Recent AHA/ACC guidelines on cholesterol management expands the role of the clinical laboratory

The American Heart Association (AHA) and American College of Cardiology (ACC) recently published new guidelines for managing blood cholesterol. Five years from the publication of Pooled Cohort Equation to estimate 10-year risk of atherosclerotic cardiovascular disease (ASCVD), the newest guidelines put more focus on individualized risk assessment which necessitates increased participation of laboratory medicine in the prevention and management of ASCVD. This mini-review summarizes key ideas from the new guideline that influence laboratory practice, including the renewed low-density lipoprotein cholesterol (LDL-C) treatment targets in primary and secondary prevention, the use of non-fasting lipids, new calculations of LDL cholesterol, and recommendations on assessing risk-enhancing factors in certain populations to aid the decision on statin and non-statin therapy. The shift in strategies for monitoring and lowering LDL-C has created opportunities for clinical laboratorians to more actively contribute to better identification of individuals at risk for ASCVD and partner with physicians taking care of the patient.