High Intensity Lipid Lowering Following Acute Coronary Syndromes for Persons Living With HIV

Exclusion Criteria

• •Serious illness or AIDS-related complication within 21 days of screening requiring systemic treatment and/or hospitalization
• •No coronary heart disease (CHD) and 10-year ASCVD risk \<15.0%.
• •Not currently receiving antiretroviral therapy or taking any of the following antiretroviral agents: atazanavir/ritonavir, lopinavir/ritonavir.
• •History of statin intolerance leading to discontinuation, dose decrease, or change to less potent dose equivalent
• •Statin absolute contraindication
• •Current use of atorvastatin 20mg daily or greater or rosuvastatin 10mg daily or greater
• •Chronic kidney disease stage 4 or greater (including dialysis)
• •Systolic heart failure with last documented LVEF \<35%
• •Pregnant or breastfeeding
• •Laboratory values obtained within 45 days prior to study entry:
• •LDL-c \<80 mg/dl while not on statin or LDL-c \<60 mg/dl while on statin ALT \> 3 x Upper Limit of Normal (ULN) AST \> 3 x ULN Creatinine kinase (CK) \>3 x ULN (calculated creatinine clearance (CrCl) \<50 mL/min, as estimated by the Cockcroft-Gault equation)
• •Life expectancy \<12 months
• •Prior organ transplant
• •Active malignancy
• •Inflammatory muscle disease