CLS Non-Statin Lipid-Lowering Pharmacotherapy 3

Question 1

The REDUCE-IT trial demonstrated significant cardiovascular risk reduction using which specific omega-3 product at 4 g/day?

Accepted Answer

Icosapentaenoic acid (EPA only; Vascepa/icosapent ethyl)

Answer

Omega-3 acid ethyl esters containing both EPA and DHA (Lovaza)

Answer

Docosahexaenoic acid (DHA only)

Answer

Over-the-counter fish oil at 4 g/day

Question 2

A concern with omega-3 products containing DHA (compared to EPA-only products) is that DHA may cause which adverse lipid effect?

Accepted Answer

Increased LDL-C

Answer

Increased triglycerides

Answer

Decreased HDL-C

Answer

Increased Lp(a)

Question 3

What is the primary lipid effect of prescription omega-3 fatty acids at 4 g/day?

Accepted Answer

Primarily reduce triglycerides by 25–50%

Answer

Primarily reduce LDL-C by 25–40%

Answer

Primarily increase HDL-C by 15–25%

Answer

Primarily reduce Lp(a) by 20–30%

Question 4

When ezetimibe is added to a maximally tolerated statin, what incremental LDL-C reduction is typically expected?

Accepted Answer

15–20% additional reduction

Answer

5–10% additional reduction

Answer

25–35% additional reduction

Answer

40–50% additional reduction

Question 5

According to 2018 ACC/AHA guidelines, which non-statin agent is recommended as the preferred first add-on to statin therapy in very high-risk ASCVD patients requiring further LDL-C reduction?

Accepted Answer

Ezetimibe

Answer

Niacin

Answer

Fenofibrate

Answer

Bile acid sequestrant

Question 6

Both icosapentaenoic acid (Vascepa) and omega-3-acid ethyl esters (Lovaza) are FDA-approved at 4 g/day for treating which condition?

Accepted Answer

Severe hypertriglyceridemia (≥500 mg/dL)

Answer

LDL-C >190 mg/dL unresponsive to statins

Answer

Mixed dyslipidemia with low HDL-C

Answer

Heterozygous familial hypercholesterolemia

Question 7

A patient with established ASCVD remains at LDL-C 110 mg/dL despite maximum-dose statin plus ezetimibe. According to ACC/AHA guidelines, what is the most appropriate next pharmacologic step?

Accepted Answer

Add a PCSK9 inhibitor

Answer

Add niacin to raise HDL-C

Answer

Add fenofibrate to further lower triglycerides

Answer

Add a bile acid sequestrant