1. Which of the following statements is false?
1. A 75 years old man who was admitted for acute STEMI was thrombolysed. Angiogram showed diffuse triple vessel disease and it was decided to put him on intensive medical treatment. He is a type 2 diabetic for the last 25 years. Starting him on Atorvastatin 40 mg daily reduces re-infarct and cardiovascular mortality.
2. A 45 years old woman who was diagnosed to be diabetic 2 months back is now on aggressive diet and exercise for her diabetes control. She has a strong family history of coronary artery disease. Starting her on Atorvastatin 40 mg daily is effective in preventing coronary artery disease.
3. A 60 years old man who was recently diagnosed as a diabetic was put on Atorvastatin 80 mg daily as his serum LDL concentration was 125 mg/dL. This man needs to be on a statin and it would be advisable to reduce the dose to 40 mg per day.
4. The above gentleman needs to have 3 monthly evaluation of his liver enzymes and muscle enzymes to check for adverse drug reactions.

Answer: The correct answer is (d). For those patients with type 2 diabetes who are taking statins, routine monitoring of liver function tests or muscle enzymes is not recommended except in specific circumstances. Lipid-lowering therapy should be used for secondary prevention of cardiovascular mortality and morbidity for all patients (both men and women) with known coronary artery disease and type 2 diabetes. Statins should be used for primary prevention against macrovascular complications in patients (both men and women) with type 2 diabetes and other cardiovascular risk factors.