Answer to Question 1
The hsCRP level can be an indicator of any type of inflammatory response in the body. Values of less
than 1.0 mg/dL indicate low risk for heart disease; values of 1.0 to 3.0 mg/dL indicate moderate risk.
Values above 3.0 mg/dL place the patient at high risk for heart disease; elevated levels are seen in
patients with low HDL and high triglyceride levels, such as in R.M.'s laboratory results.
Homocysteine is an amino acid formed during the metabolism of methionine. There is increasing
evidence that seems to indicate that elevated levels of homocysteine are associated with the
progression of atherosclerosis, thus increasing the risk of heart disease. Normal levels for males are
5.2 to 12.9 mmol/L; R.M.'s result indicates an elevation.
Answer to Question 2
Atorvastatin (Lipitor) is a statin, also known as an HMG-CoA reductase inhibitor, and works to
reduce cholesterol synthesis. It is used to reduce elevated cholesterol and triglyceride levels, and
thus aids in the prevention of cardiovascular disease.
Folic acid, B6, and B12 are B vitamins that will help stabilize arteries and prevent restenosis of
lesions that have been angioplastied or stented. In addition, they might help reduce the elevated
homocysteine level.
Niacin will increase HDL particles and provide more protection to the arteries and also works to
reduce cholesterol, LDL, and triglyceride levels.
Omega-3 fatty acids will help increase HDL and decrease triglycerides. They are also helpful in
preventing sudden cardiac death.
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A medical assistant listening to the patient and physician discuss the patient's care.
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