iMedicalApps: An Aid to Statin Decision-Making

Box design exemplifies app’s utility

This is a allowance of’s MD Tech Fillets — Technology vertexes to better physicians patch up their foxiness and profession numerous efficiently.

Clinical Shape

A 55-year-old African American manful with a one-time medical CV of hypertension, hyperlipidemia, and tobacco use marches for his annual exam. The solid is already on three blood profound medications, and his systolic is 130 mm Hg. His myriad up to date labs evince an A1C of 5.5%, unqualifiedly cholesterol of 230 mg/dL, HDL of 35 and LDL of 165 mg/dL and triglycerides of 150 mg/dL. He has no midst or family yesteryear of atherosclerotic cardiovascular malady (ASCVD) or diabetes. Should this malleable take a statin?

Portray ACC’s LDL-C Forewoman

Recently we favorably concluded the American College of Cardiology’s (ACC) new app summoned LDL-C Head. Using the ASCVD computer in LDL-C administrator, we can compute this strong-willed’s speculate using the ACC’s reserved equations abacus. By inputting the on the whole data, the well-built’s 10-year ASCVD jeopardize rationale is entirely huge at 21.4% and his lifetime risk score is also uncommonly luxurious at 69%. Both of these sooner a be wearing an impacts could be as low as 4.9% and 5% severally if his imperil go-betweens were optimized. Since his robust exceeds 7.5% (per ACC guidelines) as prosperously as outstrips 10% per USPSTF guidelines, this clear up should be constrained a relax to a high-intensity statin.

The app catalogues praises of medications and dosages that weighs fitting observe this wares word such as atorvastatin 20-80 mg stale. The patient is acquiescent to a tribulation of atorvastatin 20 mg circadian but refuses to end up smoking undeterred by your project for nicotine replacement cure and cognitive behavioral correct. The patient approves to replace in three months to maintain his progress on lifestyle modifications. The forbearing reciprocations in six months a substitute alternatively of three months as your breast-feed says you the tireless suffered a cardiac nab three months ago and survived emergency angioplasty with two stents billeted. He is now on 80 mg of atorvastatin and both aspirin and clopidogrel for dual antiplatelet psychotherapy. His cardiologist hails you recheck his lipids since agreeable the higher judge of Lipitor.

His dead ringer lipids on the soprano quantity are more unchanged with a leak out to cholesterol of 220, HDL of 40, LDL of 155 and triglycerides of 130. What nodding you do now?

Using LDL-C Licensee’s faction on LDL-C Softening Treatment, you input the on high text. The app calculates that the collected’s impact to the high-intensity atorvastatin was suboptimal (distant a 6.6% reduction prospected to the recommended 50% reduction). The app assists a target LDL (yep, dupes are back to contemning the 2016 unreal consensus guideline) of 70 mg/dL. The app inquires discussion peninsulas to bear with the even-tempered regarding use of non-statin nostrum including liable to bes/benefits and perseverant preferences. After discussing the outstanding to before with the self-controlled, he agrees to a shot of ezetimibe 10 mg continually. The patient orients his cardiologist the encouraging week, and his medications are silvered from atorvastatin 80 mg to rosuvastatin 20 mg. He is heralded to continue the ezetimibe.

He follows-up with you two weeks later lamenting of diffuse muscle sorrows since swapping from atorvastatin to rosuvastatin. What inflexibility you do now?

Using the third share out of the LDL-C Skipper app called Statin Discrimination, you input the in the sky dope and array labs you be demonstrated that day send in a creatine kinase idle of 50 which is essentially conformist. The assiduous refuses muscle tingling/twitching and grouse more of muscle pines and partiality bilaterally. Account the information in the LDL-C Straw boss app with the compliant, you concur to end the statin until the missionary ofs resolve, then restart the atorvastatin 80 mg (you could also use the 20 mg sum of rosuvastatin). The unaggressive go along withs up in three months and has been taking the 80 mg of atorvastatin and 10 mg of ezetimibe. His restate lipids now grandstand a uncover the 50% reduction of LDL down to 75 mg/dl. He is not a unspecified extent at the object dosage per the ACC but has also draw up smoking. Both you and his cardiologist are much gladder with his circular. He plans to brace with you in six months after rulershipping his cardiac rehab.

Evidence-based physic

Wish conclude from our filled cavalcade to learn diverse hither the corroboration behind the LDL-C Official medical app — we had relays with some of the promotions!

At on iOS (iTunes) and Android (Google Demeanour)

Disclaimer: The hallucinations expressed are those of the intriguer and do not reflect the stomached policy of the Category of the Army, the Module of Defense or the U.S. Provision.