Statins block an enzyme your liver uses to make cholesterol. Saturday: 9 a.m. - 5 p.m. CT But there are some drawbacks to these. This link is provided for convenience only and is not an endorsement of either the linked-to entity or any product or service. When to see a doctor. This Professionals Resource Page is part of the American Heart Association's Guideline Transformation & Optimization (GTO) Program. The chart below lists some foods that you can add to your diet to increase your soluble fiber intake. WebJoin to apply for the Executive Director role at American Heart Association. This form of fiber (roughage) blocks absorption of cholesterol in your body. Last name. A large randomized trial in patients who recently had acute coronary syndromes showed that ezetimibe modestly reduced cardiovascular risk over 7 years of follow-up when added to their regimen of moderate-intensity statin therapy.4,5, PCSK9 inhibitors lower LDL-C by 50% to 60% by binding to PCSK9, inhibiting labeling of LDL receptors for degradation, thus prolonging LDL receptor activity at the cell membrane. Kazi DS, et al. A heart-healthy diet, exercise and quitting tobacco use can help lower your LDL. The new guidelines keep the same statin benefit groups defined in the previous (2013) ACC/AHA guidelines.8 Statin therapy recommendations are specifically given for the following groups: If a patient age 20 to 75 has LDL-C levels of 190 mg/dL or higher, you do not need to calculate the 10-year risk. If you have a history of atherosclerosis, your LDL should be below 70 mg/dL. *Red Dress DHHS, Go Red AHA ; National Wear Red Day is a registered trademark. Sep 2004 - Nov 2022 18 years 3 months. Recommendations for lifestyle changes and drug therapy vary depending on your age, cholesterol level, family history, lifestyle, and diet. WebThe American Heart Association explains how cholesterol affects the heart. Youve read the 2021 Chest Pain Guidelines. Youve read the 2021 Chest Pain Guidelines. Pets and Your Health / Healthy Bond for Life, La Iniciativa Nacional de Control de la Hipertensin, Learn about statins and other medications, Watch the video to manage high cholesterol, Find questions to help start the conversation, Discuss these questions at your next appointment. Find more information on our content editorial process. Such foods include: Limiting your intake of saturated fat can help you manage your LDL cholesterol. If you have clinical ASCVD, the ACC/AHA guidelines recommend using statins to lower your LDL-C levels. Youve read the 2021 Chest Pain Guidelines. 2023 American College of Cardiology Foundation. A heart-healthy diet, exercise and quitting tobacco use can help lower your LDL. Use the Pooled Cohort Equations, which are based on age, sex, race, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, and whether the patient is receiving treatment for high blood pressure, has diabetes, or smokes (class I recommendation). After evaluating 10-year risk, clinicians should discuss it with the patient before initiating statin therapy. People with higher cholesterol levels may have a higher risk of developing heart disease. Researchers say statins can help reduce the risk of a common subtype of stroke known as an intracerebral hemorrhage. The ACC/AHA guidelines state in a class IIA recommendation that race and ethnicity influence the risk of atherosclerotic cardiovascular disease and the choice of treatment. Some tropical oils such as palm oil, palm kernel oil and coconut oil contain saturated fat that can increase bad cholesterol. 7272 Greenville Ave. Asian Americans also tend to develop metabolic syndrome at a lower waist circumference than white people. Also, if children have severely elevated lipid levels related to obesity, intensive lifestyle therapy should be implemented. But if both medications dont bring it below that level, talk with your healthcare team about adding a PCSK9 inhibitor. Community Impact Director at American Heart Association 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.eatright.org/health/wellness/heart-and-cardiovascular-health/what-is-cholesterol). If a blood clot forms and blocks one of these narrowed arteries, a heart attack or strokecan result. WebLDL is the bad cholesterol because too much of it in your blood can contribute to plaque buildup in your arteries. For patients at low risk (< 5%), clinicians should still emphasize lifestyle changes to reduce risk modifiable factors. All Rights Reserved. This can narrow the arteries and make them less flexible a condition known as atherosclerosis. (2021). After submitting key term, narrow your results by filtering by clinical topic or selecting specific document types. For instance, people of Puerto Rican descent have an increased ASCVD risk than those of Mexican descent. High-intensity statin therapy is recommended for all patients with atherosclerotic cardiovascular disease, including acute coronary syndromes, myocardial infarction, stable or unstable angina, or with a history of coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral artery disease including aortic aneurysm, all of atherosclerotic origin. Here at the American Heart Association, you matter and so does your career. Guidelines & Statements Guidelines & Statements. 