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Cardiology Clinics

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https://www.readbyqxmd.com/read/29609763/lipidology
#1
EDITORIAL
Stephen J Nicholls
No abstract text is available yet for this article.
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609762/intravascular-ultrasound-studies-of-plaque-progression-and-regression-impact-of-lipid-modifying-therapies
#2
REVIEW
Daisuke Shishikura, Satoshi Honda, Jordan Andrews, Stephen J Nicholls
Application of serial intravascular ultrasound imaging within the coronary arteries enables characterization of the factors associated with progression of atherosclerotic plaque. Integration into clinical trials has enabled determination of the impact of medical therapies on coronary disease. These trials have provided important insights into the effects of lipid-modifying agents currently used in clinical practice and of experimental agents at early stages of clinical development. The results of these trials are reviewed...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609761/high-density-lipoproteins-effects-on-vascular-function-and-role-in-the-immune-response
#3
REVIEW
Arash Haghikia, Ulf Landmesser
The focus in studies of high-density lipoproteins was on their capacity to remove excess cholesterol and deliver it to the liver. Other functions and vascular effects have been described. Clinical trials and translational/genetic studies have led to a refined understanding of the role of high-density lipoprotein; it is likely not a causal cardiovascular risk factor. In healthy subjects, it limits lipid oxidation, protects endothelial cell functions/integrity, and exerts antiinflammatory/antiapoptotic effects...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609760/high-density-lipoprotein-infusions
#4
REVIEW
Kohei Takata, Belinda A Di Bartolo, Stephen J Nicholls
High-density lipoproteins (HDLs) have presented an attractive target for development of new therapies for cardiovascular prevention on the basis of epidemiology and preclinical studies demonstrating their protective properties. Development of HDL mimetics provides an opportunity to administer functional HDL. However, clinical trials have produced variable results, with no evidence to date that they reduce cardiovascular events. This article reviews development programs of HDL mimetics.
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609759/cholesteryl-ester-transfer-protein-inhibitors-as-agents-to-reduce-coronary-heart-disease-risk
#5
REVIEW
Philip J Barter, Kerry-Anne Rye
Cholesteryl ester transfer protein (CETP) promotes the transfer of cholesteryl esters from the nonatherogenic high density lipoprotein (HDL) fraction to potentially proatherogenic non-HDL fractions. Inhibition of CETP reduces the concentration of non-HDL cholesterol, enhances HDL functionality, and increases the concentration of HDL cholesterol and apoA-I. Despite an absence of benefit in earlier trials of CETP inhibition, the REVEAL trial has shown that treatment with the CETP inhibitor anacetrapib reduces the risk of having a coronary event in high-risk, statin-treated patients...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609758/is-lipoprotein-a-ready-for-prime-time-use-in-the-clinic
#6
REVIEW
Katrina L Ellis, Gerald F Watts
Lipoprotein (a) is a low-density lipoprotein-like particle covalently bound to a glycoprotein called apolipoprotein(a) that is under potent genetic control. Plasma levels of lipoprotein (a) vary by up to 1000-fold among individuals, with 1 in 4 having levels that increase the risk of atherosclerotic cardiovascular disease. New evidence supports a causal role for lipoprotein (a) in atherosclerotic cardiovascular disease and aortic valve stenosis. Individuals with elevated lipoprotein (a) have a high life-time burden of atherosclerotic cardiovascular disease...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609757/evolution-of-omega-3-fatty-acid-therapy-and-current-and-future-role-in-the-management-of-dyslipidemia
#7
REVIEW
Lane B Benes, Nikhil S Bassi, Mohamad A Kalot, Michael H Davidson
Omega-3 fatty acids have shown modest benefit in certain subgroups at higher cardiovascular risk. Ongoing trials are investigating cardiovascular event rate reduction with newer, more efficacious formulations with a focus on these higher risk patients. This article focuses on the previously demonstrated benefits of omega-3 fatty acid therapies, currently available formulations, and their current and future role in reducing cardiovascular risk.
