Dyslipidemia - PLAS

Question 1

Risk Factors

Answer 1

male
smoker
HPN > 140/90
BMI 25 kg/m2
family hx of premature coronary heart disease
proteinuria
L ventricular hypertrophy
postmenopausal women

Question 2

Recommendations Statin Treatment

Answer 2

📌 individuals (-) DM > 45 y/o (+) LDL- > 130 mg/dL AND > 2 risk factors (-) ASCVD

📌 (+) diabetes (-) evidence of ASCVD
LDL goal < 100 mg/dL - primary prevention
LDL goal < 70 mg/dL - (+) diabetes > 1 risk factor
LDL goal < 50 - extremely high risk of having recurrent CV events d.t. previous occurence of major cardiovascular events (M.I., unstable angina or CVD stroke)

📌 (+) familial hypercholesterolemia
high intensity dose of statin
LDL goal < 70 mg/dL - (+) FH (-) target organ damage
LDL goal < 55 mg/dL - (+) FH (+) target organ damage

📌 CKD not on dialysis

📌 ACS

Question 3

Pediatric population (<19 y/o) at risk for devt of atherosclerosis and premature cardiovascular disease

Answer 3

screening w/ a fasting lipid profile

Question 4

Statin Treatment Intensity

LOW INTENSITY
% LDL reduction < 30

Answer 4

Fluvastatin 20-40 mg

Pravastatin 10-20 mg

Question 5

Statin Treatment Intensity

MODERATE INTENSITY
% LDL reduction < 30 - 50

Answer 5

Atorvastatin 10-20 mg
Fluvastatin 80 mg
Rosuvastatin 5-10 mg
Simvastatin 20-40 mg
Pravastatin 40-80 mg
Pitavastatin 2-4 mg

Question 6

Statin Treatment Intensity

HIGH INTENSITY
% LDL reduction > 50

Answer 6

Atorvastatin 40-80 mg

Rosuvastatin 20-40 mg

Question 7

Individuals with documented ACS and target LDL has not been reached despite maximally tolerated high intensity statin therapy

Answer 7

EZETIMIBE + statin

Question 8

Men with controlled diabetes, low HDL (<35 mg/dL) and persistently high triglycerides (> 200 mg/dL) for prevention of CV disease

Answer 8

FIBRATES + STATIN - may be considered

Question 9

ASVCD on statin therapy at goal LDL but with persistently high TGL levels 150-499 mg/dL

Answer 9

Omega FA - MAY be given