Clinical ASCVD Definition
G. All options are correct - Clinical atherosclerotic cardiovascular disease (ASCVD) encompasses all of the listed conditions when they are of atherosclerotic origin. 1
Complete Definition According to ACC/AHA Guidelines
Clinical ASCVD is comprehensively defined by the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline as including:
- Acute coronary syndrome (ACS) 1
- History of myocardial infarction (MI) 1
- Stable or unstable angina 1
- Coronary or other arterial revascularization 1
- Stroke 1
- Transient ischemic attack (TIA) 1
- Peripheral artery disease (PAD) including aortic aneurysm 1
Critical qualifier: All manifestations must be of atherosclerotic origin. 1
Clinical Significance of This Broad Definition
The comprehensive definition matters because patients meeting any of these criteria qualify for intensive secondary prevention strategies, including high-intensity statin therapy as a Class I recommendation. 1 This broad definition ensures that all patients with established atherosclerotic disease receive appropriate risk-reduction therapy regardless of which vascular bed initially manifested disease. 1
Common Pitfall to Avoid
Do not exclude patients with peripheral manifestations or cerebrovascular disease from the ASCVD category. 1 A patient with PAD or prior stroke has the same ASCVD designation and treatment intensity recommendations as someone with prior MI. 1 The atherosclerotic process is systemic, and the location of initial clinical manifestation does not diminish the need for aggressive secondary prevention. 2, 3