By vgreene, 27 January, 2020 Deprescribing statin reasonable when risks/adverse effects outweigh meaningful benefit, d/t physical/cognitive decline, life expectancy, etc
By vgreene, 27 January, 2020 If LDL-C 70-189: After discussion, may be reasonable to start mod-intensity statin, though data limited; if 76-80 yo, may be reasonable to measure CAC,CC since zero CAC score could avoid statin for some
By vgreene, 27 January, 2020 Mod intensity 30 49 LDL C lowering atorvastatin 10 or 20 mg rosuvastatin 5 or 10 mg simvastatin 20 40 mg pravastatin 40 or 80 mg lovastatin 40 or 80 mg fluvastatin XL 80 mg fluvastatin 40 mg bid pitavastatin 1 4 mg
By vgreene, 27 January, 2020 High intensity 50 LDL C lowering atorvastatin 40 or 80 mg rosuvastatin 20 or 40 mg
By vgreene, 27 January, 2020 Assess ASCVD risk calc 1 risks 1 risk enhancing factors1 to inform shared decision making on risk reduction net benefits pt preferences AACE specifies target LDL C based on risk 2 Heart healthy lifestyle 2 Base decisions on 10 yr ASCVD risk per ACC AHA 1
By vgreene, 27 January, 2020 7 5 to 19 9 intermediate w LDL C 70 189 Mod intensity statin if discussion of risks and risk enhancers1 eg CKD1 favors statins For optimal risk reduction esp if at higher risk 1 darr LDL C by 50 if high intensity not accepted tolerated mod intensity stati
By vgreene, 27 January, 2020 5 to 7 4 borderline Presence of risk enhancers1 favor mod intensity statins If statin decision uncertain consider CAC1 in select pts eg 40 55 yo