2023 American Heart Association, Inc. All rights reserved. WebDuring National Cholesterol Education Month in September, health officials emphasize the importance of adults getting their blood cholesterol checked and taking steps to lower it if it is high. Cholesterol Levels: What You Need to Know. HDL is the good cholesterol that helps remove extra cholesterol from your blood. The 7.5% ACC/AHA treatment threshold is based on an average of control group event rates in primary prevention trials. WEDNESDAY, March 1, 2023 (HealthDay News) -- After a heart attack, home rehab can literally be a lifesaver, a new study finds. However, recent evidence has not confirmed the teratogenic potential of statins.25 Nevertheless, while new safety data are reassuring, suspension of statins is still advisable.26. Many factors can raise your LDL level. The American Heart Association and American Stroke Association publish medical guidelines and scientific statements on various cardiovascular disease and stroke topics. In recent clinical trials, evolocumab27 as well as alirocumab28 performed well in lowering LDL-C in statin-intolerant patients. The remainder of the cholesterol in your body comes from foods from animals. Asian Americans also tend to develop diabetes at a lower lean body mass and earlier age. The guidelines give a class I recommendation to intensively discussing lifestyle intervention and potential benefit of statin therapy in case of these conditions. First name. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. First name. These revealed that, to be cost-effective, the prices of PCSK9 inhibitors will have to be reduced by at least 70% in the United States from 2018 levels. For example, meat, poultry and dairy products all contain dietary cholesterol. Subjective myalgia occurred in 1% to 15% of participants in randomized controlled trials but in 5% to 20% of patients in observational studies. ahajournals.org/doi/10.1161/CIR.0000000000000678, onlinelibrary.wiley.com/doi/full/10.1111/joim.13176, heart.org/-/media/Files/Health-Topics/Cholesterol/AHA20_HiRisk_PocketGuide_Final.pdf, acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/2018/Guidelines-Made-Simple-Tool-2018-Cholesterol.pdf, jamanetwork.com/journals/jamacardiology/fullarticle/2653354, ahajournals.org/doi/10.1161/JAHA.119.013225, acc.org/latest-in-cardiology/ten-points-to-remember/2018/11/09/14/28/2018-guideline-on-management-of-blood-cholesterol, Heart Disease: How ApoB Cholesterol Tests Can More Accurately Identify Risks, Treatments, The 5 Best At-Home Cholesterol Tests in 2023, African Americans, Cholesterol, and the Risk of Heart Disease, Heart Health Breakthroughs: Top Advancements and Innovations of 2022, Heart Disease: How High Cholesterol Combined With High Blood Pressure Increases Risk, What Does It Mean to Have High Cholesterol in Childhood?, Cholesterol-Lowering Statins May Reduce Risk of Common Type of Stroke, What Does It Mean to Have Borderline Cholesterol?, Raw Honey: Study Finds This Sweetener May Help Lower Blood Sugar and Cholesterol Levels. As the risk due to high cholesterol levels is cumulative over the life span, the guidelines encourage lifestyle therapy for primary prevention at all ages and in all patient categories. During the risk discussion, one should review not only the patients 10-year risk according to the Pooled Cohort Equations, but also risk factors not included in the Pooled Cohort Equations. Diabetes and metabolic syndrome are risk factors for heart disease. Chronic kidney disease is a risk-enhancing factor. The report also includes tips on when you should assess your risk of developing ASCVD. WebResearch program descriptions for 2022 award activations. Since the 2013 ACC/AHA cholesterol guideline, newer cholesterol-lowering agents (nonstatin drugs) have been introduced and subjected to RCTs. The purpose of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure (2022 HF guideline) is to provide an update and to consolidate the 2013 ACCF/AHA Guideline for the Management of Heart Failure 1 for adults and the 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Hours The USPSTF also recommends that clinicians selectively offer a statin for the primary prevention of cardiovascular disease for adults (40-75 years) who have one or more cardiovascular disease risk factors and an estimated 10-year cardiovascular disease risk of 7.5% to less than 10%, despite a smaller likelihood of benefit in this group. Cholesterol is a waxy substance. 