Question of the week
Additional LDL-C Reduction in a Patient Taking High-Intensity Statin Therapy
Jan 09, 2018
· 37-year-old Caucasian male who had an ischemic stroke 3 months ago.
· He was not taking any medications prior to the stroke.
· On the day of admission, his LDL-C was measured and found to be 140 mg/dL. At discharge, the patient received prescriptions for rosuvastatin 40 mg and aspirin 81 mg.
· During his office visit today, his LDL-C is 84 mig/dL. His total cholesterol is 154 mg/dL, HDL-C is 42 mg/dL, triglycerides are 140 mg/dL.
The patient states he has been adherent to maximal lifestyle modifications and pharmacotherapy.
According to the 2017 Expert Consensus Decision Pathway (ECDP) on non-statin therapies for LDL-C lowering in the management of atherosclerotic cardiovascular disease risk, which ONE of the following choices is the best consideration at this time?
- A. Discontinue rosuvastatin 40 mg. Prescribe atorvastatin 40 mg PO daily.
- B. Discontinue rosuvastatin 40 mg. Prescribe simvastatin 40 mg and ezetimibe 10 mg PO daily
- C. Continue rosuvastatin 40 mg. Prescribe alirocumab 150 mg SQ every 2 weeks.
- D. Continue rosuvastatin 40 mg. Add ezetimibe 10 mg PO daily.