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609756/triglyceride-rich-lipoproteins
#8
REVIEW
Maaike Kockx, Leonard Kritharides
Plasma triglyceride levels are causally related to an increased risk of cardiovascular disease. Here, the authors summarize their understanding of triglyceride-rich lipoprotein metabolism, previous and newly identified regulators, and their relevance as candidate targets for therapeutic intervention.
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609755/bempedoic-acid-etc-1002-a-current-review
#9
REVIEW
Anum Saeed, Christie M Ballantyne
Although statins are first-line therapy for low-density lipoprotein cholesterol (LDL-C) reduction, many individuals on maximally tolerated statin therapy have elevated LDL-C. Bempedoic acid (ETC-1002) is a novel once-daily LDL-C-lowering agent in phase 3 clinical trials. In phase 1 and 2 studies, ETC-1002 was efficacious in lowering LDL-C when used as monotherapy and when added to statin and/or ezetimibe and was well tolerated in patients with statin intolerance. ETC-1002 also improved cardiometabolic risk factors...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609754/proprotein-convertase-subtilisin-kexin-9-inhibitors
#10
REVIEW
Angela Pirillo, Alberico Luigi Catapano
High levels of low-density lipoprotein cholesterol (LDL-C) are directly associated with an increased risk of cardiovascular disease. Reducing LDL-C levels reduces the incidence of cardiovascular events. Several lipid-lowering approaches are available to achieve the LDL-C levels recommended by current guidelines, statins being the first-line therapy. However, many patients cannot achieve the recommended LDL-C levels with current therapies. The discovery of the role of proprotein convertase subtilisin kexin 9 (PCSK9) in the regulation of plasma LDL-C levels suggested it as a potential pharmacologic target and led to the development of PCSK9 inhibitors for the management of LDL-C levels...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609753/treating-dyslipidemia-in-type-2-diabetes
#11
REVIEW
Adam J Nelson, Stephen J Nicholls
Type 2 diabetes is associated with elevated levels of triglycerides and small, dense low-density lipoprotein particles, in addition to low levels of high-density lipoprotein cholesterol. Clinical trials have demonstrated the clear cardiovascular benefit of use of statin therapy in patients with diabetes. Additional lipid-modifying agents are typically guided by the presence of additional lipid abnormalities. The optimal use of existing lipid agents and the potential for novel therapies in patients with diabetes is reviewed...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609752/statin-intolerance-some-practical-hints
#12
REVIEW
Maciej Banach, Dimitri P Mikhailidis
Statin intolerance is the inability to tolerate a dose of statin required to sufficiently reduce cardiovascular risk. With the five-step approach, more than 90% of these patients might be treated with statins. The principal approaches are to try not to discontinue statin therapy and to treat these patients as effectively as possible. New therapies with the proprotein convertase subtilisin-kexin type 9 inhibitors and bempedoic acid might be an effective response to these needs. In case of lack of achieved goal of the therapy nutraceuticals with confirmed low-density lipoprotein cholesterol reduction properties may be considered as a part of the lipid-lowering combination therapy...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609751/optimizing-statins-and-ezetimibe-in-guideline-focused-management
#13
REVIEW
Aref A Bin Abdulhak, Jennifer G Robinson
Statins are essential medications in the management of patients with clinical atherosclerotic cardiovascular disease, and have been supported by numerous clinical trials. Emerging evidence suggests that adding ezetimibe to statin therapy is associated with a net benefit and improved hard clinical outcomes, particularly in patients with significantly elevated atherosclerotic cardiovascular disease risk and elevated low-density lipoprotein cholesterol levels.