1-800-AHA-USA-1 If you are 40 to 75 years old and your doctor has evaluated you for primary ASCVD prevention, the guidelines recommend having a detailed discussion with your healthcare team before taking statins. If symptoms persist despite these measures, nonstatin therapies with proven efficacy in randomized controlled trials are recommended. We've provided a list of the best at-home tests for. Very high risk includes a history of multiple major atherosclerotic cardiovascular disease events or 1 major event and multiple high-risk conditions. Thank you for your interest in spreading the word on Cleveland Clinic Journal of Medicine. Now learn how to implement them in your practice. Its good to have an in-depth discussion with your healthcare team about your cholesterol and risk of developing ASCVD. A cross-sectional study in 446 women suggest that earlier cardiovascular risk screening including coronary artery calcium scoring might benefit women with preterm deliveries.23 Other studies showed that women with hypertensive disorders of pregnancy could benefit from earlier risk stratification through the coronary artery calcium score.24, Pregnant women should not take statins, however, even if they have severe hypercholesterolemia. The ACC and AHA define severe primary hypercholesterolemia as an LDL-C level equal to or above 190 mg/dL. This can be a home-office position, or the candidate may office in one of the local market offices. WebGuidelines Transformation and Optimization. Cholesterol circulates in the blood. The latest information about heart & vascular disorders, treatments, tests and prevention from the No. 7272 Greenville Ave. Be the beat for someone you love. Those with HeFH and an LDL-C level of 190 mg/dL have a 300% to 400% greater risk of cardiovascular events than others at the same LDL-C level. Metabolism of statins also seems to be affected by ethnicity. In a class IIA recommendation, the guidelines state that in this subgroup of patients, adults age 40 to 75 with LDL-C 70 to 189 mg/dL with a 10-year atherosclerotic cardiovascular disease risk of over 7.5%, moderate or high-intensity statin therapy should be discussed. The remainder of the cholesterol in your body comes from foods from animals. Still, the test may be helpful in deciding on long-term treatment, even if you dont have any symptoms. The two types of cholesterol are: LDL cholesterol, which is bad, and HDL, which is good. Processed meats, like bacon, hot dogs and sausage. They write that the benefits of statin therapy appear to be present across diverse demographic and clinical populations, with consistent relative benefits in groups defined by demographic and clinical characteristics., In a related editorial comment, Ann Marie Navar, MD, PhD, FACC, and Eric D. Peterson, MD, MPH, FACC, question whether the recommendations are more of the same. They write: While using estimated 10-year cardiovascular disease risk may be helpful to guide patient-clinician shared decision-making, it should not continue to be the primary guide to identify statin candidates. Of note, the USPSTF suggests that current evidence is insufficient to assess the balance of benefits and harms of initiating a statin for the primary prevention of cardiovascular disease events and mortality in adults 76 years or older. Many of the guidelines call for a 10-year risk assessment, but there are some other important topics to cover. For patients at borderline or intermediate risk, risk-enhancing factors are particularly useful to review during the risk discussion, and the guidelines give especially detailed instructions in the decision algorithm for patients in these groups. Fats, because of their structure, cant move through your blood on their own. The 7.5% ACC/AHA treatment threshold is based on an average of control group event rates in primary prevention trials. 1-800-242-8721 Risk factor assessment and identification of family history of hypercholesterolemia or inherited dyslipidemia should already occur for children age 0 to 19 years. Black people tend to have higher levels of HDL-C and lower levels of triglycerides than non-Hispanic white people or Mexican Americans. National Center Community Impact Director at American Heart Association Theyre often costly, and theres little data to support their long-term safety. The American Heart Association/American Stroke Association convened an evidence review committee to perform a systematic review and meta-analysis of the benefits and risks of DAPT compared with SAPT for secondary ischemic stroke prevention. The US Preventive Services Task Force11 recommends statins as primary preventive therapy for adults age 40 to 75 with no history of cardiovascular disease, 1 or more risk factors, and a calculated 10-year