Description
The patient who is still above target
Starting a statin is not the difficult part. The difficult part is the patient six months later, on the maximum dose they tolerate, still above target, sitting in a general clinic where the next step is not obvious and a specialist lipid opinion may not be available at all.
These 349 pages are written for that clinician.
Agent choice on evidence, and on availability
Ezetimibe, PCSK9 inhibition, bempedoic acid and inclisiran are sequenced by the strength of their outcome evidence rather than by novelty — and, unusually, the book is explicit about relative cost and about what to do when the preferred agent is unavailable on a local formulary. For much of our directory that is the binding constraint rather than the evidence.
Statin intolerance
Handled at length, because it removes more patients from effective therapy than any other factor. The distinction between genuine myopathy and the nocebo effect demonstrated in blinded rechallenge trials is laid out clearly enough to use in a consultation.
Also covered
When apoB is the more reliable number. Lipoprotein(a) — who to measure and what can currently be done. Hypertriglyceridaemia and pancreatitis risk. Familial hypercholesterolaemia and cascade screening of relatives, which is the highest-yield activity in the whole subject. Lipids in kidney disease, diabetes and pregnancy.
Suits
General physicians, family doctors, cardiologists, endocrinologists and nephrologists.
PDF, 349 pages, lifetime access from CardiologyBooks.com.
