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Post-MI statin intensity — GPhC CRA MCQ

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HardCardiovascular TherapeuticsPost-MI statin intensityGPhC CRA

A patient with a previous myocardial infarction takes their maximum tolerated statin dose. Total cholesterol is 4.9 mmol/L and HDL cholesterol is 1.2 mmol/L. Which calculation and NICE secondary-prevention interpretation are correct?

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Correct answer: B — Non-HDL is 3.7 mmol/L and remains above target

Non-HDL cholesterol equals total cholesterol minus HDL cholesterol: 4.9 − 1.2 = 3.7 mmol/L. NICE sets a secondary-prevention target of non-HDL cholesterol at or below 2.6 mmol/L, or LDL cholesterol at or below 2.0 mmol/L. This result is therefore 1.1 mmol/L above the non-HDL target and should prompt adherence and treatment-escalation review rather than being described as controlled.

Reference: NICE NG238: https://www.nice.org.uk/guidance/ng238/chapter/Recommendations