Atorvastatin calcium tablets (Lipitor), as HMG CoA reductase inhibitors, can significantly reduce LDL-C levels and lower the risk of cardiovascular events. Discontinuation of the medication should be gradually reduced to avoid rebound effects. The following will explain the treatment effect and the precautions for stopping medication from two aspects.

1. Treatment effect

(1) The daily dose of 10-80mg can reduce LDL-C by 39% -60%, TG by 19% -37%, and increase HDL-C by 5% -9%. The therapeutic effect is dose-dependent, with the maximum effect occurring after 4 weeks of medication.

(2) Long term cardiovascular protection treatment reduces the risk of major cardiovascular events by 36% and stroke risk by 48%. It has more significant benefits for patients with diabetes and coronary heart disease, and needs to continue to use drugs to maintain the efficacy.

(3) Anti atherosclerosis can reverse the plaque volume and delay the progress of coronary calcification. For every 1mmol/LLDL-C decrease, the all-cause mortality rate decreases by 12%.

2 Precautions for discontinuation of medication

(4) Discontinuation of medication is indicated by rhabdomyolysis (CK>10 times ULN), liver injury (ALT/AST>3 times ULN), or severe allergic reactions that require immediate discontinuation. Avoid sudden shutdown in non emergency situations.

(5) The reduction plan suggests halving the dose every 4 weeks, such as reducing from 40mg to 20mg and then to 10mg. Monitor blood lipid levels, and if LDL-C rebounds>30%, re evaluate the treatment plan.

(6) The risk of rebound arrest may lead to the rebound of inflammatory markers, increasing the risk of acute cardiovascular events. Medication should not be discontinued during postoperative or infectious stress states.

(7) Monitoring requires re examination of blood lipids, liver enzymes, and creatine kinase within 6 weeks after discontinuation of medication. Patients with diabetes should pay attention to blood sugar fluctuation, because statins may slightly increase blood sugar.