Statin intolerant with Vascular Disease or high risk factors (Diabetes, women over age 65, men over 60).

If you are interested in participating in this clinical trial, please answer the seven questions below
1) Have you been told of ever having a heart attack?
Yes No
2) Have you had cardiac chest discomfort of shortness of breath that resulted in needing a heart catheterization?
Yes No
3) Have you had a cardiac stent placed or had bypass surgery?
Yes No
4) Have you had a cardiac stent placed or had bypass surgery?
Yes No
5) Have you had a stroke?
Yes No
6) Have you been diagnosed with PAD (blockage in the artery supplying an extremity or repair of abdominal aortic aneurysm, or carotid artery blockage or experienced calf or thigh discomfort of cramping on exertion)?
Yes No
7) Are you currently taking cholesterol lowering medicine?
Yes No
8) Have you had elevated triglyceride (TG) levels?
Yes No Not Sure
9) Do you have diabetes?
Yes No Not Sure
10) Have you not been able to tolerate cholesterol lowering statin medicine?
Yes No Not Sure
If yes, which medicine and at what doseage have you not been able to tolerate?

 
Direct Phone Number*
Email Address*
I Would Prefer To Be Contacted By:
Email Phone
What is the best time to contact you?
*This information is required. It will only be used to contact you regarding ossible participation in a clinica trial.
 
 

 

 

 

 

 

 
 
 
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