Driving Patient Engagement in ASCVD

In this episode, 'Driving Patient Engagement in ASCVD,' the panelists explore the powerful role that individualized risk communication and imaging tools play in motivating patients to engage with lipid-lowering therapy. The discussion opens with the use of personalized risk reduction graphs, which visually contrast a patient's likely cardiovascular trajectory if they remain untreated versus if they achieve LDL lowering, with panelists noting that no patient shown this visualization has declined treatment. The conversation places particular emphasis on coronary calcium scoring as a motivational tool, with one panelist describing how showing post-STEMI patients the residual plaque burden in their arteries beyond the treated lesion powerfully illustrates why LDL lowering remains essential. The panel also discusses how framing calcium score results in terms of age and sex-specific percentiles, rather than absolute numbers alone, helps patients understand their relative risk in a more meaningful way, and how 30-year risk projections can further reinforce the urgency of early intervention.

The panelists then address the practical achievability of current LDL goals, with one noting that with full access to available combination therapies, the proportion of very high-risk patients reaching less than 55 mg/dL could rise from roughly 10% to approximately 90%. The group acknowledges that adherence remains a significant barrier, while also welcoming the anticipated arrival of new oral combination therapies and improved access to existing agents. The episode closes on a sobering note, with the panel citing national registry data showing that the leading reason patients in the United States are not on guideline-recommended therapy is that their physician never offered it, reinforcing that awareness gaps among both patients and clinicians remain the most fundamental obstacle to closing the treatment gap in ASCVD.

The next episode in this series, 'Optimizing ASCVD Prevention Through Combination Therapy and Managing Statin Intolerance,' features the panelists advancing their conversation on ASCVD and focusing on how clinicians can strategically sequence and combine lipid-lowering therapies to achieve guideline-recommended LDL goals, while navigating the practical realities of statin intolerance in high and very high-risk patients.