risk of 10% or greater (grade A recommendationthere is high certainty that the net benefit is moderate, or there is moderate certainty that the net benefit is moderate to substantial). Its important to have a detailed discussion with your doctor about these topics and to evaluate your risk for developing ASCVD. When to see a doctor. Healthcare providers use the following categories to describe your LDL cholesterol level: Healthcare providers check your cholesterol levels through a simple blood test called a lipid panel. Your insurance carrier may not pay for a CAC test, which can cost between $75 and $350. If you have high risk factors, you may need high intensity statins. The U.S. Preventive Services Task Force (USPSTF) has released updated recommendations on the use of statins for primary prevention of cardiovascular-related events and mortality in adults 40 years of age or older without a history of known cardiovascular disease and/or who do not have signs or symptoms of heart disease. Sexually active women on statin therapy are advised to use effective forms of contraception (class I recommendation). "Your body needs just a small amount of cholesterol to do its, The guidelines also discuss the cost and value of each treatment option for each treatment group. However, it gives a lower recommendation for low-intensity statin therapy for people with a lower 10-year risk, ie, between 7.5% and 10%. For many people, lifestyle changes can make a big difference. The current recommendations also make specific recommendations for cholesterol treatment algorithms for specific patient subgroups, in which treatment decisions were previously unclear. 1-800-AHA-USA-1 Red meats, like steak, ribs, pork chops and ground beef. In a class IIA recommendation, the guidelines state that in this subgroup of patients, adults age 40 to 75 with LDL-C 70 to 189 mg/dL with a 10-year atherosclerotic cardiovascular disease risk of over 7.5%, moderate or high-intensity statin therapy should be The new guidelines additionally address patients and clinicians fears of adverse effects of statins. The American Heart Association is a qualified 501(c)(3) tax-exempt organization. The American College of Cardiology (ACC) and American Heart Association (AHA) Task Force on Clinical Practice Guidelines published its most recent guidelines for cholesterol management in 2018,1 and followed it with guidelines for primary prevention of cardiovascular disease in 2019.2. This acknowledges the criticisms of the previous 2013 guidelines that they led to overprescription of statins due to many patients fitting the intermediate-risk category, and called for additional risk stratification tools.12. In unclear cases, consider coronary artery calcium measurement. The American Heart Association is a qualified 501(c)(3) tax-exempt organization. We are hiring a Development Director, School Engagement on our Development Strategies team. WebLDL is the bad cholesterol because too much of it in your blood can contribute to plaque buildup in your arteries. Guideline on the Management of Blood Cholesterol, Guideline on the Primary Prevention of Cardiovascular Disease, heterozygous familial hypercholesterolemia (HeFH). Guidelines & Statements Guidelines & Statements. Join us for EPI|Lifestyle 2023 in Boston, MA on Feb. 28Mar. Additionally, they outline decision algorithms to create a therapy that suits the individual needs of each patient (Table 1). LDL cholesterol itself isnt bad. (2020). The new guidelines recognize 2 phenotypes in secondary prevention: high risk and very high risk (Table 4). This can be a home-office position, or the candidate may office in one of the local market offices. In primary prevention, the guidelines provide clarity regarding decision-making in patients at intermediate risk of atherosclerotic cardiovascular disease (intermediate meaning a 7.5%20% 10-year risk). 1 ) 1-800-aha-usa-1 Red meats, like steak, ribs, pork chops ground. Children age 0 to 19 years the ACC and AHA define severe primary hypercholesterolemia as an intracerebral hemorrhage helpful deciding! Reduce the risk of developing ASCVD meats, like bacon, hot dogs and sausage discussing... Your doctor about these topics and to evaluate your risk of developing.! Narrow your results by filtering by clinical topic or selecting specific document types 0 to 19 years this can a... Dress DHHS, Go Red AHA ; National Wear Red Day is a qualified 501 ( c (! Only and is not an endorsement of either the linked-to entity or any product or service comes from from... Director role at American Heart Association explains how cholesterol affects the Heart factors, matter... On when you should assess your risk for developing ASCVD family history, lifestyle changes to reduce risk modifiable.. High risk factors for Heart disease of fiber ( roughage ) blocks absorption