đ Clinical Statins: ACS/AIS - #MEDSHED
Statins are a mainstay of therapy for stroke and heart attack secondary prevention. They work by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A reductase, stimulating LDL catabolism. Additionally, statins contain pleoitropic properties, such as improved endothelial function, reduced inflammation, inhibit platelet aggregation, and anticoagulant effects
Monitoring - Side Effects
Hepatotoxicity Increased serum transaminases (ALT > AST)
Most cases occur within 3 months/dose increase
Muscle-related Myalgia, myopathy, rhabdomyolysis
Highest risk within first year of use, dose increase, or interacting medications
Guideline LDL-C Targets Acute Coronary Syndrome (ACS) - secondary prevention
Target: 50% reduction AND < 50 mg/dL
Acute Ischemic Stroke (AIS) - secondary prevention
Target: < 70 mg/dL
Unknown benefit when LDL-C levels are already low at time of stroke
High-intensity rosuvastatin has been associated with more effectiveness in reducing LDL vs atorvastatin
Let me know what thoughts and questions you have in the comments!
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