ESC / EAS Protocol • Dr. RRP Cardio

Dr. RRP Cardio DtT Calculator

From Target to Action: Point-of-Care Lipid Regimen Decision Support. Match lipid-lowering therapy potency directly to patient distance to goal.

1. Clinical Parameters
The Clinical "Rule of Six": Doubling any statin dose yields only ~6% additional LDL-C lowering while escalating side-effect risk. To bridge moderate or extreme distances (>50%), combination therapy (adding Ezetimibe, Bempedoic acid, PCSK9 mAb, or Inclisiran) is required.
2. Recommendation & DtT Band
Calculated Distance to Target (DtT)
60.7%
DtT 61–70% Band
0% 50% High Intensity 100%
<20% 20-29% 30-49% 50-60% 61-70% 71-80%
Recommended Therapy Options:
3. Reference Table: Expected LDL-C Reduction by Therapy (ESC/EAS)
Therapy / Regimen Class / Mechanism Average LDL-C Reduction Notes & Examples
High-intensity statin + EZE + PCSK9 mAb Triple Combination (Oral + SQ Biologic) ~85% Atorva 80mg/Rosuva 40mg + Ezetimibe 10mg + Evolocumab/Alirocumab
High-intensity statin + PCSK9 mAb Dual Combination (Oral + Biologic) ~75% High-potency statin + Evolocumab 140mg Q2W
High-intensity statin + EZE + Bempedoic acid Triple Oral Therapy ~72% Statin + NPC1L1 inhibitor + ACL inhibitor (all oral)
High-intensity statin + Ezetimibe 10mg Dual Oral Therapy ~65% First-line recommendation for Very High Risk missing target on statin alone
PCSK9 mAb monotherapy SQ Monoclonal Antibody ~60% Evolocumab 140mg Q2W or Alirocumab 75/150mg Q2W
High-intensity statin monotherapy Oral HMG-CoA Reductase Inhibitor ~50% Atorvastatin 40–80 mg, Rosuvastatin 20–40 mg
Inclisiran (siRNA) SQ Small Interfering RNA ~50–52% Twice-yearly maintenance dosing targeting hepatic PCSK9 mRNA
Moderate-intensity statin Oral Monotherapy ~35% Atorvastatin 10–20 mg, Rosuvastatin 5–10 mg, Simvastatin 20–40 mg
Ezetimibe + Bempedoic acid Dual Non-Statin Oral ~38% Fixed-dose combination ideal for statin intolerance
Low-intensity statin / Ezetimibe mono / BA mono Low-Dose Oral Monotherapy ~18–25% Pravastatin 10–20mg, Ezetimibe 10mg, or Bempedoic acid 180mg
Diet & Lifestyle Interventions Non-pharmacological ~5–15% Mediterranean diet, plant sterols/stanols, aerobic exercise