Guideline | Statin medication | Cholesterol targets | Frequency of monitoring | ||||||
Recommendation | LoE | SoR | Recommendation | LoE | SoR | Recommendation | LoE | SoR | |
ACD | ≤75 year: high-intensity statins >75 year: initiate moderate or high-intensity statins if benefit–risk ratio favourable | A B | I IIa | – | – | – | Fasting lipids 4–12 weeks after initiation, then every 3–12 months | A | I |
AUSS | Atherosclerotic: high-intensity statins if reasonable life expectancy | High | Strong | – | – | – | – | – | – |
AUST | Statins | – | – | LDL-C <1.8 mmol/L Or LDL-C >50% reduction Non-HDL-C<2.6 mmol/L | – – – | – – – | – | – | – |
CCSG | Moderate/high-intensity statins | High | Strong | LDL-C <2.0 mmol/L Or LDL-C >50% reduction Alternatively, apoB <0.8 g/L Or non-HDL-C<2.6 mmol/L ACS: LDL-C <1.8 mmol/L Or LDL-C >50% reduction | Mod Mod Mod Mod – – | Strong Strong Strong Strong V&Ps V&Ps | Until stable | – | PO |
CSN | Ischaemic: high-intensity statins | A | I | LDL-C <1.8 mmol/L Or LDL-C ≥50% reduction | B B | II II | – | – | – |
ESCEAS | Baseline LDL-C >1.4 mmol/L: offer med <1.4 mmol/L: consider med | A A | I IIa | LDL-C <1.4 mmol/L Or LDL-C >50% reduction Further event <2 years: LDL-C <1.0 mmol/L | A A B | I I IIb | Starting/adjusting: 8 (±4) weeks Once achieved: Annually | – – | – – |
ESVS | Statins prior to endarterectomy or stenting | A | I | -- | – | – | – | – | – |
HKCTF | High-intensity statins | – | – | LDL-C <1.8 mmol/L Or LDL-C >50% reduction if baseline 1.8-3.5 mmol/L | – – | – – | – | – | – |
IAS | Maximal statins | – | – | LDL-C <1.8 mmol/L. Non-HDL-C<2.6 mmol/L | – – | – – | – | – | – |
IDF | Statins | – | RC | Triglyceride <2.3 mmol/L HDL-C >1.0 mmol/L. Non-HDL-C<2.5 mmol/L LDL-C <1.8 mmol/L | – – – – | RC RC RC RC | At least annually | – | RC |
JAS | Statins | 1+ | A | LDL-C <2.6 mmol/L Or LDL-C >50% reduction if target cannot be met If additional conditions: LDL-C <1.8 mmol/L If triglyceride high: Non-HDL-C<3.4 mmol/L Non-HDL-C<2.6 mmol/L if additional conditions | 3 3 – – – | A A – – – | Regular blood testing Every 3–6 months | – – | B – |
JBS3 | Atorvastatin, up to 80 mg in ACS | – | – | LDL-C <2.0 mmol/L Non-HDL-C<2.5 mmol/L | – – | – – | Annual non–fasting TC and HDL–C once stable | – | – |
NHF | Highest tolerated dose of statins | 1A | Strong | LDL-C ≤1.8 mmol/L | – | – | TC and LDL–C approx. 3 months after starting | – | – |
NICE | Atorvastatin 80 mg, lower dose if not tolerated. | – | Strong | Non-HDL-C>40% reduction | – | Strong | 3 months after treatment start. Annual non–fasting lipids | – – | Strong Weak |
NLA | Moderate/high-intensity statins | High | A | Non-HDL-C<2.6 mmol/L LDL-C <1.8 mmol/L | High High | A A | 4–12 months once achieved | Low | E |
NZ | Statins | – | – | LDL-C 1.6-1.8 mmol/L | – | – | Non–fasting 6–12 months until target achieved. Annually. | – – | – – |
SAF | Atherosclerotic and TC >3.5 mmol/L: statins Trial strength, for example, 40 mg simvastatin | I – | A – | – | – | – | – | – | – |
SAHA | High-intensity statins | – | – | LDL-C <1.8 mmol/L Or LDL-C >50% reduction if baseline 1.8-3.5 mmol/L | – – | – – | Starting/adjusting: 8 (±4) weeks Once achieved: 6 months | – – | – – |
SAM | Statins | – | – | LDL-C <2.6 mmol/L | – | – | – | – | – |
SIGN | Atorvastatin 80 mg Lower if not tolerated | – – | Strong GP | – | – | – | Annual Review | – | GP |
SMH | Statins | 1++ | A | LDL-C <2.1 mmol/L | 1++ | A | Annually | – | GP |
TSC | Statins | A | I | LDL-C <1.8 mmol/L Diabetes: LDL-C <1.4 mmol/L | B B | I IIa | – | – | – |
ACD, American College of Cardiology/American Heart Association/American Association of Cardiovascular and Pulmonary Rehabilitation/American Association Academy of Physician Assistants/Association of Black Cardiologists/American College of Preventive Medicine/American Diabetes Association/American Geriatrics Society/American Pharmacists Association/American Society for Preventive Cardiology/National Lipid Association/Preventive Cardiovascular Nurses Association; ACS, acute coronary syndromes; AUSS, Australia Stroke Society; AUST, Austrian Obesity Association/Austrian Atherosclerosis Society/Austrian Diabetes Association/Austrian Society of Hypertension/Austrian Society for Internal Angiology/Austrian Society of Nephrology/Austrian Society of Cardiology/Austrian Stroke Society; CCSG, Canadian Cardiovascular Society; CSN, Chinese Society of Neurology and Cerebrovascular Disease Group; ESCEAS, European Society of Cardiology and European Atherosclerosis Society; ESVS, European Society for Vascular Surgery; GP, good practice; ; (non) HDL-C, (non) HDL-cholesterol; HKCTF, Hong Kong Cardiovascular Task Force ; IAS, International Atherosclerosis Society; IDF, International Diabetes Federation; JAS, Japan Atherosclerosis Society; JBS3, Joint British Societies ; LDL-C, LDL cholesterol; LoE, level of evidence; Med, medication; Mod, moderate; NHF, National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand; NICE, National Institute for Health and Clinical Excellence; NLA, National Lipid Association; NZ, New Zealand Ministry of Health; PO, panel opinion; RC, recommended care; SAF, South African Stroke Society; SAHA, South African Heart Association; SAM, Sociedade Brasileira de Cardiologia; SIGN, Scottish Intercollegiate Guidelines Network; SMH, Singapore Ministry of Health; SoR, strength of recommendation; TC, total cholesterol; TSC, Taiwan Society of Cardiology/Taiwan Society of Emergency Medicine/Taiwan Society of Cardiovascular Interventions; V&Ps, values and preferences.