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Lipid modification - primary and secondary CVD prevention - Management
What follow up are recommended after initiating a lipid modification therapy for secondary prevention of CVD?
- Repeat lipid measurement:
- For people with acute coronary syndrome:
- Perform a fasting lipid measurement around 3 months after initiating statin therapy.
- For all other people taking a statin or other lipid-modifying drugs for secondary prevention:
- Check lipid profile around 8 (+/– 4) weeks after initiation, and after each adjustment to treatment.
- Lipid profile should be reviewed annually once the individual has reached an optimal, achievable target.
- For people taking statins, recheck liver function tests (LFTs) within 3 months of starting treatment and again at 12 months.
- If they develop unexplained muscle symptoms (pain, tenderness, weakness):
- Check creatine kinase (CK).
- Stop the lipid-modifying drug immediately if muscle symptoms are severe or if CK is five times or more the upper limit of normal.
- Note: people should be advised to seek medical advice and to stop the lipid-modifying drug if they develop unexplained muscle symptoms.
- Discontinue the statin and seek specialist advice if they develop unexplained peripheral neuropathy or presenting features of interstitial lung disease.
In depth
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