Should we treat all patients with coronary heart disease or the equivalent with statins?
Statins have proven benefit in preventing cardiovascular events and should be prescribed for almost all patients with coronary heart disease (CHD) or equivalent. However, evidence is lacking to support treating all such individuals. Potential exceptions include those in the initial days of acute coronary syndrome, those with symptomatic systolic heart failure, those with very low low-density lipoprotein cholesterol, diabetic patients without associated metabolic syndrome, and those with high CHD risk calculated mainly on the basis of advanced age. In these cases, the decision to prescribe statins depends on clinical judgment, and surrogate tests for CHD may be useful.
Baginsky
Peter
P
College of Osteopathic Medicine, Touro University, Vallejo, CA 94592, USA. pbaginsk@touro.edu
D008078:Cholesterol, LDL / Q000097:blood; D000075202:Contraindications; D003327:Coronary Disease / Q000188:drug therapy*; D003657:Decision Making; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D024821:Metabolic Syndrome / Q000188:drug therapy; D018570:Risk Assessment
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors