NAPLEX Sample Question 22

Who may fall to a major statin benefit groups?
 
I. Patients with LDL 190 mg/dL or higher.
II. Patients age 40 to 75 years of age with diabetes and LDL 70 to 189 mg/dL.
III. Patients without clinical atherosclerotic cardiovascular disease or diabetes with LDL 70 to 189 mg/dL.
 
a. I only
b. I and II only
c. II and III only
d. All
 
Answer: d, All. There are four major statin benefit groups:

a. Patients with clinical atherosclerotic cardiovascular disease.

b. Patients with LDL 190 mg/dL (5 mmol/L) or higher.

c. Patients age 40 to 75 years of age with diabetes (but without clinical atherosclerotic cardiovascular disease) and LDL 70 to 189 mg/dL (1.8 to 4.9 mmol/L).

d. Patients without clinical atherosclerotic cardiovascular disease or diabetes with LDL 70 to 189 mg/dL (1.8 to 4.9 mmol/L), with an estimated 10-year risk of atherosclerotic cardiovascular disease of 7.5% or higher.

If a patient does not fit into one of the four statin benefit groups (e.g., LDL 70 to 189 mg/dL [1.8 to 4.9 mmol/L] with 10-year risk 5% to 7.5%), but there is clinical suspicion that they may benefit from a statin, additional factors can be taken into consideration:

a. LDL 160 mg/dL or higher or other evidence of genetic hyperlipidemia.

b. Cardiovascular disease onset in a first degree male relative before age 55, or in a first degree female relative before age 65.

c. High-sensitivity C-reactive protein 2 mg/dL or higher.

d. Elevated lifetime risk of atherosclerotic cardiovascular disease.

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