Clinical Statins: Acute Coronary Syndrome & Ischemic Stroke - #MEDSHED

Mark Nguyen, PharmD, BCEMP
Apr 4, 2024
1 min read

🐔 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!