The Sandusky Dyslipidemia Model
A comprehensive clinical model for outpatient dyslipidemia management based on the 2026 ACC/AHA/Multisociety Guidelines, augmented with advanced diagnostic and therapeutic tools.
1.0 Purpose
The Sandusky Dyslipidemia Model provides a structured, evidence-based framework for managing dyslipidemia in a specialized outpatient clinic setting. This model serves as a clinical decision support resource for providers at The Sandusky Dyslipidemia Model clinic, which accepts regional referrals specifically for cardiovascular risk factor management with a focus on dyslipidemia.
2.0 Philosophy
This model adheres strictly to the 2026 ACC/AHA/Multisociety Guidelines on the Management of Dyslipidemia [1] as its foundation. Beyond the guideline framework, the model adopts a “lower is better” philosophy for atherogenic lipoproteins, using advanced tools — including apolipoprotein B (ApoB), advanced lipid fractionation, lipoprotein(a), and coronary artery calcium (CAC) scoring — to identify patients at increased residual risk and to drive more aggressive lipid control where clinically appropriate.
3.0 Document Structure
This model is organized into four sections:
Clinical Documents
Provider-facing clinical protocols, pathways, and reference materials.
| Document | Description |
|---|---|
| 01 — Clinic Overview | Mission, scope, staffing, and excluded therapies |
| 02 — Patient Eligibility | Referral criteria, inclusion/exclusion, triage |
| 03 — Initial Assessment | History, examination, and laboratory guidance |
| 04 — Risk Stratification | PREVENT calculator, risk enhancers, advanced testing |
| 05 — Treatment Pathways | Pharmacotherapy escalation and lipid targets |
| 06 — Advanced Tools | ApoB, NMR LipoProfile, Lp(a), CAC, imaging |
| 07 — FH Pathway | Familial hypercholesterolemia diagnosis and management |
| 08 — Statin Intolerance | Rechallenge protocol and alternative regimens |
| 09 — Secondary Dyslipidemia | Screening for secondary causes |
| 10 — Medication Reference | Drug dosing, monitoring, and interactions |
| 11 — Prior Authorization | Templates for PCSK9i and inclisiran |
| 12 — Follow-Up Protocol | Monitoring intervals and discharge criteria |
Clinical Workflows
Visual flowcharts for clinical decision-making, rendered as Mermaid diagrams.
Interactive Tools
JavaScript-based clinical decision support tools, including the AHA PREVENT risk calculator.
Patient Materials
Plain-language educational handouts for patients.
4.0 Latest in Lipidology
Ongoing surveillance of new lipidology evidence, regulatory actions, and guideline developments relevant to this clinic.
Latest in Lipidology
Summaries of practice-relevant lipid literature, updated as it appears.
Most recent updates:
- PCSK9 inhibitors lower LDL after a heart transplant, but the graft benefit is unproven — 2026-08-31
- When Lp(a) is high, a standard apoB result understates the risk — 2026-08-31
- Lp(a) treatment is now being tested in people who have not yet had a heart attack — 2026-08-24
5.0 Author & Attributions
George Augustine Koromia, MD, MMCi, FACC
Contact: g [at] koromia [dot] com
Website: https://www.koromia.com
| Area | Attribution |
|---|---|
| Content & Editing | George Augustine Koromia, MD, MMCi, FACC |
| Clinical guideline text | Copyrighted by the original guideline writing organizations |
6.0 Disclaimers
- This model is intended for clinical decision support only and does not replace individualized clinical judgment.
- Telemedicine is not currently offered but may be added in future versions to expand access.
- Electronic health record (EHR) integration is not currently available.
- Patient materials are currently available in English only. Additional languages may be added in future versions to expand access.
7.0 Version History
| Version | Date | Description |
|---|---|---|
| 1.0.0 | 2026-03-30 | Initial release |
| 1.0.1 | 2026-08-31 | Latest in Lipidology updates |
| 1.0.1 | 2026-08-24 | Latest in Lipidology updates |
| 1.0.1 | 2026-08-20 | Latest in Lipidology updates |
References
- 2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia. Journal of the American College of Cardiology. 2026.