The Living Guidelines: UA/NSTEMI Recommendations for Lipid Management Polling Results for CLASS IIa Guidelines

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Class IIa Guidelines
1. The following lipid management strategies can be beneficial:

a. Further reduction of LDL-C to <70 mg/dL is reasonable. (Level of Evidence: A)

 UA/NSTEMI Guidelines Class IIa Recommendation 1a for Lipid Management should be: CLASS I CLASS IIa CLASS IIb CLASS III

b. If baseline LDL cholesterol is 70-100 mg/dL, it is reasonable to treat LDL-C to less than 70 mg/dL. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 1b for Lipid Management should be: CLASS I CLASS IIa CLASS IIb CLASS III

c. Further reduction of non HDL-C to <100 mg/dL is reasonable; if triglycerides are 200 to 499 mg/dL, non HDL-C target is <130 mg/dL. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 1c for Lipid Management should be: CLASS I CLASS IIa CLASS IIb CLASS III

d. Therapeutic options to reduce non-HDL-C (after LDL-C lowering) include niacin or fibrate therapy.

 UA/NSTEMI Guidelines Class IIa Recommendation 1d for Lipid Management should be: CLASS I CLASS IIa CLASS IIb CLASS III

e. Nicotinic acid (niacin)† and fibric acid derivatives (fenofibrate, gemfibrozil) can be useful as therapeutic options (after LDLC– lowering therapy) for HDL-C <40 mg/dL. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 1e for Lipid Management should be: CLASS I CLASS IIa CLASS IIb CLASS III

f. Nicotinic acid (niacin) and fibric acid derivatives (fenofibrate, gemfibrozil) can be useful as therapeutic options (after LDL-C lowering therapy) for triglycerides >200 mg/dL. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 1f for Lipid Management should be: CLASS I CLASS IIa CLASS IIb CLASS III

g. The addition of plant stanol/sterols (2 g/day) and/or viscous fiber (>10 g/day) is reasonable to further lower LDL-C. (Level of Evidence: A)

 UA/NSTEMI Guidelines Class IIa Recommendation 1g for Lipid Management should be: CLASS I CLASS IIa CLASS IIb CLASS III