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#1
07-17-2012
 USMLE Forums Veteran Steps History: 1+CK+CS Posts: 257 Threads: 69 Thanked 122 Times in 63 Posts Reputation: 132
When to start drug therapy in CHD/equivalent?

There are two questions in UW that say two different things in their table, so I'm confused. do you start drug therapy in CHD/ equivalent pts at LDL level of 100 or 130? ...and will that apply exactly to a DM pt or do we start at lower LDL levels when diabetic?

#2
07-17-2012
 USMLE Forums Master Steps History: --- Posts: 1,365 Threads: 648 Thanked 584 Times in 354 Posts Reputation: 594

yup . thats true. i dont think they will make us pick between 2 but if they do, ans should be -> above 130 and patient has CAD|equivalents, start LDL. same for DM as it is equivalent.
for CAD and DM, it is 100.
make sense ?
#3
07-17-2012
 USMLE Forums Veteran Steps History: 1+CK+CS Posts: 289 Threads: 7 Thanked 129 Times in 102 Posts Reputation: 139
LDL level!

Quote:
 Originally Posted by usmledee There are two questions in UW that say two different things in their table, so I'm confused. do you start drug therapy in CHD/ equivalent pts at LDL level of 100 or 130? ...and will that apply exactly to a DM pt or do we start at lower LDL levels when diabetic? Please clarify. Thank you.
From my understanding: you need to bring LDL to less than 100 mg/dl if you have an isolated CHD/equivalnt pt. But if you have two of these risk factors then you need to bring LDL to less than 70 mg/dl such as pt. with CHD & D.M. then the target LDL should be less than 70 mg/dl.
The more risk factors the pt. has then the lower LDL level should be achieved
#4
07-17-2012
 USMLE Forums Veteran Steps History: 1+CK+CS Posts: 257 Threads: 69 Thanked 122 Times in 63 Posts Reputation: 132

But my question was when ...at what LDL level do you start them on a statin...
@ tyagee.. You say 130 then You say 100... Sorry didn't understand.
#5
07-17-2012
 USMLE Forums Veteran Steps History: 1+CK+CS Posts: 289 Threads: 7 Thanked 129 Times in 102 Posts Reputation: 139

Quote:
 Originally Posted by usmledee But my question was when ...at what LDL level do you start them on a statin... @ tyagee.. You say 130 then You say 100... Sorry didn't understand.
 The above post was thanked by: usmledee (07-17-2012)
#6
07-17-2012
 USMLE Forums Master Steps History: --- Posts: 1,365 Threads: 648 Thanked 584 Times in 354 Posts Reputation: 594

Quote:
 Originally Posted by usmledee But my question was when ...at what LDL level do you start them on a statin... @ tyagee.. You say 130 then You say 100... Sorry didn't understand.

this what i meant.
 The above post was thanked by: usmledee (07-17-2012)
#7
07-17-2012
 USMLE Forums Master Steps History: 1+CK+CS Posts: 646 Threads: 52 Thanked 760 Times in 256 Posts Reputation: 771

these are the ATP III guidelines from the national cholesterol education program.

points to note --
in the second one -- for usmle -- overlook the survival period and just remember the goal of <130.

CAD equivalents (MTB 2 page 59)
1-DM
3- Carotid disease (NOT STROKE)
4- Aortic disease (not valvular)

if you want to read up in greater detail just go to their website.
http://www.nhlbi.nih.gov/guidelines/...l/atglance.pdf
Attached Thumbnails

 The above post was thanked by: Anders (07-17-2012), Novobiocin (07-17-2012), usmledee (07-17-2012)

 Tags Cardiology-, Internal-Medicine-, Step-2-Questions

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