ASCVD Risk
Patient Demographics
Lab Values & Vitals
Risk Factors
Frequently Asked Questions
What is the ASCVD risk score based on?
The Pooled Cohort Equations (PCE) estimate 10-year risk of a first atherosclerotic cardiovascular event (MI or stroke). Variables include age, sex, race, total cholesterol, HDL, systolic BP, blood pressure treatment, diabetes status, and smoking. The equations were derived from multiple large US cohorts including ARIC, CHS, CARDIA, and Framingham.
When should I consider a coronary artery calcium (CAC) score?
CAC scoring is most useful for intermediate-risk patients (7.5-19.9%) where the statin decision is uncertain, or borderline-risk patients (5-7.4%) with risk enhancers. A CAC of 0 generally favors deferring statin therapy (except in smokers, diabetics, and those with strong family history). CAC >= 100 or >= 75th percentile for age/sex/race favors statin initiation.
What are the 4 statin benefit groups?
(1) Clinical ASCVD (secondary prevention): high-intensity statin, LDL goal <70. (2) LDL >= 190 mg/dL (e.g., familial hypercholesterolemia): high-intensity statin without needing risk calculation. (3) Diabetes, age 40-75: at least moderate-intensity statin. (4) Primary prevention, age 40-75, with 10-year ASCVD risk >= 7.5%: moderate-to-high-intensity statin based on risk discussion.