When To Take A High Intensity Statin For Ascvd
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FOUR KEY HIGHLIGHTS - Lipid
ASCVD In patients with clinical ASCVD, reduce low-density lipoprotein cholesterol (LDL-C) with high intensity statin therapy or maximally tolerated statin therapy. The more LDL-C is reduced on statin therapy, the greater will be subsequent risk reduction. Use a maximally tolerated statin to lower LDL-C levels by 250%. 2018 Guideline on the
Slide Set for 2018 Guideline on the Management of Blood
start moderate-intensity statin therapy without calculating 10-year ASCVD risk. In patients with diabetes mellitus at higher risk, especially those with multiple risk factors or those 50 to 75 years of age, it is reasonable to use a high-intensity statin to reduce the LDL-C level by ≥50%.
Cholesterol Management Practice Module
(LDL-C) with high-intensity statin therapy or maximally tolerated statin therapy. 3 In very high-risk ASCVD patients, use an LDL-C threshold of 70 mg/dL to consider the addition of non-statins to statin therapy. 4 In patients with severe primary hypercholesterolemia (LDL-C level >= 190 mg/dL, without calculating 10-year ASCVD risk, begin high
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Fallacies in Modern Medicine: Statins and the Cholesterol
1987, are very effective in lowering cholesterol. High-intensity statin therapy, rosuvastatin 20mg/day or atorvastatin (Lipitor) 40-80 mg, reduces LDL-C by 50 percent or greater. Moderate-intensity therapy, rosuvastatin 10 mg, atorvastatin 10 mg, simvastatin (Zocor) 20-40 mg, or pravastatin (Pravachol) 40
Individualizing Treatment with Statin Therapy
overall 10-year ASCVD risk.1,2 In general, moderate- to high-intensity statins are recommended for patients with a 10-year ASCVD risk score ≥7.5% or who have previously experienced a CV event. Moderate-intensity statins can also be considered for patients with a 10-year ASCVD risk score of 5% to <7.5%.
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2. In patients with clinical ASCVD, reduce low-density lipoprotein cholesterol (LDL-C) with high-intensity statin therapy or maximally tolerated statin therapy 3. In very high-risk ASCVD, use a LDL-C threshold of 70 mg/dL (1.8 mmol/L) to consider addition of nonstatins to statin therapy 4.
Clinician pocket guide. Treatment of high blood cholesterol.
Take-home messages to reduce ASCVD risk through cholesterol management (refer to chart for full guidelines) In patients with severe primary hypercholesterolemia (LDL-C level ≥190 mg/dL preeclampsia, premature menopause) (≥4.9 mmol/L)), begin high-intensity statin therapy without calculating 10-year ASCVD risk.
Correction to: 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA
left column, Take Home Message 4: The first sentence read, 4. In patients with severe primary hypercholes-terolemia begin high-intensity statin therapy without calculating 10-year ASCVD risk. It has been updated to read, 4. In patients with severe primary hypercholesterolemia without calculating 10-year ASCVD risk,
2018 Guideline on the Management of Blood Cholesterol
If high-intensity statin not tolerated, use moderate-intensity statin (Class I) If on maximal statin & LDL-C ≥70 mg/dL (≥1.8 mmol/L), adding ezetimibe may be reasonable (Class IIb) Age >75 ASCVD not at very high-risk* Very high-risk* ASCVD Healthy Lifestyle Initiation of moderate or high-intensity statin is reasonable (Class IIa
When Should You Start Statin Therapy and/or Consider Other
ASCVD not at very high-risk. High-Intensity Statin (goal: ↓LDL ≥50%) If high-intensity statin not tolerated, use moderate-intensity statin. If on maximal statin therapy and LDL ≥70 mg/dL, consider adding ezetimibe *Age >75 y: initiation and/or continuation of statin is reasonable
Aggressive cholesterol management for patients at highest
High Risk Groups Prior ASCVD LDL-C 190mg/dL Diabetes LDL-C 70-189mg/dL, Age 40-75 y High-intensity statin 75 y YES 7.5% Estimated 10-y ASCVD risk Moderate- intensit statin > 75 y If not a candidate for high-intensity statin < 7.5% Estimated 10-y ASCVD risk
CAC Score to Guide CV Risk Assessment - ACOI
that an ASCVD risk ≥7.5% is a statin benefit group, and a moderate intensity statin should be considered (Class I recommendation, for ages 40-75). This decision should be made as part of a Clinician-Patient Risk Discussion (IIa recommendation) and if risk is uncertain, additional testing such as CAC can be considered (IIa
Management of Hypercholesterolemia Clinical Practice
>= 7.5% High-Intensity Statin preferred, otherwise use Moderate-Intensity 4) Individuals 40-75 years of age without diabetes or clinical ASCVD and with LDL 70-189 mg/dL and an estimated 10-year ASCVD risk of 7.5% or higher Moderate to High-
Cholesterol Management Guide for Health Care Practitioners
2. In patients with clinical ASCVD, reduce low-density lipoprotein cholesterol (LDL-C) with high-intensity statins or maximally tolerated statins to decrease ASCVD risk. Greater LDL-C reductions on statin therapy, leading to lower LDL-C levels, lower subsequent risk; use a maximally tolerated statin to reduce LDL-C levels by ≥50%. 3.
