Step 2

Cardiovascular 2

A 58-year-old man is evaluated during a routine visit. He has rheumatoid arthritis and hypertension. His mother had a myocardial infarction at age 53 years. His current medications are methotrexate, folic acid, losartan, and amlodipine. On exam BP 138/80, HR 72, RR 12, O2 sat 98% on RA, afebrile and BMI 27. No other pertinent physical findings. Lipid panel and HgbA1c results are:

  • HgbA1C 5.6
  • LDL 162 mg/dL
  • HDL 38 mg/dL
  • TAG 275 mg/dL
  • Total cholesterol 164 mg/dL

The patient's 10-year risk for atherosclerotic cardiovascular disease is 14.2%. In addition to therapeutic lifestyle changes, which of the following is the most appropriate treatment based on the ACC/AHA and USPTF?

  • A) Ezetimibe
  • B) Gemfibrozil
  • C) Alirocumab (Praluent)
  • D) High-intensity atorvastatin
  • E) Moderate-intensity atorvastatin


Dr. Raj Dasgupta


Dr. Raj Dasgupta