A 58-year-old woman is admitted to hospital with left-sided hemiparesis. She is diagnosed with an ischemic right cortical stroke, and started on amino salicylic acid (ASA) for secondary prevention. Her carotid ultrasound reveals no arterial stenosis. She has no other significant past medical history but she does smoke half pack a day. Her fasting lipid profile is T-chol 240 mg/dL, HDL 50 mg/dL, LDL 160 mg/dL, and triglycerides 130 mg/dL.For the above patient with dyslipidemia, select the most appropriate treatment.
Recent evidence has suggested that lipid modification for patients with ischemic stroke (that is not cardioembolic in origin) by lowering LDL level with statins is beneficial in reducing future stroke risk. This evidence comes from the analysis of cardiovascular statin trials that have a lower rate of ischemic strokes in patients taking the medication as compared to the placebo group. In addition, lifestyle modification is important for this individual, especially smoking cessation.
fibric acid derivatives (clofibrate, gemfibrozil)
nicotinic acid
bile acid-binding resins (cholestyramine, colestipol)
hepatic hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (lovastatin, simvastatin, pravastatin)
C.V.S.