Dyslipidemia Statin Guidelines-Mary

Question 1

List examples of ASCVD

ASCVD= atherosclerosis cardiovascular disease

Answer 1

1. CAD
2. MI
3. Angina (S/uS)
4. Stroke/TIA
5. Peripheral Arterial Disease

Question 2

4 Statin Benefit Groups

Answer 2

1-2. ASCVD pt.; LDL-C >/= 190

3. 40-75yo w/ DM & LDL-C= 70-189
4. > /= 7.5% 10yr estimated risk

Question 3

How to identify individuals w/ >7.5 % 10yr estimated risk

Answer 3

Pooled Cohort Equations for ASCVD

Question 4

Helpful Lifestyle Mods

Answer 4

1. diet
2. Exercise
3. No smoking
4. healthy weight

Question 5

ADDITIONAL factors to consider when determining if a patient should take a statin (5)

Answer 5

Fx of premature ASCVD///LDL-C > 160///CRP >2///Coronary Calcium >300//Ankle-Brachial index

Question 6

What % LDL-C reduction is used to define:

1. High-intensity statin therapy
2. Mod-intensity statin therapy

Answer 6

High: >/= 50%

Mod: 30-50%

Question 7

Who should receive high-intensity statin therapy (2)?

Answer 7

1. all > 75yo

2. patients with acute coronary syndromes

Question 8

What do you do if a patient is not a candidate for high-intensity statins?
(meaning like if they can’t tolerate high doses)

Answer 8

use mod-intensity statin therapy

Question 9

Patients w/ LDL-C >190 on statins should…?

Answer 9

consider adjunct of other cholesterol lowering agents

Question 10

Describe diabetic statin therapy

Answer 10

1. High Statin if >7.5% risk

2. Mod Statin if less than 7.5 % risk

Question 11

What do the New ASCVD guidelines say about therapy?

Answer 11

1. treat to the level of ASCVD risk based on 10yr estimate

2. guidelines include nothing about initiating/discontinuing statins in NYHA class 2-4 or pt. on hemodialysis

Question 12

What heavily influences the %risk calculator?

Answer 12

age

*so use your “physician’s judgment” when determining to act on this estimation

Question 13

NYHA CLASS BREAKDOWN

1-4

Answer 13

1. Cardiac disease w/o symp
2. mild symp like angina or dyspnea
3. marked limitations
4. severe limitations (mostly bedbound)