Prescribe maximally tolerated statin
Indication: Very high risk ASCVD
Preferred statins: Atorvastatin 40 mg Atorvastatin 80 mg Rosuvastatin 20 mg Rosuvastatin 40mg Calculate 10-year ASCVD risk (link in menu) Follow up Lipid panel in 4-12 weeks Goal: LDL reduction of <70 mg/dL |
Next visit:
If repeat LDL is still >70 mg/dL: add ezetimibe 10mg daily -Reassess Lipid panel in 4-12 weeks If repeat LDL <70 mg/dL: monitor every 3-12 months Subsequent visit: If LDL still >70 mg/dL and non-HDL (total cholesterol minus HDL) >100 mg/dL: add PCSK9 inhibitors after risk discussion |