What is the recommendation for primary prevention of ASCVD after a risk discussion of treatment options?
Prior guidelines recommended moderate- or high- intensity statins as first-line LDL-C lowering therapy in primary prevention of ASCVD after a risk discussion of treatment options. This was based on 3 large-scale exclusively primary-prevention RCTs that demonstrated that moderate-intensity and high-intensity statin were associated with ASCVD risk reduction that outweighed the observable risks. Since those ACC/AHA 2013 guidelines, a large- scale RCT in a racially/ethnically diverse population confirmed statin benefit from a moderate-inten- sity dose of a statin as compared with placebo in intermediate-risk patients.