Case StudiesCase 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.
Prof. Samer Ellahham
First published: December 9, 2022
Case Study: RS is a 64-year-old Male having dyslipidemia.
Vital parameters: | 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 |
Medication: | Valsartan 80 mg/d |
Family history: | Father developed type 2 diabetes mellitus (T2DM) and ASCVD at age 58 |
Labs: | Fasting blood glucose 103 mg/dL HbA1C 5.8% 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.
Case StudiesQuiz of the month – November 2022
Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Chern-En Chiang.
Prof. Chern-En Chiang
First published: November 8, 2022
Case Study: A 48 y male patient presented with anterior chest pain for 1 hour. He was sent to ER where acute anterior ST-elevation MI was diagnosed. Emergent cardiac catheterization demonstrated a 30-40% stenosis over left main artery, a 100% occlusion over middle portion of left anterior descending artery, 90% stenosis over middle portion of right coronary artery, and a 50% stenosis in the proximal portion of left circumflex artery. Two DES were implanted uneventful: one on LAD and the other on RCA. Echocardiogram revealed an LVEF 52% with mild hypokinesis over LV anterior wall.
Past history: | Type 2 diabetes for 5 years with metformin 1000 mg/d Hypercholesterolemia under rosuvastatin 10 mg/d Denied history of HT No smoking history |
Family history: | Strong family history of premature CVD (His father died of MI at the age of 58. His grandfather died of MI at the age of 65, and his uncle has TVD.) |
Before discharge: | BMI 25 BP 128/76 mmHg, HR 76/min eGFR 76 ml/min, Na 141 meq/L, K 4.1 meq/L HbA1c 7.1% LDL-C 124 mg/dL, HDL-C 42 mg/dL, triglyceride 210 mg/dL, Lp(a) 105 mg/dL |
Discharge medications: | Aspirin 100 mg QD, ticagrelor 90 mg BD, bisoprolol 5 mg QD, metformin 850 mg BD, dapagliflozin 10 mg QD, rosuvastatin 20 mg QD, ezetimibe 10 mg QD |
3-month follow-up clinic: | No symptom BMI 24 BP 120/72 mmHg, HR 66/min eGFR 72 ml/min, Na 144 meq/L, K 4.2 meq/L HbA1c 6.4 % LDL-C 77 mg/dL, HDL-C 48 mg/dL, triglyceride 198 mg/dL, Lp(a) 108 mg/dL |