The 2022 ACC Expert Consensus Decision Pathway:
The Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of ASCVD in Primary and Secondary Prevention

When Statins Do Not Adequately Lower LDL-C: Novel Therapies to Improve Outcomes in Patients with HeFH and ASCVD


James Underberg MD, FACP, MNLA

Clinical Assistant Professor of Medicine

New York University School of Medicine, NYU Center for the Prevention of Cardiovascular Disease, New York, NY
Director, Bellevue Hospital Lipid Clinic, New York, NY
Past-President, National Lipid Association, Jacksonville, FL
President, American Board Clinical Lipidology

Daniel Soffer, MD, FNLA, FACP

Clinical Associate Professor of Medicine Internal Medicine/Clinical Lipidology

Perelman School of Medicine

University of Pennsylvania Health System Philadelphia, PA

President-Elect National Lipid Association

Erin D. Michos, MD, MHS

Associate Director of Preventive Cardiology

Division of Cardiology

Johns Hopkins University School of Medicine

Co-Editor in Chief of the American Journal of Preventive Cardiology

Program Overview

Since the release of the 2018 Cholesterol Guideline, new lipid-lowering medications have been approved by the Food and Drug Administration (FDA). To address new lipid-lowering therapies’ place in clinical treatment, the ACC published the Expert Consensus Decision Pathways (ECDPs). The goal of the ECDP is to accelerate real-time use of clinical policy at the point of care. This program is designed to improve clinicians’ knowledge about the collection of available cholesterol-lowering medications, with an emphasis on newer therapies and how to utilize them to narrow the treatment gap and improve outcomes in patients with HeFH and ASCVD.

Target Audience

This educational initiative is designed for specialty physicians, nurse practitioners (NPs), and physician assistants (PAs) interested in the diagnosis and treatment of hypercholesterolemia.

Learning Objectives

Upon completion of this activity, the participant should be able to:

  • Summarize the Expert Consensus Decision Pathways regarding adding non-statin therapies when maximally tolerated statin monotherapy does not adequately reduce low-density lipoprotein cholesterol (LDL-C) in patients with HeFH and ASCVD

  • Differentiate between monoclonal antibody and small interfering RNA (siRNA) classes of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors with regard to their mechanism of action, LDL-C-lowering effect and evidence for cardiovascular benefit.


Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Iridium Continuing Education (Iridium). Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must
  • Read the learning objectives and faculty disclosures Complete the pretest
  • View the broadcast
  • Complete the posttest with a score of 70% or higher

A statement of credit will be issued within four weeks of receipt of a completed activity evaluation form.

Fee Information and Refund/Cancellation Policy

There is no fee for this educational activity.

Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or


Disclosures of Relevant Financial Relationships

Global Education Group (Global) adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited CE, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by Global are required to disclose all financial relationships with any ineligible company within the past 24 months to Global. All financial relationships reported are identified as relevant and mitigated by Global in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by Global to assure objectivity and that the activity is free of commercial bias.

All relevant financial relationships have been mitigated.

The faculty have the following relevant financial relationships with ineligible companies:

James A. Underberg, MD, MS, FACP, FNLA
Consulting Fees (e.g., Advisory Boards): Amgen, Ambry
Contracted Research: Amryt
Honoraria: Amben, Esperion, Merck, Novartis, Pfizer, Regeneron
Speakers’ Bureaus: Amben, Amryt, Esperion, Regeneron

Daniel Soffer, MD, FNLA, FACP
Consulting Fee (e.g., Advisory Board): Akcea, Amgen, Ionis, Kaneka, Novartis
Contracted Research: Akcea, Amgen, Amryt, Astra-Zeneca, Ionis, Novartis, Regeneron, RegenXBio, Verve Therapeutics

Erin D. Michos, MD, MHS
Consulting Fees: (e.g., Advisory Boards): Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Esperion, Novartis, Novo Nordisk, Pfizer

The following planners and managers involved in the development of this activity have no relevant financial relationships with ineligible companies to disclose.

The planners and managers at Global Education Group have no relevant financial relationships to disclose.

Iridium staff and others involved with the planning, development, and review of the content for this activity have no relevant financial relationships to disclose.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global and Iridium do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
This activity is jointly provided by Global Education Group and Iridium Continuing Education.
This educational activity is supported by an independent educational grant from Novartis Pharmaceuticals.

Credit Amount: 0.75
Credit Type: CME
Release: January 13, 2023
Expiration: January 13, 2024