*Clinical atherosclerotic cardiovascular disease (ASCVD) includes acute coronary syndrome (ACS), those with history
of myocardial infarction (MI), stable or unstable angina or coronary or other arterial revascularization, stroke,
transient ischemic attack (TIA), or peripheral artery disease (PAD) including aortic aneurysm, all of atherosclerotic
origin.
Should I initiate statins or not?
The 2014 National Lipid Association (NLA) recommendations provides a more comprehensive, patient-centered approach to identifying ASCVD risk.
In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) issued guidelines to use the intensity of statin therapy as the treatment goal instead of LDL-C or non–HDL-C targets, as in previous guidelines, to reduce atherosclerotic cardiovascular disease (ASCVD) risk ( )
The guideline classifies statin therapy as
high-intensity (lowers LDL-C by an average of ≥50%),
moderate-intensity (lowers LDL-C by an average of 30% to 50%),
and low-intensity (lowers LDL-C by an average <30%).
Strong evidence indicates four groups of individuals should receive moderate- or high-intensity statin therapy to reduce ASCVD risk: with clinical ASCVD; with primary elevations of LDL-C of 190 mg/dL or higher; age 40 to 75 with diabetes, LDL-C 70 to 189 mg/dL without clinical ASCVD; and without clinical ASCVD or diabetes, age 40 to 75, LDL-C 70 to 189 mg/dL, an estimated 10-year ASCVD risk of 7.5% or greater (this requires a clinician-patient discussion).
Source:
Lipids and Dyslipoproteinemia, Henry's Clinical Diagnosis and Management by Laboratory Methods, Chapter 17, 221-243.e2
High-, Moderate-, and Low-Intensity Statin Therapy
| Statin Therapy | High-Intensity (Daily Dose Lowers LDL-C Levels by an Average of ≥50%) | Moderate-Intensity (Daily Dose Lowers LDL-C Levels by an Average of 30% to <50%) | Low-Intensity (Daily Dose Lowers LDL-C Levels by an Average of <30%) |
|---|---|---|---|
| Atorvastatin | 40-80 mg | 10 (20) mg | — |
| Rosuvastatin | 20 (40) mg | (5) 10 mg | — |
| Simvastatin | — | 20-40 mg | 10 mg |
| Pravastatin | — | 40 (80) mg | 10-20 mg |
| Lovastatin | — | 40 mg | 20 mg |
| Fluvastatin | — | 80 mg (Fluvastatin XL) | — |
| 40 mg twice daily | |||
| Pitavastatin | — | 2-4 mg | 1 mg |
You are providing good knowledge. It is really helpful and factual information for us and everyone to increase knowledge. about Best Hospital in Aundh .Continue sharing your data. Thank you.
ReplyDeleteI generally check this kind of article and I found your article which is related to my interest.chiropractic treatment near me Genuinely it is good and instructive information. Thankful to you for sharing an article like this.
ReplyDeleteYou wrote this post very carefully.pain management doctors nj The amount of information is stunning and also a gainful article for us. Keep sharing this kind of articles, Thank you.
ReplyDeleteYou have a genuine capacity to compose a substance that is useful for us. You have shared an amazing blog about Best Pediatrician in Pune thanks for sharing this blog with us.
ReplyDeleteYou have worked nicely with your insights that makes our work easy. The information you have provided is really factual and significant for us. Miami Gastric Band Surgery Keep sharing these types of article, Thank you.
ReplyDeleteYour blog is entirely significant which you have shared here about Obstetrician St Leonards I value the endeavors which you have placed into this blog and furthermore it is a profitable blog for us. Much obliged to you for sharing this here.
ReplyDeleteYou have used excellent material right here about Compare Best Medical Insurance Plans. I rejoice to find this article, as I situated a lot of important details in your article. Thanks for sharing a message such as this.
ReplyDelete