Statin therapy for ASCVD prevention: Difference between revisions
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==Major Recommendations for Statin Therapy for ASCVD Prevention== | ==Major Recommendations for Statin Therapy for ASCVD Prevention== | ||
The following is a treatment algorithm proposed by the AHA/ACC guidelines committee:<ref name="pmid24222016">{{cite journal| author=Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH et al.| title=2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2014 | volume= 129 | issue= 25 Suppl 2 | pages= S1-S45 | pmid=24222016 | doi=10.1161/01.cir.0000437738.63853.7a | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24222016 }} </ref> | The following is a treatment algorithm proposed by the AHA/ACC guidelines committee:<ref name=ACC/AHA-Chol-Guide> 2013 ACC/AHA Guideline on the | ||
Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. http://ac.els-cdn.com/S0735109713060282/1-s2.0-S0735109713060282-main.pdf?_tid=06f509a0-9c67-11e6-b670-00000aab0f01&acdnat=1477587879_04fcb2e98e9d9b3a556253eefd0247d2 Accessed on October 27, 2016</ref><ref name="pmid24222016">{{cite journal| author=Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH et al.| title=2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2014 | volume= 129 | issue= 25 Suppl 2 | pages= S1-S45 | pmid=24222016 | doi=10.1161/01.cir.0000437738.63853.7a | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24222016 }} </ref> | |||
[[File:ACCAHA cholesterol treatment algorithm.jpg|900px]] | [[File:ACCAHA cholesterol treatment algorithm.jpg|900px]] | ||
Revision as of 14:05, 28 October 2016
Template:Hypercholesterolemia Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Major Recommendations for Statin Therapy for ASCVD Prevention
The following is a treatment algorithm proposed by the AHA/ACC guidelines committee:[1][2]
Initial evaluation prior to statin initiation
Initial evaluation prior to statin initiation include:
- Fasting lipid panel
- Fasting lipid panel preferred. In a nonfasting individual, a non–HDL-C level ≥220 mg/dL could indicate genetic hypercholesterolemia that requires further evaluation or a secondary etiology. If nonfasting triglycerides are ≥500 mg/dL, a fasting lipid panel is required.
- ALT
- CK
- Consider evaluation for other secondary causes
| Secondary Cause | Elevated LDL-C | Elevated Triglycerides |
|---|---|---|
| Diet | Saturated or trans fats
Weight gain Anorexia nervosa |
Weight gain
Very-low-fat diets High intake of refined carbohydrates Excessive alcohol intake |
| Drugs | Diuretics
Cyclosporine Glucocorticoids Amiodarone |
Oral estrogens
Glucocorticoids Bile acid sequestrants Protease inhibitors Retinoic acid Anabolic steroids Sirolimus Raloxifene Tamoxifen Beta blockers |
| Diseases | Biliary obstruction
Nephrotic syndrome |
Nephrotic syndrome
Chronic renal failure Lipodystrophies |
| Disorders and altered states of metabolism | Hypothyroidism
Obesity Pregnancy |
Diabetes (poorly controlled)
Hypothyroidism Obesity Pregnancy |
- ↑ 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. http://ac.els-cdn.com/S0735109713060282/1-s2.0-S0735109713060282-main.pdf?_tid=06f509a0-9c67-11e6-b670-00000aab0f01&acdnat=1477587879_04fcb2e98e9d9b3a556253eefd0247d2 Accessed on October 27, 2016
- ↑ Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH; et al. (2014). "2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation. 129 (25 Suppl 2): S1–S45. doi:10.1161/01.cir.0000437738.63853.7a. PMID 24222016.