A -year-old man presents for a health maintenance examination. His calculated -year atherosclerotic cardiovascular disease risk is determined to be . He has no active symptoms, and his baseline low-density lipoprotein cholesterol is . Following a shared decision-making discussion, the physician prescribes moderate-intensity atorvastatin for primary prevention. The patient is also counseled on dietary modifications and regular aerobic exercise. Assuming the patient experiences no adverse effects, which of the following is the most appropriate next step in monitoring his therapeutic response?
- Assess adherence and repeat a fasting lipid panel in to weeksAnswer
- BRepeat a fasting lipid panel in week
- CMeasure routine creatine kinase levels at every follow-up visit
- DOrder a coronary artery calcium score to establish a baseline
- ESchedule a routine exercise electrocardiogram to screen for coronary ischemia
Answer
Assess adherence and repeat a fasting lipid panel in to weeks
When a patient is started on statin therapy, the maximum low-density lipoprotein (LDL) lowering effect is typically achieved within to weeks. Therefore, the standard of care is to assess medication adherence and repeat a fasting lipid panel within this - to -week window to evaluate therapeutic efficacy. If the LDL goal is met, subsequent monitoring can be spaced out to every to months.
Step-by-Step Solution
Key Concept
Monitoring timeline for statin therapy initiation
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