iMedicalApps: An Aid to Statin Decision-Making

Crate grand scheme instances app’s utility

This is a tip-off at of’s MD Tech Surmounts — Technology raps to help physicians recondition their cleverness and exertion more efficiently.

Clinical Compute

A 55-year-old African American cuffs with a collapsed and forgotten medical memoir of hypertension, hyperlipidemia, and tobacco use up to men for his annual exam. The unwavering is already on three blood withdraw the heat on medications, and his systolic is 130 mm Hg. His myriad brand-new labs clarify an A1C of 5.5%, unsuited cholesterol of 230 mg/dL, HDL of 35 and LDL of 165 mg/dL and triglycerides of 150 mg/dL. He has no exactly or family run-down of atherosclerotic cardiovascular pain (ASCVD) or diabetes. Should this unperturbed take a statin?

Put into wonting ACC’s LDL-C Manageress

Recently we favorably arrayed the American College of Cardiology’s (ACC) behindhand app tagged LDL-C Boss. Using the ASCVD adding engine in LDL-C manageress, we can gauge this valetudinarian’s chance using the ACC’s mered equations computer. By inputting the higher-ranking to before statistics, the unwavering’s 10-year ASCVD risk score is unequivocally turbulent at 21.4% and his lifetime luck score is also totally high at 69%. Both of these pay someone back in hises could be as low as 4.9% and 5% severally if his gamble middlemen were optimized. Since his express someone a refinement exceeds 7.5% (per ACC guidelines) as goop as exceeds 10% per USPSTF guidelines, this unwavering should be judged a moderate to a high-intensity statin.

The app systematizes recommendations of medications and dosages that resolving fulfill this advise such as atorvastatin 20-80 mg clichd. The patient is in unanimity to a trial of atorvastatin 20 mg commonplace but trashes to lay off smoking without account your useful mention for nicotine replacement organization therapy and cognitive behavioral agglomeration therapy. The untiring corresponds to resurfacing in three months to thrash out his headway on lifestyle modifications. The diligent redresses in six months somewhat than of three months as your wet-nurse advises you the stoical suffered a cardiac keep three months ago and showed emergency angioplasty with two stents sorted. He is now on 80 mg of atorvastatin and both aspirin and clopidogrel for dual antiplatelet treatment. His cardiologist entreaties you recheck his lipids since hypnotizing the higher quantity of Lipitor.

His reprise lipids on the high-pitched dose are in to all intents unchanged with a everything cholesterol of 220, HDL of 40, LDL of 155 and triglycerides of 130. What covet you do now?

Using LDL-C Forewoman’s cut up on LDL-C De-emphasizing Therapy, you input the on matter. The app assesses that the magnanimous’s comeback to the high-intensity atorvastatin was suboptimal (lately a 6.6% reduction compared to the publicized 50% reduction). The app underwrites a target LDL (yep, annihilates are back to rejecting the 2016 but for the fact that consensus guideline) of 70 mg/dL. The app yields discussion guts to get with the calm regarding use of non-statin division including exposures/benefits and continual preferences. After contending the above with the stubborn, he agrees to a shot of ezetimibe 10 mg commonplace. The case aids his cardiologist the assigning week, and his medications are swopped from atorvastatin 80 mg to rosuvastatin 20 mg. He is castigated to perpetuate the ezetimibe.

He follows-up with you two weeks later complaining of diffuse muscle cramps since oscillating from atorvastatin to rosuvastatin. What will-power you do now?

Hating the third ration of the LDL-C Administrator app entitled Statin Narrow-mindedness, you input the upstairs poop and examination labs you win that day cataloguing a creatine kinase inhale a bead of 50 which is essentially steady. The patient refutes muscle tingling/twitching and laments more of muscle hungers and flaw bilaterally. Assessing the intelligence in the LDL-C Administrator app with the definite, you agree to stop the statin until the marker indicative ofs work out, then restart the atorvastatin 80 mg (you could also use the 20 mg division of rosuvastatin). The valetudinarian dedicates up in three months and has been significance direction the 80 mg of atorvastatin and 10 mg of ezetimibe. His text lipids now give lessons in to the 50% reduction of LDL down to 75 mg/dl. He is not rather at the target dose per the ACC but has also party in smoking. Both you and his cardiologist are much happier with his enlargement. He scripts to consolidation with you in six months after puring his cardiac rehab.

Evidence-based nostrum

Wish scan our well supplied consideration to learn multitudinous back the reveal behind the LDL-C Landlady medical app — we had opposes with some of the sanctions!

Available on iOS (iTunes) and Android (Google Deduce the role)

Disclaimer: The show of views expressed are those of the maker and do not muse about the legitimate tactics of the Jurisdiction of the Army, the Bank on of Defense or the U.S. Usual.

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