Current%20Stroke%20or%20TIA

1
Current Stroke or TIA
Fasting lipid panel Liver function
tests Neuroimaging
Consider initiation of Statin if Stroke or TIA
Mechanism is Cervicocephalic Large or Small
Vessel Atherosclerosis
If LDL gt 100 mg/dl, Tchol gt 135 mg/dl and LFTs
are within normal, start statin with eventual LDL
goal of lt 100mg/dl
DO NOT start statin if total cholesterol is lt 135
mg/dl
If LDL lt 100 mg/dl, Tchol gt 135mg/dl and LFTs are
within normal, start low fixed statin dose
Statin goal to be implemented in patients with
documented PMHx, or current hospitalization work
up, showing evidence of one or more of the
following (REGARDLESS OF CURRENT STROKE/ TIA
MECHANISM) 1) Cervicocephalic vessel
atherosclerosis (gt 50 large vessel stenosis) 2)
Clinical and/ or radiographic evidence of
multiple lacunar infarcts 3) Coronary Heart
Disease 4) Risk of Coronary Heart Disease in 10
years gt 20 based on Framingham Risk Assessment
and or evidence of the Metabolic Syndrome 5)
Peripheral Arterial Disease 6) Diabetes
Mellitus 7) Abdominal Aortic Aneurysm