Triglycerides Case Studies

  • Case Studies

    Quiz of the month – August 2023

    Take this short quiz to test your knowledge on the recently published debate on dyslipidemias titled “Great debate: lipid-lowering therapies should be guided by vascular imaging rather than by circulating biomarkers”.

    CLICK HERE TO VIEW THE DEBATE.

    Eur Heart J. 2023 Jul 1;44(25):2292-2304. doi: 10.1093/eurheartj/ehad275

    Prof. Lale Tokyozoglu, Prof. David Morrow, Prof. Stephen Nicholls

    First published: August 22, 2023  

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  • Case Studies

    Quiz of the month – April 2023

    Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Samer Ellahham.

    Prof. Samer Ellahham

    First published: April 17, 2023  

    Case Study: A 65-year-old man with a history of dyslipidemia, type 2 diabetes mellitus and systemic hypertension.

     

    Presentation:

    New onset crescendo angina x 5 days culminating

    Rest pain for the past 2h

    No history of other vascular events or heart attack, no TIA or stroke

    Weight: 90 kg

    Exam: BP 150/85 (slightly elevated), Heart Rate 80

    No murmur detected

     

    Medication:

    Valsartan 160 mg daily, Aspirin 81 mg daily, Rosuvastatin 10 mg daily, Metformin 500 mg twice daily

     

    Labs:

    BMI 31kg/m2, waist circumference 101.6 cm (40 inches), (-) tobacco (quit last year – 60-pack-year history)

    Normal CBC, electrolytes

    Troponin: Elevated

    Electrocardiogram:1-2 mm horizontal ST depression infero-lateral leads

    Chest X-ray: Normal

     

    Lipid panel:

    Total cholesterol (TC) 192 mg/dL

    HDL-C 46 mg/dL

    Triglycerides 180 mg/dL (non-fasting)

    LDL-C 110 mg/dL

    Non-HDL-C 146 mg/ dL

     

    What are the first impressions about this patient?

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  • Case Studies

    Quiz of the month – February 2023

    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).

    Prof. Stephen Nicholls

    First published: February 2, 2023  

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  • Which of the following might be appropriate at this time?

  • Case Studies

    Quiz of the month – August 2022

    Take our patient case study quiz specially curated for you by our Faculty Member, Prof. Stephen Nicholls.

    Case Study: A 63 year old man presents for review after experiencing an inferior myocardial infarction 6 months previously with successful PCI and stenting to the right coronary artery. Angiography revealed minor coronary disease involving the left anterior descending and circumflex arteries. He has a background of hypertension and type 2 diabetes mellitus.

    His current medications include aspirin 100 mg daily, ticagrelor 90 mg bd, atorvastatin 80 mg daily, metformin 1000 mg daily, empagliflozin 10 mg daily, perindopril 5 mg daily and metoprolol 25 mg bd.

    His biochemistry revealed HbA1c 6.8%, LDL-C 70 mg/dL, HDL-C 37 mg/dL and triglycerides 225 mg/dL.

    Prof. Stephen Nicholls

    First published: August 23, 2022  

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  • What would be the next therapeutic step?