Lipoprotein Management in Patients With Cardiometabolic Risk: Consensus statement from the American Diabetes Association and the American College of Cardiology Foundation

Central role of LDL in atherogenesis Among the many contributing factors, elevated cholesterol levels play a dominant role in both the initiation and progression of atherosclerosis, as well as in the clinical consequences such as myocardial infarction, stroke, peripheral vascular disease, and heart failure. In terms of dyslipoproteinemia, we recommend the following: * Statin therapy for the majority of dyslipoproteinemic adult patients with CMR * For patients with CMR on statin therapy, guiding therapy with measurements of apoB and treatment to apoB goals in addition to LDL cholesterol and non-HDL cholesterol assessments * Treatment goals, summarized in Table 1, that address the high lifetime risk of patients with dyslipoproteinemia and CMR. * Clinical trials to determine whether the pharmacologic therapy required to achieve very low levels of atherogenic lipoproteins is safe and cost-effective * A concerted, multifaceted, public health effort, focused on lifestyle modification, to reduce mean population levels of atherogenic lipoproteins to values well below current ones.