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609750/lipids-and-lipoproteins-in-risk-prediction
#14
REVIEW
Savvas Hadjiphilippou, Kausik K Ray
Ischemic heart disease remains the leading cause of death worldwide. Low-density lipoprotein cholesterol (LDL-C) has proved to have a causal relationship with atherosclerotic cardiovascular disease. Lowering LDL-C improves outcomes, although some patients continue to have residual risk of cardiovascular disease. Cardiovascular risk prediction calculators are routinely used in to identify patients most at risk. Research into other lipoprotein factors has suggested that they may have advantages over LDL-C and improve the ability to identify those most at risk...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609749/causal-effect-of-lipids-and-lipoproteins-on-atherosclerosis-lessons-from-genomic-studies
#15
REVIEW
Brian A Ference
Mendelian randomization studies demonstrate that apolipoprotein B-containing lipoproteins have both causal and cumulative effects on the risk of atherosclerotic cardiovascular disease. The clinical benefit of lipid-lowering therapies depends on both the absolute reduction in circulating apolipoprotein B-containing lipoproteins and the total duration of exposure to these particles. Because atherosclerosis seems to be caused by the retention of apolipoprotein B-containing lipoproteins rather than by the cholesterol content carried by those lipoproteins, high-density lipoprotein-mediated efflux of cholesterol from the arterial wall may not reduce the risk of atherosclerotic cardiovascular disease...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609748/impact-of-lipoproteins-on-atherobiology-emerging-insights
#16
REVIEW
Ma Feng, Fabiana Rached, Anatol Kontush, M John Chapman
Apolipoprotein B-containing lipoproteins and low-density lipoprotein play a key role in atherosclerotic vascular disease. Modified forms of low-density lipoprotein drive inflammation, an integral aspect of plaque progression. High-density lipoprotein particles are equipped to protect low-density lipoprotein from enzymatic and nonenzymatic modification. Under normal conditions, high-density lipoproteins facilitate cholesterol efflux from tissues, preventing its accumulation with deleterious consequences. However, the high-density lipoprotein particles characteristic of dyslipidemic states associated with premature atherosclerosis are typically dysfunctional as a result of alteration in their metabolism and consequently their structure and composition...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173684/multidisciplinary-management-of-the-post-cardiac-arrest-patient
#17
REVIEW
Ryan D Madder, Joshua C Reynolds
Cardiac arrest afflicts more than 300,000 persons annually in North America alone. Improving outcomes after cardiac arrest requires an integrated and multidisciplinary approach to postresuscitation intensive care and subsequent recovery. This article reviews components of injury within the post-cardiac arrest syndrome, the salient features of brain-oriented intensive care, best practices in neurologic prognostication, and a rational approach to emergency revascularization and hemodynamic support.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173683/evolving-strategies-in-cardiac-arrest-management
#18
REVIEW
Bram J Geller, Benjamin S Abella
Cardiac arrest is a leading cause of death in the United States, with a hospital discharge rate of approximately 10%. International resuscitation guidelines offer standardized cardiac arrest management approaches, but beyond the guidelines, are promising innovations to improve resuscitative care. Although clinical data do not yet support the routine use of mechanical chest compressions, corticosteroids, thrombolytics, and adjunctive ventilation devices during arrest, these therapies may have an important role in select patients...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173682/acute-dyspnea-and-decompensated-heart-failure
#19
REVIEW
Peter S Pang, Sean P Collins, Mihai Gheorghiade, Javed Butler
The majority of patients hospitalized with acute heart failure (AHF) initially present to the emergency department (ED). Correct diagnosis followed by prompt treatment ensures optimal outcomes. Paradoxically, identification of high risk is not the unmet need, given nearly all ED AHF patients are hospitalized; rather, it is identification of low-risk. Currently, no risk-stratification instrument can be universally recommended to safely discharge ED patients. With the exception of diagnosis, management recommendations are largely expert opinion, informed by existing evidence and tradition...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173681/cardiogenic-shock
#20
REVIEW
Semhar Z Tewelde, Stanley S Liu, Michael E Winters
Cardiogenic shock (CS) is a physiologic state in which cardiac pump function is inadequate to perfuse the tissues. If CS is not rapidly recognized and treated, tissue hypoperfusion can quickly lead to organ dysfunction and patient death. Evaluation of patients with suspected CS should include an electrocardiogram, chest radiograph, laboratory studies, and bedside echocardiogram. Initial resuscitation is directed toward restoring cardiac output and tissue perfusion. Mechanical circulatory support is indicated for patients with CS who do not respond to pharmacologic therapy...
February 2018: Cardiology Clinics
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