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    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.
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    ASCVD (Atherosclerotic Cardiovascular Disease) Risk Algorithm including Known ASCVD from AHA/ACC

    Determines 10-year risk of heart disease or stroke and provides statin recommendations.

    IMPORTANT

    This calculator includes inputs based on race, which may or may not provide better estimates, so we have decided to make race optional. See here for more on our approach to addressing race and bias on MDCalc.

    For the same other inputs, this calculator estimates higher cardiovascular risk for African American patients.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients at risk for atherosclerotic cardiovascular disease (ASCVD).

    • In 2013 the American College of Cardiology (ACC) and the American Heart Association (AHA) released new guidelines for the evaluation and treatment of cholesterol in order to reduce the risk of atherosclerotic cardiovascular disease (ASCVD).
    • This calculator provides a simplified way to follow the ASCVD treatment algorithm, which includes specific advice for patients with known ASCVD (defined as: history of ACS, MI, stable angina, coronary/other arterial revascularization, stroke, transient ischemic attack, or PAD from atherosclerosis) and patients with extreme LDL levels (≥190 mg/dL / 4.92 mmol/L).
    • The ASCVD Risk Calculator is only appropriate for patients without ASCVD and with LDL levels 70-189mg/dL (1.81-4.90 mmol/L).
    • The treatment algorithm proposed by the ACC/AHA suggests aggressive treatment for many patients, but specifically notes that patients with known ASCVD and patients with extreme LDL levels (≥190 mg/dL / 4.92 mmol/L) are at the highest risk; it also provides the “intensity” of statin treatment based on patients' predicted risk levels.

    Points to keep in mind:

    • While the score was developed and validated in a large population, several studies have suggested that the risk calculator substantially over-estimates 10-year risk. Some studies have suggested that its risk estimates are accurate.
    • Statins are highly emphasized in the guidelines and recommendations, but lifestyle modifications are likely just as – if not more – important to ASCVD risk.
    • Sometimes referred to as the Pooled Cohort Equation.

    The ASCVD Risk Algorithm is a standardized guideline to predict risk and recommend management strategies for those at risk of ASCVD.

    Step 1: High-Risk Criteria: History of ASCVD
    No
    Yes

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. David Goff

    About the Creator

    David C. Goff, Jr., MD, PhD, is a professor of epidemiology at the University of Colorado and is the dean of the Colorado School of Public Health. He is a former recipient of the Public Policy Award from the National Forum for Heart Disease and Stroke Prevention, and he is currently the Interim Chair of the ASPPH accreditation and credentialing committee. His research interests include the prevention and understanding of heart disease and stroke.

    To view Dr. David Goff's publications, visit PubMed

    Are you Dr. David Goff? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. David Goff
    Are you Dr. David Goff?
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