Table 4.

Guideline comparisons for treatment thresholds and targets

THRESHOLD TO START TREATMENTTREATMENT TARGET
RISK LEVEL AND GUIDELINEPRIMARYALTERNATEPRIMARYALTERNATE
High
  • CCSTreat all patientsTreat all patientsLDL: < 2.0 mmol/L or decrease by ≥ 50%Non-HDL: < 2.8 mmol/L or decrease by ≥ 50% TC/HDL ratio: < 4.0
Apo B: < 0.80 g/L
  • ATP IIILDL: ≥ 2.5 mmol/L; consider treating allNon-HDL: ≥ 3.3 mmol/L; consider treating allLDL: < 1.8–2.5 mmol/LNon-HDL: < 2.6–3.3 mmol/L
  • European*Clinical judgmentNALDL: <1.8 mmol/L or decrease by ≥ 50%Non-HDL: < 2.6 mmol/L or decrease by ≥ 50%
Apo B: < 80 mg/dL
Moderate
  • CCSLDL: > 3.5 mmol/LNon-HDL: > 4.3 mmol/L TC/HDL ratio: > 5LDL: <2.0 mmol/L or decrease by ≥ 50%Non-HDL: < 2.8 mmol/L or decrease by ≥ 50%
TC/HDL ratio: < 4.0
Apo B: < 0.80 g/L
  • ATP IIILDL: > 2.5–3.4 mmol/LNon-HDL: > 3.3–4.2 mmol/LLDL: < 3.4 mmol/LNon-HDL: < 4.2 mmol/L
  • European*Clinical judgmentNALDL: < 2.5 mmol/LNon-HDL: < 3.3 mmol/L
Apo B: < 100 mg/dL
Low
  • CCSLDL: ≥ 5 mmol/LNon-HDL: ≥ 5.8 mmol/L
TC/HDL ratio: > 6
LDL: decrease by ≥ 50%Non-HDL: Decrease by ≥ 50%
TC/HDL ratio < 4.0
  • ATP IIILDL: ≥ 4.0–5.0 mmol/LNon-HDL: ≥ 4.8–5.8 mmol/LLDL: < 4.0 mmol/LNon-HDL: < 4.8 mmol/L
  • European*Clinical judgmentNALDL: < 3.0 mmol/LNon-HDL: < 3.8 mmol/L
  • Apo B—apolipoprotein B, ATP—Adult Treatment Panel, CCS—Canadian Cardiovascular Society, HDL—high-density lipoprotein, IDL—intermediate-density lipoprotein, LDL—low-density lipoprotein, NA—not applicable, TC—total cholesterol, TG—triglyceride, VLDL—very low–density lipoprotein.

  • * European guidelines are based on a different risk scoring system.

  • Data from Genest et al,6 Anderson et al,7 Grundy et al,28 and Reiner et al.29