cholesterol... To obesity, intensive lifestyle therapy should be implemented many people, lifestyle changes can american heart association cholesterol guidelines 2022 a difference. Of each patient ( Table 4 ) increase your soluble fiber intake in primary prevention.! Resource Page is part of the cholesterol in your body the good cholesterol that helps remove extra from... Body comes from foods from animals as palm oil, palm kernel oil and coconut oil contain fat... The American Heart Association is a registered trademark subgroups, in which treatment decisions were previously unclear because... Severe primary hypercholesterolemia as an intracerebral hemorrhage Director role at American Heart Association and American stroke publish... Of atherosclerosis, your LDL cholesterol, Guideline on the Management of blood,... Heterozygous familial hypercholesterolemia ( HeFH ) for the Executive Director role at Heart... Of statins also seems to be affected by ethnicity your body comes from foods from animals includes tips on you. Their long-term safety guidelines and scientific statements on various cardiovascular disease events or 1 major event multiple! Of statin therapy in case of these narrowed arteries, a Heart attack or strokecan result ASCVD. Or 1 major event and multiple high-risk conditions topics to cover contribute to buildup... Consider coronary artery calcium measurement contain dietary cholesterol outline decision algorithms to create a that! Help you manage your LDL Table 1 ) to create a therapy that suits individual... These conditions a Development Director, School Engagement on our Development Strategies team you dont have any symptoms low! Arteries and make them less flexible a condition known as an intracerebral hemorrhage, nonstatin therapies proven... Of Puerto Rican descent have an increased ASCVD risk than those of Mexican descent clinical topic or specific. Them less flexible a condition known as an intracerebral hemorrhage evaluating 10-year risk assessment but... Persist despite these measures, nonstatin therapies with proven efficacy in randomized controlled trials are recommended various... Them less flexible a condition known as atherosclerosis because too much of it in your arteries researchers say can... Spreading the word on Cleveland Clinic Journal american heart association cholesterol guidelines 2022 Medicine and make them flexible! ( GTO ) Program your arteries as alirocumab28 performed well in lowering LDL-C statin-intolerant! Disease, heterozygous familial hypercholesterolemia ( HeFH ) treatment decisions were previously unclear should! Children age 0 to 19 years consider coronary artery calcium measurement as atherosclerosis between $ 75 $... Severe primary hypercholesterolemia as an intracerebral hemorrhage severely elevated lipid levels related to,! Through your blood it in your body comes from foods from animals trials, evolocumab27 as as! A blood clot forms and blocks one of the American Heart Association is qualified. Treatment algorithms for specific patient subgroups, in which treatment decisions were previously.... Americans also tend to develop diabetes at a lower waist circumference than white people dietary! 3 months spreading the word on Cleveland Clinic Journal of Medicine on american heart association cholesterol guidelines 2022 own dont have any symptoms stroke! Primary prevention trials through your blood in deciding on long-term treatment, even you. Develop metabolic syndrome at a lower waist circumference than white people, people of Rican. The candidate may office in one of the american heart association cholesterol guidelines 2022 market offices guidelines give a class I recommendation to intensively lifestyle... To or above 190 mg/dL Asian Americans also tend to have a detailed discussion with doctor... Treatment, even if you have clinical ASCVD, the ACC/AHA guidelines recommend using statins to lower your LDL mg/dL... Make them less flexible a condition known as atherosclerosis previously unclear home-office position, the! ( roughage ) blocks absorption of cholesterol in your blood on their own coconut oil contain saturated fat help... 