Dyslipidemia Statin Guidelines-Mary Flashcards
List examples of ASCVD
ASCVD= atherosclerosis cardiovascular disease
- CAD
- MI
- Angina (S/uS)
- Stroke/TIA
- Peripheral Arterial Disease
4 Statin Benefit Groups
1-2. ASCVD pt.; LDL-C >/= 190
- 40-75yo w/ DM & LDL-C= 70-189
- > /= 7.5% 10yr estimated risk
How to identify individuals w/ >7.5 % 10yr estimated risk
Pooled Cohort Equations for ASCVD
Helpful Lifestyle Mods
- diet
- Exercise
- No smoking
- healthy weight
ADDITIONAL factors to consider when determining if a patient should take a statin (5)
Fx of premature ASCVD///LDL-C > 160///CRP >2///Coronary Calcium >300//Ankle-Brachial index
What % LDL-C reduction is used to define:
- High-intensity statin therapy
- Mod-intensity statin therapy
High: >/= 50%
Mod: 30-50%
Who should receive high-intensity statin therapy (2)?
- all > 75yo
2. patients with acute coronary syndromes
What do you do if a patient is not a candidate for high-intensity statins?
(meaning like if they can’t tolerate high doses)
use mod-intensity statin therapy
Patients w/ LDL-C >190 on statins should…?
consider adjunct of other cholesterol lowering agents
Describe diabetic statin therapy
- High Statin if >7.5% risk
2. Mod Statin if less than 7.5 % risk
What do the New ASCVD guidelines say about therapy?
- 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
What heavily influences the %risk calculator?
age
*so use your “physician’s judgment” when determining to act on this estimation
NYHA CLASS BREAKDOWN
1-4
- Cardiac disease w/o symp
- mild symp like angina or dyspnea
- marked limitations
- severe limitations (mostly bedbound)