Monitoring
Your Organizational Guidance
ebpracticenet urges you to prioritize the following organizational guidance:
Évaluation du risque cardiovasculaire en première lignePublished by: Domus MedicaLast published: 2010Cardiovasculaire risicobepaling in de eerste lijnPublished by: Domus MedicaLast published: 2020The optimal method of monitoring the effects of lipid-lowering therapy has yet to be defined. Lipid levels should be monitored every 6 weeks initially until the low-density lipoprotein target is achieved.[34] The 2019 European Society of Cardiology guidelines for the management of dyslipidemias recommend reassessment of lipid levels 4-6 weeks after an acute coronary event and until lipid levels are at goal.[41] This interval can be extended to every 6-12 months in patients adherent to lifestyle modifications and after lipid levels have stabilized.
Baseline liver and muscle enzymes should be measured in patients starting statin therapy, despite the low incidence of toxicity (0.5% to 2%). The Food and Drug Administration (FDA) has stated that there is no longer any need for routine measurement of liver enzymes with the use of statins. The FDA concluded that serious liver injury with statins is rare and unpredictable, and that routine periodic monitoring of liver enzymes does not appear to be effective in detecting or preventing this rare adverse effect.[141]
After initiation of statin therapy, muscle enzyme levels need not be checked regularly unless patients develop myalgias or other muscle symptoms.[142]
Despite the possible small risk of diabetes onset with the use of statins, there is no formal recommendation for additional monitoring of glucose and glycated hemoglobin levels, and these measurements should be done on an individual basis.
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