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Premature CAD defined as a heart attack or stroke before age 60 years in a 1st degree relative.
Threshold cutoff values as follows:
*The risk stratification tool for the ESC is the SCORE system which estimates 10y risk of CVD death. Patients with a 10y risk of CVD death ≥5% are considered high risk. The lipid guidelines recognize risk equivalents as a distinct category that warrant immediate treatment. For patients with an ESC SCORE ≥ 5% a 3 month trial of lifestyle measures is a reasonable starting point. If after 3 months the lipids remain above moderate risk targets and the SCORE remains ≥ 5% then intensive therapy to reach high risk targets is recommended.
References
Reynolds Risk Score Homepage
Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007 Feb 14;297(6):611-9. View Abstract
McPherson R et al. Canadian Cardiovascular Society position statement ñ recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease. Can J Cardiol 2006;22:913-27.View Abstract
Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) ñ 2004 Update.Online Link, accessed July 3 2008
European Guidelines on Cardiovascular disease prevention in clinical practice: Executive summary. EHJ 2007; 28; 2375-2414.";
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