Case Study – December 2022
Our patient case study specially curated for you by our Faculty Member, Prof. Samer Ellahham on concerns about statin associated Diabetes Mellitus.
Case Study: RS is a 64-year-old Male having dyslipidemia.
BP 144/87 mm Hg
Low-density lipoprotein cholesterol (LDL-C) 112 mg/dL
High-density lipoprotein cholesterol (HDL-C) of 47 mg/dL
Triglycerides 190 mg/dL
(-) tobacco, (-) alcohol
Body mass index (BMI) 33 kg/m2
Valsartan 80 mg/d
Father developed type 2 diabetes mellitus (T2DM) and ASCVD at age 58
Fasting blood glucose 103 mg/dL
Serum Creatinine 1.1 mg/dL
Urinary analysis within normal limits
RS reports that he is reluctant to take statins as they cause diabetes especially with his family history.
Quiz of the month – January 2022
Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Christopher Cannon.
Case Study: David is a 63-year-old man with a 20-year history of hypercholesterolemia and 5-year history of prediabetes. When the hypercholesterolemia was diagnosed, his LDL-C was 256 mg/dL. Since then, he has been managed primarily with high-intensity statin treatment (rosuvastatin 40 mg/d), dietary modification (low saturated fat diet), and daily exercise. One year ago, cardiology workup identified evidence of ASCVD (see chart below). At the time, David’s LDL-C was 162 mg/dL on treatment with maximal dose rosuvastatin, so the cardiologist recommended adding ezetimibe 10 mg qd. After 6 months of treatment, David’s LDL-C fell to 134 mg/dL.
Hypercholesterolemia, 20 years
Prediabetes, 5 years
Heart rate: 72 bpm
Blood pressure: 118/74 mmHg
Respiration rate: 18 bpm
Heart: normal sinus rhythm
Lungs: clear to auscultation
Extremities: no edema
Joints: no tendon xanthomas
BMI: 23.5 kg/m2
Random blood glucose: 103 mg/dL
A1C: 5.8% [normal <5.7]
eGFR: 77 mL/min/1.73m2
– LDL-C 134 mg/dL
– HDL-C 52 mg/dL
– Triglycerides 68 mg/dL
– Total cholesterol 176 mg/dL
One year ago:
CT angiogram: high coronary artery calcium, nonocclusive atherosclerosis
Rosuvastatin 40 mg qd
Ezetimibe 10 mg qd
Based on his diagnosis of established ASCVD, the cardiologist identified an LDL-C goal <70 mg/dL and added a PCSK9 inhibitor.
It has been 6 months since he started the PCSK9 inhibitor. He returned to the clinic today for a checkup. Workup identifies LDL-C 47 mg/dL. David reports good adherence to therapy and no side effects of treatment with rosuvastatin 40 mg, ezetimibe 10 mg qd, and a PCSK9 inhibitor.