PCP View: ACC/AHA Guidelines: Role of Moderate Intensity Statins

Goals

About Our Panel

2013 ACC/AHA Cholesterol Guidelines Four Statin Benefit Groups Identified

IMPROVE-IT Simvastatin 40 mg vs Simvastatin/Ezetimibe 40 mg/10 mg

IMPROVE-IT (cont)

FOURIER: CV Outcomes

Clinical Implications of FOURIER

Statins Options

More Is Not Better

Multiple Challenges in Statin Selection

Statins: High/Medium/Low

Many Scenarios for Moderate Intensity

Recognize the At-Risk Populations

CYP450

Human Cytochrome P450 Isoenzymes Known to Oxidize Clinically Used Drugs

Selected Drug Interactions Increasing Statin Levels

Statins Not Metabolized by CYP450 System

Certain Statins Increase the Risk for New-Onset T2D

Statin Safety in HIV on ART Variable Increases in Statin AUC by Protease Inhibitors

Approach to Improve Adherence

Certain Statins Increase the Risk of New-Onset T2D (cont)

JUPITER: Rosuvastatin Therapy and Diabetes Risk

Use of Statins With Protease Inhibitors

Pitavastatin Does Not Adversely Affect FBG, HbA1c, or T2D Development

Diet and Exercise Approach to Reducing Risk for Diabetes

Patient-Centered Approach

Patient Education -- Team Approach

Abbreviations

Abbreviations (cont)

Abbreviations (cont)