Cardio- Hyperlipidemia Flashcards
T/F
HDL has the most impact on Hyperlipidemia.
False
LDL
T/F
ACC/AHA Risk Calculator focuses on secondary prevention.
False
PRIMARY prevention prior to having an event.
What factors are taken into consideration for the ACC/AHA 10-year ASCVD Risk Score and if ASA is needed?
- Age
- Gender
- Race
- HDL
- BP
- DM
- Smoking
What is the 10-yr ASCVD Risk 5-10% gray area
May consider coronary calcium (CAC) testing
- which is scored by points or percentile
What is the Coronary Artery Calcium Point Scoring?
> 100-300= significant CV Risk
300= very high risk
What is the Coronary Artery Calcium Percentile Scoring?
> 75% add LDL lowering pharmacotherapy (comparing it against the population)
Goal LDL for patients with CV events?
LDL < 70 mg/dL
High Intensity Examples
- Atherosclerotic CVD
- LDL >190
- DM and CVD 10 year risk >/= 7.5%
– age 40-75 high intensity
– ADA LDL < 55 mg/dL
Note: Age 75 is when you access risk/benefits
What are the only 2 high intensity statins and there moderate doses?
- Atorvastatin 40-80 mg (moderate 10-20 mg)
- Rosuvastatin 20-40 mg (moderate 5-10 mg)
Why should simvastatin initiation be avoided?
CYP3A4 interactions with amlodipine, amiodarone, diltiazem etc…
Which statin has the most POTENT LDL lowering property?
Rosuvastatin
What hydrophillic statins may reduce myopathy?
- Pravastatin
- Rosuvastatin
- Fluvastatin
PCSK9 Inhibitors injections
alirocumab, evolocumab, and inclisiran
- reduce LDL up to 60-70%
Bempedoic acid (Nexletol)
MOA: adenosine-triphosphate citrate lyase (ACL) inhibitor
- Caution in gout patients (increase UA levels)
- tendon risk
Zetia
MOA: inhibits gut absorption of cholestrol via Niemann-Pick C-1 Like1 transportor.
GI upset and possible myopathy
