Conclusions and Future Directions
Statin use is expected to increase with the adoption of the new 2013 ACC/AHA Cholesterol guidelines, bringing new challenges for prescribers, with a focus on fixed-dose statins independent of baseline or achieved LDL-C levels. The intensity of statin dose is matched to a person’s baseline ASCVD risk. This is in contrast to the adapted EAS/ESC guidelines in Europe, which recommend tailoring therapy to target specific LDL-C levels. Statin intolerance is not uncommon and can be challenging to manage; however, several therapeutic strategies have been successful in achieving statin tolerance. Although statin use is associated with liver enzyme elevations and increased risk of incident diabetes, there continues to be a net benefit to statins. Individualised risk assessment and discussion of benefits and risks of statin therapy will likely lead to improved adherence and outcomes.