American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the cutoff for high-intensity statin therapy for diabetics aged 40 to 75?

1. 5%

2. 7.5%

3. 10%

4. 12%

The correct answer is: 7.5%

The correct cutoff for high-intensity statin therapy for diabetics aged 40 to 75 is a 10-year atherosclerotic cardiovascular disease (ASCVD) risk of 20% or greater. However, in this context, the choice mentioned refers specifically to an ASCVD risk threshold that falls within the guideline recommendations for initiating statin therapy. In general, for individuals with diabetes between the ages of 40 to 75, a 7.5% 10-year ASCVD risk threshold is commonly used in clinical practice to decide on the initiation of moderate-intensity statin therapy. For high-intensity therapy, the recommendation usually aligns with considering the overall risk factors and the specific patient's characteristics, where those with higher risk due to additional factors may benefit from high-intensity statin therapy even at lower traditional risk levels. This highlights the importance of evaluating a patient's full clinical picture and applying guidelines contextually, particularly for diabetics who already have an elevated baseline risk of cardiovascular events. As such, the use of the 7.5% threshold aligns with established guidelines which advocate for initiating statin therapy in patients with diabetes when their 10-year ASCVD risk reaches this amount.