Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Stephen Nicholls.
Case Study: A 58-year-old overweight man with a 10-year history of primary hypercholesterolemia presents for a checkup. At diagnosis of hypercholesterolemia, his LDL-C was 198 mg/dL; his clinician recommended diet and exercise interventions and started atorvastatin 10 mg qd. The patient follows a low saturated-fat diet and exercises daily. However, he could not tolerate higher doses of atorvastatin or rosuvastatin 5 mg or pravastatin 20 mg. Today, his LDL-C is 138 mg/dL, HDL-C 52 mg/dL, and triglycerides 78 mg/dL. He continues to take atorvastatin 10 mg qd.
You add ezetimibe, and follow-up bloods a month later show an LDL-C of 108 mg/dl. You are not sure if he has ASCVD, so review of prior imaging shows he had a CT scan a year ago to evaluate shortness of breath, and the report comments that he has “moderate coronary artery calcification”. You check and Lp(a) and it is elevated at 200 nmol/L (upper limit of normal is 75 nmol/L).
Ballantyne CM, Banka P, Mendez G, et al.Journal:
J Am Coll Cardiol
First published: March 6, 2023 DOI: 10.1016/j.jacc.2023.02.018