• The 2017 AACE/ACE Guidelines for the Management of Dyslipidemia and Prevention of Cardiovascular Disease provided important and groundbreaking new treatment goals. These guidelines were the first anywhere to establish an “Extreme Risk” category with an LDL goal of <55 mg/dl. Prior to this document “Very High Risk” patients from all published guidelines proposed either no specific LDL goal or an LDL goal of <70mg/dl. The "Extreme Risk" category is validated by both the IMPROVE-IT and FOURIER trials and supported by several large meta-analysis including those from the Cholesterol Treatment Trialists’ 2010 Collaboration (CTT 2010) and Boekholdt 2014. Numerous prospective trials in the past have strongly suggested that "lower is better” pointing to further CAD event reduction with LDL levels well below 50 mg/dl.

The Risk Categories including Extreme Risk are noted in the table below. Other important contributions are the emergence of coronary artery calcification (CAC) as a useful tool for risk stratification and the strongest predictor of CVD in low risk patients, recommendations for risk assessment in Type 1 diabetes, discussion of FH, lipid screening recommendations for children and adolescents and the effectiveness and appropriate use of PSCK-9i agents.

The Lipid Guidelines Executive Summary (www.aace.com/publications) is followed by an extensive Evidence Base/Source Document with nearly 700 evidence ranked references.