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Old 07-17-2012
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Question 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?

Please clarify. Thank you.
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Old 07-17-2012
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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 ?
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Old 07-17-2012
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Default LDL level!

Quote:
Originally Posted by usmledee View Post
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
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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.
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Old 07-17-2012
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Quote:
Originally Posted by usmledee View Post
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.
Above 100 mg/dl we should start with CHD/equivalent.
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Old 07-17-2012
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Quote:
Originally Posted by usmledee View Post
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.
130 for CAD->start statin.
100 for CAD+DM->start statin

this what i meant.
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Old 07-17-2012
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please see the attachment...
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
2- PAD
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
When to start drug therapy in CHD/equivalent?-atpiii.jpg  
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