Lipid Manager vs CV Risk Estimation

The ACC Lipid Manager app provides two clinical decision support tools in one app to help clinicians manage a patient’s triglycerides and LDL-C from therapy initiation through treatment calibration with the goal of lowering ASCVD risk: •  Lipid Lowering Therapy tool: Supports selection of lipid‑lowering therapies and individualized goals to reduce ASCVD risk through targeted management of LDL-C and triglycerides (previously known as LDL-C Lowering Therapy) •  Statin Intolerance tool: Evaluate the patient for possible statin intolerance, and determine appropriate next steps The information and recommendations in this clinical decision support app are not meant to represent the only or best course of care nor replace clinical judgement. Therapeutic options should be determined after discussion between the patient and their care provider. Financial support for Lipid Manager was provided by Esperion. All content was independently developed with no sponsor involvement.

This app is for CLINICIANS, not the lay public. The CV Risk app presents clinicians with three valuable 10-year cardiovascular event risk calculators to serve clinicians and learners in primary prevention of cardiovascular disease. It is for clinicians only, not the lay public. The calculators are Framingham 2008, ASCVD 2013, and the revised pooled cohort equations ASCVD of 2018. The app addresses such common questions as: • What is the ASCVD 10-year CV risk for a 57 year old male hypertensive smoker with a given set of lipid and blood pressure numbers? • What’s the magnitude of impact of a patient on their own improving their cholesterol by 11, 27, or 41 points? • For a poorly controlled hypertensive smoker with a 10-year risk of 31.3%, how impactful would improved blood pressure control or smoking cessation be? • How impactful is a cholesterol of 220 on a given patient's risk at 35 vs. 55 vs. 75 years old? • I hear that ASCVD 2013 overestimates risk, particularly for black adults? True? What about the revised pooled cohort equations of 2018? The app explicitly does not include treatment thresholds, LDL targets, estimates of impact of therapy, coronary calcium scoring, etc. I wanted the cleanest simplest tool possible for evaluating and discussing cardiovascular risk with all the other more subjective, controversial stuff out of the way. This app is written and intended for practicing clinicians like internists and family physicians; for resident physician trainees; for medical students; and of course for other clinician colleagues like NP's and PA's. Cardiologists could use this app, but you folks are focused on secondary prevention, which is an entirely different ballgame. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.