To the Editor: In his Clinical Crossroads article, Dr Caplan1 discussed a 70-year-old man with coronary, aortic, and peripheral arterial disease who had an episode of brain ischemia caused by severe preocclusive internal carotid disease. Caplan recommended treatment with a high dose of statin (atorvastatin, 80 mg daily). However, this is based on extrapolation from studies of younger patients and does not consider adverse effects.
Mascitelli L, Pezzetta F, Goldstein MR. Carotid Endarterectomy and Statin Therapy in the Management of Patients With Carotid Artery Disease. JAMA. 2008;300(18):2117–2119. doi:10.1001/jama.2008.583