (Atherosclerosis Risk in Communities) study, the Cardiovascular Health Study, and the CARDIA (Coronary Artery Risk Development in Young Adults) study, combined with applicable data from the Framingham Original and Offspring Study cohorts.1

 

Equations

Scoring information available in Appendix 7 in this document

Definitions

ASCVD Risk Enhancers

  • Family history of premature ASCVD
  • Persistently elevated LDL-C ≥160 mg/dL (≥4.1 mmol/L)
  • Chronic kidney disease
  • Metabolic syndrome
  • Conditions specific to women (e.g. preeclampsia, premature menopause)
  • Inflammatory diseases (especially rheumatoid arthritis, psoriasis, HIV)
  • Ethnicity factors (e.g. South Asian ancestory)

References

1. Goff DC Jr, et. al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S49-73. Full Text
2. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/ APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol J Am Coll Cardiol 2018; Nov 10: [Epub ahead of print]. Full Text

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Developer: Sirikarn Napan, MD, FACC