7
Table 8. Drugs That May Elevate LDL-C or Triglyceride
Concentrations
Drugs That Elevate LDL-C Drugs That Elevate Triglycerides
• Some progestins
• Anabolic steroids
• Danazol
• Isotretinoin
• Immunosuppressive drugs
(cyclosporine)
• Amiodarone
• Thiazide diuretics
• Glucocorticoids
• Thiazolidinediones
• Fibric acids (in severe
hypertriglyceridemia)
• Long-chain omega-3 fatty acids
(in severe hypertriglyceridemia, if
containing docosahexaenoic acid)
• Oral estrogens
• Tamoxifen
• Raloxifene
• Retinoids
• Immunosuppressive drugs
(cyclosporine, sirolimus)
• Interferon
• Beta-blockers
(especially non-beta 1-selective)
• Atypical antipsychotic drugs
(fluperlapine, clozapine, olanzapine)
• Protease inhibitors
• Thiazide diuretics
• Glucocorticoids
• Rosiglitazone
• Bile acid sequestrants
• L-asparaginase
• Cyclophosphamide
Table 9. Risk Indicators (Other Than Major ASCVD Risk
Factors) That Might be Considered for Risk
Refinement
a
1. A severe disturbance in a major ASCVD risk factor, such as multi-pack per day
smoking or strong family history of premature CHD
2. Indicators of subclinical disease, including coronary artery calcium ≥300 Agatston
units
b
is considered high risk
3. LDL-C ≥160 mg/dL and/or non-HDL-C ≥190 mg/dL
4. High-sensitivity C-reactive protein ≥2.0 mg/L
c
5. Lipoprotein (a) ≥50 mg/dL (protein) using an isoform insensitive assay
6. Urine albumin/creatinine ratio ≥30 mg/g
a
e presence of one or more of the risk indicators listed may be considered, in conjunction with
major ASCVD risk factors, to reclassify an individual into a higher risk category. Except in the
case of evidence of subclinical disease defining the presence of ASCVD, reclassification to a higher
risk category is a matter of clinical judgment. Doing so will alter the threshold for consideration
of pharmacotherapy and/or the treatment goals for atherogenic cholesterol. Many other ASCVD
risk markers are available, but the NLA Expert Panel consensus view is that those listed have the
greatest clinical utility.
b
Or coronary artery calcium ≥75th percentile for age, sex, and ethnicity. For additional
information, see the CAC Score Reference Values web tool (http://www.mesa-nhlbi.org/
CACReference.aspx.).
c
Because of high intra-individual variability, multiple high-sensitivity C-reactive protein (hs-CRP)
values should be obtained before concluding that the level is elevated. hs-CRP should not be
tested in those who are ill, have an infection, or are injured. If hs-CRP level is >10 mg/L, consider
other etiologies such as infection, active arthritis, or concurrent illness.