AHA/ACC/Multisociety Cholesterol Guidelines: highlights
initiated. In these patients, if high intensity statin does not achieve a LDL-C< 70mg/dl or cannot be tolerated, the consideration of adding ezetimibe to a moderate- or high-intensity statin should be made.1 In patients with heart failure due to ASCVD with reduced ejection fraction, with a reasonable like expectancy of 3 5 years, moder-ate
2018 ACC/AHA guidelines for cholesterol management in adult
Without calculating 10-year ASCVD risk, begin high-intensity statin therapy. 5. Adults aged 40 75 years with diabetes and LDL-C ≥70 mg/dL Start moderate-intensity statin therapy without calculating 10-year ASCVD risk. 6. Adults aged 40 75 years evaluated for primary ASCVD prevention
2019 ACC/AHA Guideline on the Primary Prevention of
9.Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician patient risk discussion.
Prevention of ASCVD in - Omnia Education
>20%, high‐intensity statin therapyshould be added to lifestyle therapy. (A) In patients with diabetes without ASCVD but with multiple ASCVD risk factors, it is reasonable to consider high‐intensity statin therapy. (C) For patients with diabetes without ASCVD, aged 40 75 years (A), and
Statin Dose Comparison - Epocrates
Statin Moderate Daily Adult Dose Providing Similar Average LDL-Lowering(based on reference 1 unless otherwise denoted) Low -intensity (expected LDL reduction <30%) -intensity (expected LDL reduction 30 to <50%) High intensity (expected LDL reduction 50% or higher) Pitavastatin (Livalo)(U.S.) 1 mg 2 to 4 mg Use an initial dose of 1 mg in patients
ASSESSING AND MANAGING - Intermountain Healthcare
to statin YES ASCVD Risk Reduction For All Patients (a) SCREEN all adults age ≥ 20 years with full lipoprotein panel (fasting preferred) once every 5 years no Clinical ASCVD? (b) yes PRESCRIBE high-intensity statin. (c) CONSIDER adding ezemti bi e and / or PCSK9 if needed to achieve 50 % LDL reduction or if LDL remains > 70. Indicates
Clinician-Patient Risk Discussion for Atherosclerotic
equivalent to an ASCVD event) to identify evidence-based 10-year ASCVD risk thresholds for initiation of moderate-intensity or high-intensity statin therapy. For a moderate-intensity statin, the estimated NNT vs.NNHwas36to44vs.100forthe$7.5% risk threshold and 57 to 67 vs 100 for patients with 5% to 7.4% risk. For a high-intensity statin
Statin Therapy and Patient Adherence - UH
Dec 05, 2016 Appropriate intensity of statin therapy should be used to reduce ASCVD risk in those most likely to benefit Focus on ASCVD risk reduction: 4 statin benefit groups Goal is to reduce ASCVD events in secondary and primary prevention High‐intensity and moderate‐intensity statin use
Lipid Therapy Screening and Management of Lipids Guideline
If not very high-risk ASCVD If age > 75 Consider initiating/continuing high-intensity statin If age ≤ 75 High-intensity statin to reduce LDL-C ≥ 50% If high-intensity statin not tolerated Moderate-intensity statin If on maximal statin and LDL-C ≥ 70 mg/dL May consider adding ezetimibe
Should all diabetic patients take statin therapy regardless
Patients with ASCVD who are on high-intensity statin therapy and have an LDL cholesterol >70 mg/dL, the addition of non-statin LDL-lowering therapy is recommended after considering the risk for further ASCVD risk reduction, adverse effects, and patient choices. The IMPROVE-IT trial studied combination ther-apy for LDL-C lowering statins and
Prevention of ASCVD in
In patients with diabetes without ASCVD but with multiple ASCVD risk factors, it is reasonable to consider high‐intensity statin therapy. (C) For patients with diabetes without ASCVD, aged 40 75 years (A),and >75 years (B), use moderate‐intensity statin in addition to lifestyle therapy.
