Dyslipidemia Statin Guidelines-Mary Flashcards

1
Q

List examples of ASCVD

ASCVD= atherosclerosis cardiovascular disease

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

4 Statin Benefit Groups

A

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

  1. 40-75yo w/ DM & LDL-C= 70-189
  2. > /= 7.5% 10yr estimated risk
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3
Q

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

A

Pooled Cohort Equations for ASCVD

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4
Q

Helpful Lifestyle Mods

A
  1. diet
  2. Exercise
  3. No smoking
  4. healthy weight
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5
Q

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

A

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

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6
Q

What % LDL-C reduction is used to define:

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

High: >/= 50%

Mod: 30-50%

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7
Q

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

A
  1. all > 75yo

2. patients with acute coronary syndromes

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8
Q

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

A

use mod-intensity statin therapy

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9
Q

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

A

consider adjunct of other cholesterol lowering agents

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10
Q

Describe diabetic statin therapy

A
  1. High Statin if >7.5% risk

2. Mod Statin if less than 7.5 % risk

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11
Q

What do the New ASCVD guidelines say about therapy?

A
  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

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12
Q

What heavily influences the %risk calculator?

A

age

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

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13
Q

NYHA CLASS BREAKDOWN

1-4

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