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Atherosclerosis. Supplements

Giorgio L Colombo, Enrico Agabiti-Rosei, Alberto Margonato, Claudio Mencacci, Carlo Maurizio Montecucco, Roberto Trevisan, Alberico L Catapano
BACKGROUND: The use of generics, equivalent but less expensive drugs, is an important opportunity to reduce healthcare expenditure. METHODS: The purpose of this study was to investigate the effect of substitution between unbranded generics on persistence and adherence to therapy in two Italian Local Health Units (ASL) in real-world clinical practice in 5 therapeutic areas using tracing drugs. Substitution of generic drugs is any change in the name of the manufacturer of the generic drug...
June 2016: Atherosclerosis. Supplements
Alberico L Catapano, Olov Wiklund
Cardiovascular disease (CVD) is still the main cause of death in Europe. Elevated plasma cholesterol, specifically low-density lipoprotein cholesterol (LDL-C), is the main causative risk factor for CVD, most prominently associated with coronary heart disease. A widespread disinformation about cholesterol and CVD is one factor underlying a poor compliance to lipid-lowering therapy. To investigate how cholesterol, CVD and cholesterol reduction is perceived in the population, a survey was commissioned by the European Atherosclerosis Society (EAS)...
December 2015: Atherosclerosis. Supplements
Carlos Aguiar, Eduardo Alegria, Riccardo C Bonadonna, Alberico L Catapano, Francesco Cosentino, Moses Elisaf, Michel Farnier, Jean Ferrières, Pasquale Perrone Filardi, Nicolae Hancu, Meral Kayikcioglu, Alberto Mello E Silva, Jesus Millan, Željko Reiner, Lale Tokgozoglu, Paul Valensi, Margus Viigimaa, Michal Vrablik, Alberto Zambon, José Luis Zamorano, Roberto Ferrari
A meeting of European experts in cardiovascular (CV) disease and lipids was convened in Paris, France, on 10 November 2014 to discuss lipid profile, and in particular atherogenic dyslipidaemia (AD), and associated CV risk. Key points that were raised and discussed during the meeting are summarised in this paper, which also accounts for further discussion and agreement on these points by the group of experts. Elevated levels of low-density lipoprotein cholesterol (LDL-c) are commonly associated with a greater CV risk than low LDL-c levels, and are routinely managed with statins...
September 2015: Atherosclerosis. Supplements
T Sampietro, F Sbrana, F Bigazzi, A Ripoli, B Dal Pino, E M Pasanisi, C Petersen, M Coceani, R Luciani, M Pianelli
AIM: Lipoprotein apheresis (LA) is the elective therapy for homozygous and other forms of familial hypercholesterolemia (FH) and familial combined hypercholesterolemia (FCH), resistant/intolerant to lipid lowering drugs, and hyperlipoproteinemia(a) for which drugs are not available. To assess the effect of LA on the incidence of adverse cardiac or vascular events (ACVE) at the time period of pre-initiation of apheresis and during the LA treatment. METHODS: We collected data of 30 patients (mean age 62 ± 8 years, males 73%), with FH, or FCH and cardiovascular disease on maximally tolerated lipid lowering therapy and LA treatment (median 5 years, interquartile range 3-8 years)...
May 2015: Atherosclerosis. Supplements
Ursula Kassner, Thomas Schlabs, Adrian Rosada, Elisabeth Steinhagen-Thiessen
It is widely accepted that elevated levels of lipoprotein(a) (Lp(a)) are associated with an increased risk for cardiovascular diseases. Several studies have identified Lp(a) as independent cardiovascular risk factor. Consequently, therapeutic concepts are targeting at lowering Lp(a) serum levels. To date, in Europe no pharmaceutical treatment to lower levels of Lp(a) is available. Current developments of pharmaceutical agents like the apolipoprotein-(B-100)-antisense mipomersen, inhibitors of PCSK9 and apolipoprotein-(a)-antisense have shown promising results in lowering Lp(a)...
May 2015: Atherosclerosis. Supplements
S Tselmin, G Müller, E Gelgaft, S Fischer, U Julius
INTRODUCTION: The causal association of elevated lipoprotein(a) (Lp(a)) plasma levels with the increased cardiovascular risk is still controversial and presently there are no standard recommendations on managing of hyperLp(a)emia. Our retrospective analysis is aimed to explore the Lp(a) thresholds, the magnitude of various cardiovascular risk factors and their combinations. METHODS: The files of 544 outpatients from our Outpatient Department of Lipid Disorders were divided into quintiles with respect to Lp(a) levels and reviewed regarding age, gender, Body Mass Index, dyslipidemias, arterial hypertension, diabetes mellitus, smoking and incidence of vascular events in coronaries, carotids and lower extremities...
