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Statin monitoring — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsStatin monitoringGPhC CRA

A 57-year-old man asks about a new prescription for atorvastatin 20mg at night. His QRISK3 score is 14%, LDL cholesterol is 4.0mmol/L and ALT is within the reference range. He has no history of cardiovascular disease. What monitoring is required?

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Correct answer: E — baseline liver function with repeat transaminases at around 3 months and 12 months

Atorvastatin for primary prevention is appropriate when cardiovascular risk is sufficiently raised after shared decision-making. Liver transaminases should be checked before treatment and again after starting according to usual monitoring guidance. Creatine kinase is checked when muscle symptoms or risk factors suggest a need, rather than weekly for everyone. INR monitoring is not relevant unless the patient is taking warfarin.

Reference: BNF; NICE CKS: Lipid modification