High-intensity statin therapy should be initiated or continued as first-line therapy in women and men 75 years of age who have clinical ASCVD, unless contraindicated. (Class I, Level of Evidence: A) 2. In individuals with clinical ASCVD* in whom high-intensity statin therapy would otherwise be used, when high-intensity statin therapy is contraindicated or when characteristics predisposing to statin-associated adverse effects are present, moderate-intensity statin therapy should be used as the second option if tolerated. (Class I, Level of Evidence: A) 3. In individuals with clinical ASCVD* >75 years of age, it is reasonable to evaluate the potential for ASCVD risk-reduction benefits and for adverse effects, drug-drug interactions and to consider patient preferences, when initiating a moderate- or high-intensity statin. It is reasonable to continue statin therapy in those who are tolerating it. (Class IIA; Level of Evidence: B) *Clinical ASCVD includes acute coronary syndromes, history of MI, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, or peripheral arterial disease presumed to be of atherosclerotic origin. Contraindications, warnings, and precautions are defined for each statin according to the manufacturer s prescribing information.14 ACC indicates American College of Cardiology; ASCVD, atherosclerotic cardiovascular disease; AHA, American Heart Association; AMI, acute myocardial infarction; HMG-CoA, 3-hydroxy-3-methylglutaryl-coenzyme A; LDL-C, low-density lipoprotein cholesterol; MI, myocardial infarction; and TIA, transient ischemic attack. Appendix A. Continued 20 Short Title: PM-5: Evaluation of LVEF PM-5: AMI: Evaluation of LVEF Measure Description: Percentage of patients, age 18 y, hospitalized with AMI, with documentation in the hospital record that LVEF is evaluated during hospitalization or is planned for after discharge. 