- Homozygous FH
- Diabetes mellitus (type 1 or 2)
- End-stage kidney disease
- Kawasaki disease with persistent coronary aneurysms
- Solid-organ transplant vasculopathy
- Childhood cancer survivor following stem cell transplantation
- Multiple comorbidities – Any moderate-risk condition plus ≥2 additional moderate- or at-risk factors
| - Severe obesity (BMI ≥99th percentile or ≥35 kg/m2)
- Confirmed hypertension (BP >95th percentile or ≥130/80 mmHg on 3 separate occasions)
- Heterozygous FH
- Predialysis chronic kidney disease
- Aortic stenosis or coarctation
- Childhood cancer survivor with exposure to chest irradiation
- Multiple risk factors – ≥3 at-risk conditions or risk factors
| - Obesity that is not severe (BMI ≥95th to <99th percentile)
- Insulin resistance with comorbidities (eg, NAFLD, PCOS)
- Family history of premature CVD*
- Parent with known dyslipidemia (eg, FH) or TC >240 mg/dL (6.2 mmol/L)
- Current smoker or significant exposure to second-hand smoke
- White-coat hypertension (elevated BP measurements in the office with normal values outside the office setting)
- Chronic inflammatory disease (eg, SLE, systemic JIA)
- HIV infection
- Kawasaki disease with regressed coronary aneurysms
- Cardiomyopathy (eg, HCM)
- Surgically repaired congenital heart disease involving coronary artery translocation (eg, TGA repair)
- Childhood cancer survivor with cardiotoxic chemotherapy only
- Adolescent depressive and bipolar disorders
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