Question 1

What is the new concept introduced in these guidelines?

Accepted Answer

The guidelines introduce 'suboptimally tolerable statins' (STS), a broader and more practical definition than strict statin intolerance, covering anyone unable to take the recommended statin dose due to real or perceived side effects.

Question 2

How should extremely high-risk patients with STS be treated?

Accepted Answer

They should receive early combination therapy with ezetimibe and bempedoic acid, with rapid escalation to PCSK9 inhibitors if LDL-C remains above the 55 mg/dL target.

Question 3

What is the first-line add-on for high-risk patients?

Accepted Answer

Ezetimibe is the recommended first-line add-on therapy for high- and very high-risk patients who cannot tolerate optimal statin doses.

New 2026 Guidelines: How Should We Manage Patients Who Cannot Tolerate High-Dose Statins?