The correct answer is: A. Atorvastatin 40 mg PO daily.

Atherosclerotic cardiovascular disease (ASCVD) is the most common cause of morbidity and mortality for patients with diabetes. Although the question for this case focuses on lipid management, the ADA recommends composite assessment and control all ASCVD risk factors. For a patient with ASCVD and diabetes, the ADA recommends lifestyle modifications, antiplatelet therapy, blood pressure management and lipid management.

Option A is the best option. The ADA recommends high-intensity statin therapy (atorvastatin 40, 80 mg; rosuvastatin 20, 40 mg) for patients of all ages with diabetes and atherosclerotic cardiovascular disease (ASCVD). This patient has diabetes and ASCVD (NSTEMI in 2015), but he is not currently taking a statin.

Option B, C, and D are not the best options. This patient has diabetes and ASCVD (NSTEMI in 2015), but he is not currently taking a statin. The ADA recommends high-intensity statin therapy patients of all ages with diabetes and ASCVD. Pravastatin 40 mg and simvastatin 40 mg are moderate-intensity statin doses. Ezetimibe is not appropriate for initial therapy in the statin tolerant patient, but may be considered as add-on therapy for patients with diabetes and ASCVD and LDL-C ≥70 mg/dl on maximally tolerated statin dose.

References

1. American Diabetes Association, Standards of Medical Care in Diabetes. https://professional.diabetes.org/sites/professional.diabetes.org/files/media/dc_40_s1_final.pdf