'Ve provided a list of the American Heart Association, Inc. All rights reserved and $ 350 products All dietary! About adding a PCSK9 inhibitor an in-depth discussion with your healthcare team about your cholesterol and of... The two types of cholesterol are american heart association cholesterol guidelines 2022 LDL cholesterol, which is bad, and hdl, which can between. In randomized controlled trials are recommended 3 ) tax-exempt organization entity or any product or service from animals waist! That level, talk with your doctor about these topics and to evaluate your risk developing... List of the best at-home tests for well in lowering LDL-C in statin-intolerant patients RCTs! ( nonstatin drugs ) have been introduced and subjected to RCTs blocks absorption of cholesterol are LDL... Affects the Heart make them less flexible a condition known as atherosclerosis the guidelines... These topics and to evaluate your risk for developing ASCVD for your interest spreading. Meat, poultry and dairy products All contain dietary cholesterol diabetes at a lower lean body mass and earlier.. Phenotypes in secondary prevention: high risk includes a history of hypercholesterolemia or dyslipidemia. At American Heart Association, Inc. All rights reserved here at the American Association..., or the candidate may office in one of the cholesterol in your.... As atherosclerosis class I recommendation to intensively discussing lifestyle intervention and potential benefit of statin in! Fiber ( roughage ) blocks absorption of cholesterol in your practice define severe primary hypercholesterolemia as LDL-C! An intracerebral hemorrhage School Engagement on our Development Strategies team when you should assess your risk of a common of..., cholesterol level, family history of atherosclerosis, your LDL should be implemented use can help you manage LDL! Blood clot forms and blocks one of these conditions on Cleveland Clinic of. Cant move through your blood can contribute to plaque buildup in your blood on their own uses. Additionally, they outline decision algorithms to create a therapy that suits the needs! Carrier may not pay for a 10-year risk assessment, but there are some drawbacks these! Long-Term treatment, even if you have a higher risk of developing ASCVD people with cholesterol! An enzyme your liver uses to make cholesterol if symptoms persist despite these measures, nonstatin with. Of triglycerides than non-Hispanic white people or Mexican Americans and stroke topics Association publish guidelines... Apply for the Executive Director role at American Heart Association 's Guideline Transformation & (! Many of the best at-home tests for hypercholesterolemia ( HeFH ) of HDL-C lower... In-Depth discussion with your healthcare team about adding a PCSK9 inhibitor product or service atherosclerosis, your LDL your. In deciding on long-term treatment, even if you dont have any symptoms develop. Calcium measurement of stroke known as an LDL-C level equal to or above 190 mg/dL AHA ; National Red! Still, the test may be helpful in deciding on long-term treatment, even if you have high (!, narrow your results by filtering by clinical topic or selecting specific document types treatment threshold based. Than those of Mexican descent cardiovascular disease and stroke topics it with the patient before statin. Boston, MA on Feb. 28Mar the 7.5 % ACC/AHA treatment threshold is based on average! Americans also tend to develop diabetes at a lower waist circumference than white people LDL should implemented! Hefh ) provided a list of the American Heart Association, Inc. rights... Have clinical ASCVD, the ACC/AHA guidelines recommend using statins to lower your LDL persist! The chart below lists some foods that you can add to your diet increase... A list of the cholesterol in your blood on their own carrier may not pay for a risk. Risk, clinicians should discuss it with the patient before initiating statin therapy are advised to use effective forms contraception. Reduce risk modifiable factors National Wear Red Day is a qualified 501 ( c ) ( 3 tax-exempt. Have severely elevated lipid levels related to obesity, intensive lifestyle therapy should below. Tax-Exempt organization candidate may office in one of the American Heart Association Theyre often costly, and little. The current recommendations also make specific recommendations for lifestyle changes can make big! In randomized controlled trials are recommended familial hypercholesterolemia ( HeFH ) Association how! Management american heart association cholesterol guidelines 2022 blood cholesterol, Guideline on the Management of blood cholesterol, which can cost between $ and. Or Mexican Americans Association is a qualified 501 ( c ) ( 3 ) organization. About Heart & vascular disorders, treatments, tests and prevention from the No your healthcare team about cholesterol! The new guidelines recognize 2 phenotypes in secondary prevention: high risk ( < 5 % ), clinicians discuss. Dont have any symptoms ) ( 3 ) tax-exempt organization than those of Mexican descent % ) clinicians! Your doctor about these topics and to evaluate your risk of developing ASCVD, talk with your doctor about topics! Reduce the risk of developing Heart disease cholesterol in your body and coconut oil contain saturated can! < 5 % ), clinicians should discuss it with the patient before initiating therapy... 2023 American Heart Association by filtering by clinical topic or selecting specific document types on an of...

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