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A laboratory report read against its ranges and the earlier reports

Every value against its reference, against the last two reports, and against what the guideline asks for in this patient, with one sentence on what it means and which values carry the decision.

Step 1
AKAnna Keller, 47 · Hypertension, prediabetes, LDL 162 mg/dl
Read her lab report against the last one.
Finished thinking

Fifteen values, seven outside their range

Lab review

Laboratory report, 8 May 2026

Anna Keller, 47 · 8 May 2026 · Shared with the patient, 12 May 2026, opened

Cholesterol

4 values · 2 to look at
LDL cholesterol162mg/dl
Above rangeaim below 100rising

Rising over three reports; with her father's heart attack at 58 the target is below 100.

Non-HDL cholesterol186mg/dl
Above rangeaim below 130rising

Moves with LDL; the same target applies.

HDL cholesterol52mg/dl
In rangeabove 45
Triglycerides148mg/dl
In rangebelow 150

Blood sugar

2 values · 2 to look at
HbA1c5.9%
Above rangebelow 5.7rising

First time above the threshold: prediabetes. Weight and movement first, control in three months.

Fasting glucose104mg/dl
Above rangebelow 100rising

Fits the HbA1c.

Liver

3 values · 2 to look at
ALT (GPT)41U/l
Above rangebelow 35rising

Mild; fits the steatosis on ultrasound. No barrier to a statin.

AST (GOT)28U/l
In rangebelow 35
GGT44U/l
Above rangebelow 40

Mildly raised. Same picture as ALT.

Kidney

2 values
Creatinine0.78mg/dl
In range0.5 to 0.9
eGFR92ml/min
In rangeabove 90

Other

4 values · 1 to look at
Vitamin D21ng/ml
Below range30 to 50falling

Low; 1,000 IU daily.

TSH1.8mU/l
In range0.4 to 4.0
Ferritin48ng/ml
In range15 to 150
CK96U/l
In rangebelow 170

What follows from this

  • Atorvastatin 20 mg in the eveningLDL, ALT and CK again after eight weeks
  • Lipoprotein(a), onceNever measured; changes the risk estimate with the family history
  • HbA1c again in NovemberLifestyle first at 5.9 %, no metformin

Sources

Lab report 08.05.2026Ultrasound 08.05.2026ESC 2021

Read from the laboratory report of 8 May 2026 and compared with the reports of September 2023 and March 2024. Reference ranges from the laboratory, targets from the ESC prevention guideline.

Open the lab reviewSee the full response

Step 2
AKAnna Keller, 47 · Hypertension, prediabetes, LDL 162 mg/dl · 14 documents, read 16 September 2026
Given her history and today's findings, what should I consider next?

Answered on 16 September 2026

Finished thinking
Practice guidelineEuropean Society of Cardiology

ESC 2021: in apparently healthy people under 50, SCORE2 estimates the 10-year risk; risk modifiers such as a family history of premature cardiovascular disease, lipoprotein(a) and coronary artery calcium can move a patient across a treatment threshold. At low-to-moderate risk, lipid-lowering treatment should be considered when LDL cholesterol stays at or above 100 mg/dl after lifestyle intervention. Eur Heart J

European Society of Cardiology

2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.

Visseren FLJ, Mach F, Smulders YM, et al. European Heart Journal. 2021;42:3227-3337. doi:10.1093/eurheartj/ehab484.

Her SCORE2 (moderate-risk region, 47 years, non-smoker now, systolic 142, non-HDL 186 mg/dl) is about 3 %, low to moderate for her age. Check-up 12.05.2026 Lab 08.05.2026 Eur Heart J Three modifiers push upward: her father's infarction at 58, an LDL of 162 mg/dl and prediabetes with steatosis. Intake 20.09.2023 Lab 08.05.2026 Ultrasound 12.05.2026

  • Lipids: statin rechallenge with atorvastatin 10 mg or rosuvastatin 5 mg, LDL target below 100 mg/dl, lipids, ALT and CK after eight weeks; lipoprotein(a) once with the next draw. Eur Heart J + 2
  • Blood pressure: home mean 136/86 is above the ESC 2024 target of 120 to 129 systolic; increase ramipril to 10 mg, potassium and creatinine after two weeks, home log again in four weeks. BP log 15.09.2026 Eur Heart J
  • Prediabetes and liver: structured lifestyle programme (the Diabetes Prevention Program reduced diabetes incidence by 58 %), HbA1c in three to six months, FIB-4 from the May values. NEJM J Hepatol
  • Optional risk refinement: a coronary calcium scan if she or you want more certainty before committing to long-term treatment. Eur Heart J

Today's draft note already lists the statin start, the ramipril increase and the booster; the FIB-4 and the lifestyle programme are not yet in it. Visit 16.09.2026

See the full response