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CPE-007 · Risk modifiers
CV-05: Risk enhancers present
Risk enhancers present. Evaluates borderline or intermediate risk.
Condition
- borderline or intermediate risk
- at least one risk enhancer: family history of premature ASCVD, persistent LDL-C 160 to 189, non-HDL-C 190 to 219, metabolic syndrome, chronic kidney disease, chronic inflammatory disease, history of preeclampsia or premature menopause, South Asian ancestry, persistent triglycerides ≥ 175, hs-CRP ≥ 2.0, Lp(a) ≥ 50 mg/dL or ≥ 125 nmol/L, apoB ≥ 130, ankle-brachial index < 0.9
What it reports
- Risk enhancers favor a statin discussion in borderline and intermediate-risk adults
Diagnostic boundary
- Enhancers inform a shared decision; they do not mandate treatment.
Evidence
- EV-ACCAHA-CHOL-2018Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Circulation. 2019;139(25):e1082-e1143.Supports: Risk categories, risk enhancers, statin benefit groups and the coronary-calcium decision aid Very-high-risk ASCVD definition
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
CVR-FX-05
Intermediate risk 12% with enhancers
Family history and an hs-CRP of 3.4.
CVR-FX-10
Lp(a) 180 nmol/L
An elevated Lp(a) in intermediate risk.
CVR-FX-11
Lp(a) never measured, family history of premature ASCVD
A one-time measurement prompt.
CVR-FX-12
apoB 138 with LDL-C 115
Particle burden above what LDL-C suggests.
CVR-FX-23
Metabolic syndrome with triglycerides 210, apoB not measured
A prompt for particle number.
CVR-FX-26
Chronic kidney disease and non-HDL-C 210
Enhancers in intermediate risk.
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