American Board of Internal Medicine (ABIM) Certification Practice Exam

In terms of ASCVD scores, what percentage indicates a need for high-intensity statin therapy?

1. Less than 7.5%

2. 7.5% to less than 20%

3. 20% or more

4. 10% to 15%

The correct answer is: 20% or more

The threshold for initiating high-intensity statin therapy based on ASCVD (Atherosclerotic Cardiovascular Disease) scores is typically set at 20% or higher. This percentage is indicative of a higher predicted risk of developing cardiovascular events over a 10-year period. High-intensity statin therapy is recommended for individuals with this level of risk because it is designed to significantly reduce LDL cholesterol levels and, consequently, the overall risk of cardiovascular events. By targeting those at a higher risk, healthcare providers can more effectively prevent incidents such as heart attacks and strokes, particularly in patients with additional risk factors. The other percentage ranges are associated with different recommendations. For example, a score of less than 7.5% usually suggests that lifestyle modifications might suffice without the need for statin therapy. Similarly, scores between 7.5% and 20% may lead to moderate-intensity statin recommendations or a discussion of individual risk factors and treatment options, rather than a blanket recommendation for high-intensity therapy. Therefore, the focus on a score of 20% or above underscores the importance of aggressive treatment in patients identified as high risk for ASCVD.