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Objectives Patients (pts) with systemic lupus erythematosus (SLE) have a significantly increased risk of atherosclerotic cardiovascular disease (ASCVD). EULAR recommends comprehensive assessment and management of cardiovascular risk (CVR), following general population guidelines. Statin therapy plays a key role in reducing CVR and preventing ASCVD events. We aimed to determine the proportion of pts with SLE eligible for statin use for primary ASCVD prevention, based on American and European CVR guidelines.Methods This observational, cross-sectional study of GLADEL 2.0, a multi-ethnic Latin-American SLE cohort, analyzed demographics, comorbidities, medications, disease activity, and laboratory data. Statin eligibility was determined using the 2019 ACC/AHA and 2021 ESC guidelines. CVR was assessed using the ASCVD risk calculator from ACC/AHA, SCORE2, and PAHO risk scores. Both guidelines only consider pts >=40 years of age as candidates for CVR prevention with statins, due to eligibility dependence on CVR scores. Therefore, a comparative analysis was conducted between pts above and below this age threshold.Results Among 1083 pts, 394 (36.4%) were >=40 years of age ( table 1). ACC/AHA could only be calculated for 164 pts, PAHO for 351 pts, and SCORE2 for 181 pts. Most of these pts were categorized as having low CVR, regardless of the calculator used. 15 pts were indicated to receive statin therapy based on European guidelines; among these only 5 (33%) had a previous prescription for statin. Among 50 pts eligible for statins based on American guidelines, only 13 (26%) had been prescribed them. Inter-guideline agreement on statin eligibility was fair (Cohen’s Kappa=0.35; 95% CI: 0.15–0.55). Pts <40 years were more obese and had higher disease activity than those >=40 years (table 2).Abstract PO:03:076 Table 1Baseline clinical characteristics, disease activity, damage index, and treatmentsAbstract PO:03:076 Table 2Comparision of clinical characteristics based on their age groupConclusions Only a small percentage of pts were candidates for statin therapy, primarily due to the predominance of pts under age 40, where traditional CVR assessment tools are not applicable. Among eligible pts, statin prescribing rates remain low. The moderate agreement between differing guidelines highlights the inconsistency in risk assessment and management approaches for this population. Tailored strategies and more inclusive guidelines are needed to comprehensively evaluate and address CVR in younger pts with chronic inflammatory conditions like SLE.