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https://www.readbyqxmd.com/read/29671538/stable-coronary-artery-disease-treatment
#1
Michael M Braun, William A Stevens, Craig H Barstow
Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or their symptoms are controlled by medications or revascularization. Treatment involves risk factor management, antiplatelet therapy, and antianginal medications. Tobacco cessation, exercise, and weight loss are the most important lifestyle modifications...
March 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29627994/the-prevalence-low-density-lipoprotein-cholesterol-levels-and-treatment-of-patients-at-very-high-risk-of-cardiovascular-events-in-the-united-kingdom-a-cross-sectional-study
#2
Mark D Danese, Eduard Sidelnikov, Lucie Kutikova
OBJECTIVE: To assess the prevalence of patients at very high risk of cardiovascular (CV) events in the United Kingdom (UK) and evaluate low-density lipoprotein cholesterol (LDL-C) values and treatment patterns in these patients. METHODS: This cross-sectional study used primary care data from UK electronic medical records in the Clinical Practice Research Datalink (CPRD) in 2013. Very high-risk patients were defined per European Society of Cardiology guidelines as those with hyperlipidemia (assessed by co-medication) and documented cardiovascular disease (CVD) or hyperlipidemia and type 2 diabetes (DM2) without CVD (DM2w/oCVD)...
April 9, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29503409/best-treatment-strategies-with-statins-to-maximize-the-cardiometabolic-benefits
#3
Kyoung Im Cho, Ichiro Sakuma, Il Suk Sohn, Toshio Hayashi, Kazunori Shimada, Kwang Kon Koh
Statins are important for preventing adverse cardiovascular events in patients with both high and low risk of vascular disease, by reducing the levels of low-density lipoprotein cholesterol (LDL-C). However, statins dose-dependently increase adverse effects and increase the risk of type 2 diabetes. Previously, it was hypothesized this was caused by to off-target effects, but recent studies demonstrate it is caused by on-target effects. