How do I assess the need for statin therapy in patients with established coronary artery disease?

In patients with established coronary artery disease (CAD), the need for statin therapy should be assessed by making decisions after an informed discussion with the patient about the risks and benefits of statins ¹.

Offer lipid-lowering treatment for secondary prevention of CVD to adults with established CVD, regardless of their cholesterol level, without delay, while discussing lifestyle changes if appropriate ¹.

Perform appropriate clinical assessments, including smoking status, alcohol consumption, blood pressure, body mass index, and measure a non-fasting full lipid profile if not already done as part of the assessment ¹.

Assess for and treat comorbidities and secondary causes of dyslipidaemia, such as uncontrolled diabetes, hypothyroidism, liver disease, and nephrotic syndrome ¹.

Measure a non-fasting full lipid profile 2-3 months after starting or changing lipid-lowering treatment to evaluate response ¹.

Make treatment decisions based on whether the LDL cholesterol level is below or above the target of 2.0 mmol/L or non-HDL cholesterol of 2.6 mmol/L, considering treatment escalation if targets are not met ².