May 2015: Atherosclerosis. Supplements
Johannes Mühlhausen, Bernd Kitze, Peter Huppke, Gerhard A Müller, Michael J Koziolek
Therapeutic apheresis has reached an important value in the treatment of neurologic disorders. In the indication of acute relapses of inflammatory demyelinating conditions plasma exchange (PE) is currently mentioned in guidelines in adults and children. Immunoadsorption (IA) is a younger but more selective apheresis method. Compared to PE, data on IA in these indications are less substantiated. Hitherto existing studies indicate IA as effective and safe with similar response rates versus PE. Our own study of 140 adult patients treated with PE or IA in steroid refractory multiple sclerosis or neuromyelitis optica affirm previous findings showing no significant difference in efficacy and treatment safety...
May 2015: Atherosclerosis. Supplements
C Stefanutti, G D'Alessandri, A Petta, M Harada-Shiba, U Julius, H Soran, P M Moriarty, S Romeo, E Drogari, B R Jaeger
The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation...
May 2015: Atherosclerosis. Supplements
E Stasiewski, M Christoph, A Christoph, A Bittner, K Weidner, U Julius
BACKGROUND: Despite the fact that extracorporeal methods such as lipoprotein apheresis (LA) and hemodialysis (HD) are highly effective in improving the physical status of patients, these treatment options may possibly harm the psychological status and the health related quality of life (HRQL). METHODS: The occurrences of anxiety, depression and the HRQL of 111 study participants treated with LA (n = 41), HD (n = 41) or undergoing plateletpheresis (PD) (n = 29) were compared to the normal population (NP), using standardized questionnaires (anxiety and depression: Hospital Anxiety and Depression Scale (HADS), heart-focused anxiety: Cardiac Anxiety Questionnaire (CAQ) and HRQL: Short-Form Health Survey (SF-12))...
May 2015: Atherosclerosis. Supplements
E Groß, B Hohenstein, U Julius
BACKGROUND: Lipoprotein(a) (Lp(a)) is a low density lipoprotein-like particle to which apolipoprotein(a) is bound. It is recognized as an atherosclerosis-inducing risk factor. Up to now a detailed description of the effect of Lipoprotein apheresis (LA) on Lp(a) levels in the long run is lacking. METHODS: We studied 59 patients with elevated Lp(a) levels who were treated with LA at the Lipoprotein Apheresis Center at the University Hospital Dresden. We analyzed Lp(a) concentrations before the start of the LA treatment and during this extracorporeal therapy...
May 2015: Atherosclerosis. Supplements
U Emmrich, B Hohenstein, U Julius
BACKGROUND: Lipoprotein apheresis (LA) is an officially accepted therapeutic approach in Germany. Reliable population-based data on the patients are scarce. It is of special interest to learn what are the main indications for this extracorporeal treatment and how many new patients started over the last years. METHODS: This paper is a summary of the situation of the treatment of high-risk patients via LA in the federal state of Saxony, Germany. The documentation of all patients who agreed to be included into this study have been evaluated...
May 2015: Atherosclerosis. Supplements
S Schampera, S Fischer, N Weiss, U Julius
BACKGROUND: Lipoprotein apheresis (LA) therapy is effective in eliminating atherogenic lipoproteins and reducing the rate of cardiovascular events (CVE) in patients suffering from severe hypercholesterolemia or increased lipoprotein(a) (Lp(a)) levels despite maximal tolerated lipid lowering therapy. METHODS: We examined the rate of CVE in 116 patients (63% males) with an isolated increase of LDL-cholesterol (LDL-C) (Group 1), an isolated increase of Lp(a) (Group 2), a combined increase of LDL-C and Lp(a) (Group 3) and patients who were referred for LA, but never started (Group 4)...
May 2015: Atherosclerosis. Supplements
U Schatz, B M W Illigens, T Siepmann, B Arneth, G Siegert, D Siegels, F Heigl, R Hettich, W Ramlow, H Prophet, S R Bornstein, U Julius
OBJECTIVES: Iron deficiency (ID) and iron deficiency anemia (IDA) are common findings in patients undergoing lipoprotein apheresis (LA). Different intravenous (iv) formulations are used to treat ID in LA patients, however guidelines and data on ID/IDA management in LA patients are lacking. We therefore performed a prospective observational multi-center cohort study of ID/IDA in LA patients, comparing two approved i.v. iron formulations, ferric gluconate (FG) and ferric carboxymaltose (FCM)...
May 2015: Atherosclerosis. Supplements
S Fischer, U Schatz, U Julius
Hyperlipidemia is a risk factor for atherosclerosis. Raised low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) levels are severe risk factors for atherosclerosis. The role of high-density lipoprotein cholesterol (HDL-C) is controversial. Total cholesterol, LDL-C, HDL-C, triglycerides and lipoprotein(a) levels should be determined in a fasting state. The basis of treating hyperlipidemia remains diet, physical exercise and weight reduction. Olive oil and nuts have been shown to be beneficial. Statins remain first line drug treatment...
