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.


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