Lipid-Lowering Therapy
Select a therapy decision below to generate a personalized, printable patient handout with icon array risk visualization.
Statin Initiation
For primary prevention patients considering statin therapy. Uses 10-year PREVENT ASCVD risk score and CTT Collaborators meta-analysis data to calculate personalized absolute risk reduction and number needed to treat.
- Auto-fills risk from the Lipid Calculator when available
- Moderate- and high-intensity statin comparison
- Smallest Worthwhile Difference context (Luo et al., JAMA Intern Med 2026)
PCSK9 Inhibitor
For secondary prevention patients on maximally tolerated statin therapy considering add-on PCSK9 inhibitor. Uses FOURIER and ODYSSEY OUTCOMES trial data with scenario-specific event rates (stable ASCVD vs. recent ACS).
- LDL-C reduction estimate (class effect ~50-60%)
- Long-term safety data from FOURIER-OLE (8.4 years)
- Self-injection vs. office injection comparison
Evidence Basis
Statin risk calculation: 10-year ASCVD risk is calculated using the AHA PREVENT equations (Khan et al., Circulation 2024), replacing the older Pooled Cohort Equations. Statin benefit estimates derive from the CTT Collaborators meta-analysis of 26 randomized trials (170,000+ participants), showing approximately 22% reduction in major vascular events per 1 mmol/L LDL-C reduction (Lancet 2010;376:1670-1681).
PCSK9 inhibitor outcomes:The FOURIER trial (Sabatine MS, et al. N Engl J Med 2017;376:1713-1722; 27,564 patients, median 2.2 years) demonstrated HR 0.85 (95% CI 0.79-0.92) for the primary composite in stable ASCVD patients (ARR 1.5%, NNT 67). The ODYSSEY OUTCOMES trial (Schwartz GG, et al. N Engl J Med 2018;379:2097-2107; 18,924 patients, median 2.8 years) showed HR 0.85 (95% CI 0.78-0.93) in recent ACS patients (ARR 1.6%, NNT 63). Long-term safety through 8.4 years of evolocumab exposure was confirmed in the FOURIER-OLE extension (O'Donoghue ML, et al. Circulation 2022;146:1109-1119). Neurocognitive safety was confirmed by the EBBINGHAUS substudy (Giugliano RP, et al. N Engl J Med 2017;377:633-643; N=1,204, median 19 months).
Patient preferences: The Smallest Worthwhile Difference (SWD) concept is from Luo et al. (JAMA Internal Medicine, February 2026), demonstrating that most statin-naive adults require substantially greater absolute risk reduction than statins typically provide before considering treatment worthwhile.
Legal disclaimer
This shared decision-making tool is intended for use by licensed healthcare professionals during patient consultations. It is clinical decision support under Section 520(o)(1)(E) of the Federal Food, Drug, and Cosmetic Act and is not a medical device. All risk estimates are derived from published, peer-reviewed clinical trial data (CTT Collaborators, Lancet 2010; FOURIER, N Engl J Med 2017; ODYSSEY OUTCOMES, N Engl J Med 2018) and represent population-level data that may not reflect individual patient risk. This tool does not replace clinical judgment — the treating clinician is solely responsible for evaluating the applicability of these estimates and for all clinical decisions. No patient data is collected, stored, or transmitted; all calculations occur entirely in your browser. AI-HEART Lab, its affiliates, and contributors assume no liability for clinical decisions or patient outcomes. By using this tool, you agree to the AI-HEART Lab Terms of Service.