Should statin initiation be considered in young adult patients with autoimmune disease or chronic inflammatory conditions without an elevated ASCVD risk score given risk of underestimation of underlying CVD?
Answer from: at Academic Institution
I would if the cholesterol/LDL is elevated or if there is a family history of premature CAD. Otherwise, additional risk stratification with a CT coronary calcium score would be appropriate.
Several thoughts: first of all, any calcium equals CAD. Meaning, a low value should be treated as aggressively as a high value (much less than 70). Secondly, I would not say premature CAD, I would just say CAD, since I am now 70 and have calcium in my coronary arteries and feel it is premature.