Lipid management in 2021‐ guidelines based approach
start moderate‐intensity statin therapy without calculating 10‐year ASCVD risk. In patients with diabetes mellitus at higher risk, especially those with multiple risk factors or those 50 to 75 years of age, it is reasonable to use a high‐intensity statin to reduce the LDL‐C level by ≥50%.
Management of Hypercholesterolemia Clinical Practice
2. In patients with clinical ASCVD, reduce low-density lipoprotein cholesterol (LDL-C) with high- intensity statin therapy or maximally tolerated statin therapy. The more LDL-C is reduced on statin therapy, the greater will be subsequent risk reduction. Use a maximally tolerated statin to lower LDL -C levels by ≥50%. 3.
Table 5. Statin Dose Intensity and Equivalency Chart*
Table 5. Statin Dose Intensity and Equivalency Chart* Statin Intensity %LDL-C Reduction HMG-CoA Reductase Inhibitor Rosuvastatin Atorvastatin Pitavastatin Simvastatin Lovastatin Pravastatin Fluvastatin High-Intensity (lowers LDL-C ≥ 50%) 63 40 mg ($196)
Dyslipidemia Care Guide
ASCVD at very high risk * Age 75 yrs Age > 75 yrs High -intensity statin (Goal : < LDL -C 50 % (Class I) If High-intensity statin not tolerated, use Moderate-intensity statin (Class I) If on maximal statin & LDL -C 70 mg/dL, adding ezetimibe may be reasonable (Class IIb) Continuation of High-intensity statin is reasonable (Class IIa) If on
Statin Use in Persons with Diabetes (SUPD)
^High‑intensity statin may be considered based on risk‑benefit profile and presence of ASCVD risk factors such as LDL cholesterol ≥100 mg/dL, high blood pressure, smoking, chronic kidney disease, albuminuria and family history of
Evolving Issues in Statin Selection
those with ASCVD or severe hypercholesterolemia and the importance of a high-intensity or maximally tolerated statin to lower LDL-C by ≥50%. The addition of non-statin therapies (eg, ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors) may be considered when LDL-C is ≥70 mg/dL 17
estimated 10-year ASCVD risk ≥ 7.5%. High intensity is optional in this group High intensity statin patient who is unable to take high intensity statin due to: o drug drug interaction o history of statin intolerance o medical conditions influencing statin safety
CORCAL RESEARCH STUDY - Intermountain Healthcare
A greater than 20 percent risk is considered high. It is recommended that you start with high-intensity statin therapy. What should I do now? Talk with your primary care provider to discuss the treatment option that is best for you. If it is recommended that you take a statin, use the Statins fact sheet in English or Spanish to learn more. Your
Critical Review of Current Lipid Management Guidelines ACC
start moderate-intensity statin therapy without calculating 10-year ASCVD risk. In patients with diabetes mellitus at higher risk, especially those with multiple risk factors or those 50 to 75 years of age, it is reasonable to use a high-intensity statin to reduce the LDL- level by ≥50%.
NEW 2013 ACC/AHA GUIDELINES ON TREATMENT OF BLOOD CHOLESTEROL
Engage in a clinician-patient discussion before initiating statin therapy. Initiate the appropriate intensity of statin therapy to reduce ASCVD risk. Use Pooled Cohort Equations for estimating 10-year ASCVD risk. Evidence is inadequate to support specific LDL-C or non-HDL-C goals.
Cholesterol Management in Primary Care - AHRQ
Statin benefits for patients with coronary artery disease. 1,2 i16% Reduction in absolute risk of death i20% Reduction in all major cardiovascular events Manage cholesterol aggressively for patients at highest risk of atherosclerotic cardiovascular disease (ASCVD) 3 Patients at highest risk should be prescribed statins unless
Using the New Lipid and Blood Pressure Guidelines in Your
Moderate-intensity statin (A / I / A) High-intensity if 10-year ASCVD risk ≥ 7.5% E / IIa / B 4) Age 40-75 (without ASCVD or DM) and estimated 10-year ASCVD risk ≥ 7.5% Moderate- to High-intensity statin A / I / A Stone NJ, et al. 2013 ACC/AHA Blood Cholesterol Guideline Statin intensity? Rosuva Atorva Simva Lova/Prava Fluva
Management of Dyslipidemia in the Elderly
tween the ages of 65 and 80 receive a high-intensity statin for secondary prevention after special consideration of the potential risks and benefits. In patients over the age of 80, NLA recommends a moderate-intensity statin for second-ary prevention. For primary prevention, NLA recommends utilizing the pooled cohort risk equation to analyze