May 2015: Atherosclerosis. Supplements
Wolfram C Poller, Henryk Dreger, Stanislao Morgera, Axel Berger, Ingo Flessenkämper, Kathrin Enke-Melzer
OBJECTIVE: Hyperlipoproteinemia(a) [Lp(a)-HLP] is a major risk factor for severe atherosclerosis. The present investigation sought to assess the effect of lipoprotein apheresis (LA) in patients with peripheral artery disease (PAD) and Lp(a)-HLP. METHODS: In January 2013, we started a registry for Lp(a)-HLP patients who receive weekly LA in our center. So far, ten patients with severe PAD and isolated Lp(a)-HLP who recently underwent revascularization (index procedure) have been included...
May 2015: Atherosclerosis. Supplements
U Julius, M Milton, D Stoellner, D Rader, B Gordon, D Polk, E Waldmann, K G Parhofer, P M Moriarty
BACKGROUND: PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) increases LDL cholesterol (LDL-C) levels by stimulating the degradation of Low Density Lipoprotein receptors (LDL-r). This protein is now of high interest because antibodies which inhibit its effect on LDL-r are being developed. A severe hypercholesterolemia and / or an elevation of lipoprotein(a) can be treated with lipoprotein apheresis (LA) in high-risk patients. METHODS: We measured serum PCSK9 levels in patients eligible for the extracorporeal treatment: in 40 patients (Cohort I) who were treated with different systems before and after apheresis sessions and in the intervals between sessions...
May 2015: Atherosclerosis. Supplements
E Windler, B-Chr Zyriax
Current guidelines of the European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS), of the American College of Cardiology and the American Heart Association (ACC/AHA), and of the International Atherosclerosis Society (IAS) are all based on the same body of evidence, but come to strikingly different conclusions with regard to lipid lowering therapy. While the ESC/EAS guidelines assign appropriate treatments to distinct lipid disorders, the ACC/AHA guidelines focus exclusively on evidence from randomized controlled trials for statins, but lack advice for those lipid disorders without evidence from randomized trials...
May 2015: Atherosclerosis. Supplements
Juergen Graessler, Kai Schuhmann, Andrej Shevchenko, Steffi Kopprasch, Ryan Ban, Sybille Bergmann, Stefan R Bornstein, Bernd Hohenstein, Ulrich Julius
OBJECTIVES: Previously we found a highly significant increase of phosphatidylethanolamines (PE) in response to acute lipoprotein apheresis (LA) with whole blood dextran sulfate adsorption (DSA) in contrast to the overall tendency of reduction of lipid metabolites of all lipid classes in post-apheresis plasma. Therefore, the aim of the present study was to analyze long-term modifications of the plasma lipidomic profile in patients with repeated DSA apheresis. METHODS: Nine patients weekly treated with DSA were followed for 40 weeks...
May 2015: Atherosclerosis. Supplements
M V Ezhov, M S Safarova, O I Afanasieva, O A Pogorelova, M I Tripoten, I Y Adamova, G A Konovalov, T V Balakhonova, S N Pokrovsky
BACKGROUND: To date, there have been no studies evaluating the effect of isolated lipoprotein(a) (Lp(a)) lowering therapy on carotid atherosclerosis progression. METHODS: We enrolled 30 patients who had coronary heart disease (CHD) verified by angiography, Lp(a) level ≥50 mg/dL, and low density lipoprotein cholesterol (LDL-C) level ≤2.6 mmol/L (100 mg/dL) on chronic statin therapy. Subjects were allocated in a 1:1 ratio to receive apheresis treatment on a weekly basis with immunoadsorption columns ("Lp(a) Lipopak"(®), POCARD Ltd...
May 2015: Atherosclerosis. Supplements
Franz Heigl, Reinhard Hettich, Norbert Lotz, Harduin Reeg, Tobias Pflederer, Dirk Osterkorn, Klaus Osterkorn, Reinhard Klingel
LDL cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) are main risk factors for cardiovascular disease (CVD). Efficacy, safety, and tolerability of lipoprotein apheresis (LA) were investigated in 36,745 LA treatments of 118 patients with CVD in a retrospective, monocentric study. Indications were severe hypercholesterolemia (n = 83) or isolated Lp(a) hyperlipoproteinemia (n = 35). Average age of patients at start of LA treatment was 58.1 years for males and 62.5 years for females. Medium interval between the first cardiovascular event and LA treatment was 6...
May 2015: Atherosclerosis. Supplements
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