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Topics:
Cardiology
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Preventive Cardiology
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Primary Care
Is there a role of prophylactic aspirin in patients with incidental findings of aortic atherosclerosis but no history CAD or CVA?
Related Questions
Should we be more cautious with the use of GLP 1 R agonist therapy in patients with Type 1 diabetes mellitus and obesity given the increased risk of cardiovascular disease with high body weight variability?
Would you recommend statin initiation in a young adult patient (age < 40) with type 1 diabetes mellitus and LDL cholesterol levels greater than 100 without any cardiovascular risk factors?
Is it worth getting a calcium score on a patient who is already on statin therapy?
How would you counsel a patient on the risk/benefit profile of preventive management such as statin initiation if they have an elevated lipoprotein (a) level, markedly elevated LDL > 200 but a CAC score of 0 without other CV risk factors?
For isolated and very high lipoprotein (a) levels (LDL of > 140, has an Lp(a) > 100) in a patient with no cardiac symptoms or risk factors, would you start lipid lowering treatment, such as with a PCSK9i if they develop statin intolerance?
When would you consider ordering additional testing such as hs-CRP, lipoprotein A levels, or CAC scoring to further risk stratify otherwise healthy pre-menopausal women with a prior history of pregnancy-related hypertension, diabetes, or premature births?
Would it be reasonable to consider switching from a high intensity statin therapy to PCSK9 inhibitor vs. adding adjunct lipid lowering medications for a patient with known coronary artery calcifications, LDL in the mid-100 range pre-statin with worsening A1C levels?
Would you favor stopping low-dose aspirin and continuing OAC alone in a patient with atrial fibrillation and mild coronary artery calcification seen on routine chest imaging?
Would you consider adding niacin to the lipid lowering regimen in statin-intolerant patients who cannot afford PCSK9i or bempedoic acid?
What are your thoughts on the applicability and utility of the PREVENT equation and how it compares to the PCE for ASCVD risk assessment?
