GP Vivas · cardiovascular-health
Dyslipidaemia — structured viva
Structured oral on dyslipidaemia: the CTT arithmetic behind every statin conversation, absolute-risk framing versus fixed cut-offs, the statin-intolerance ladder with outcome-proven steps, PCSK9 inhibitor evidence, severe triglyceridaemia and pancreatitis, and FH suspicion with DLCN criteria and cascade screening.
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Target exams
RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Statins are over-prescribed — half your healthy patients get no benefit.' Defend your practice with trial numbers, then handle intolerance, escalation, triglycerides and FH.
Stem
You are the GP. The colleague quotes internet scepticism at you. [1]
References11ShowHide
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- [2]Mihaylova B, Emberson J, Blackwell L, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials Lancet, 2012.PMID 22607822
- [3]Sabatine MS, Giugliano RP, Keech AC, et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease N Engl J Med, 2017.PMID 28304224
- [4]Schwartz GG, Steg PG, Szarek M, et al. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome N Engl J Med, 2018.PMID 30403574
- [5]Nissen SE, Lincoff AM, Brennan D, et al. Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients N Engl J Med, 2023.PMID 36876740
- [6]Sever PS, Dahlöf B, Poulter NR, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial Lancet, 2003.PMID 12686036
- [7]Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group N Engl J Med, 1995.PMID 7566020
- [8]SCORE2 working group and ESC Cardiovascular risk collaboration SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe Eur Heart J, 2021.PMID 34120177
- [9]Casula M, Olmastroni E, Pirillo A, et al. Evaluation of the performance of Dutch Lipid Clinic Network score in an Italian FH population: The LIPIGEN study Atherosclerosis, 2018.PMID 30270079
- [10]Cannon CP, Blazing MA, Giugliano RP, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes N Engl J Med, 2015.PMID 26039521
- [11]Watts GF, Ooi EM, Chan DC Demystifying the management of hypertriglyceridaemia Nat Rev Cardiol, 2013.PMID 24060958