Statin
Formal Definition
HMG-CoA reductase inhibitors: a class of lipid-lowering medications that inhibit the rate-limiting enzyme in cholesterol synthesis, reducing LDL-C and modestly raising HDL-C; also have pleiotropic effects (anti-inflammatory, plaque-stabilizing) beyond lipid lowering.
How It's Used on the Ward
"On a statin" or "high-intensity statin" — present on nearly every cardiology and internal medicine patient's medication list; more important after MI than before.
Example
""Post-MI: starting high-intensity statin (rosuvastatin 40 mg) before discharge regardless of baseline LDL. It's not just about cholesterol — the pleiotropic effects on plaque stabilization matter from day one.""
Clinical Context
High-intensity statins (atorvastatin 40–80 mg, rosuvastatin 20–40 mg) reduce LDL by ≥50%. Indicated post-ACS, for LDL ≥190, in diabetics ≥40 yo, and for primary prevention in high 10-year ASCVD risk. Side effects: myopathy (check CK if muscle pain), rarely rhabdomyolysis, transaminase elevation. Drug interactions: avoid with gemfibrozil (rhabdomyolysis risk). "Statin intolerance" is over-diagnosed — most muscle symptoms are not statin-related; try a different statin or lower dose before stopping entirely.