, males with low density lipoprotein cholesterol (LDL C) >190 mg/dL. Weak for Reviewed, Deleted We suggest establishing baseline liver function tests (LFTs) and creatinine kinase (CK) before initiation of drug therapy. Weak for Not reviewed, Deleted We recommend against routinely measuring LFTs or CK after a moderate dose statin is initiated. Strong against Not reviewed, Deleted In patients with established ASCVD, we recommend use of a moderate-dose statin following a discussion of the minimal harms, substantial benefits, and an exploration of the patient s values and preferences. Strong for Reviewed, New- replaced Recommendation In patients with ASCVD who are able to tolerate statins, we recommend against the routine use of non-statin lipid lowering drugs (e.g., fibrates, niacin, ezetimibe, omega-3 fatty acids, etc.) either alone as monotherapy or added to statins. Strong against Reviewed, New- replaced Recommendations Recommendation Number Page 2014 Recommendation Text 2014 Strength of Recommendation Recommendation Category Recommendation In patients with ASCVD who are unable to tolerate statins, we suggest reinforcing adherence to positive lifestyle changes and suggest offering niacin or gemfibrozil, noting that these agents have been associated with only a small CVD risk reduction and studied in limited populations (e.g., males with low HDL-C). Weak for Reviewed, Deleted We strongly recommend against the routine monitoring of LDL C and non- HDL C goals for the secondary prevention of ASCVD. Strong against Reviewed, New- replaced Recommendation We suggest offering a high-dose statin only in select patient populations (e.g., ACS, multiple uncontrolled risk factors or recurrent CVD events on moderate- dose statin) following a discussion of the added harms, small additional benefits, and an exploration of the patient s values and preferences. Weak for Reviewed, New- replaced Recommendations 19 29 We suggest measuring LFTs 4-12 weeks after the initiation of high-dose statin. 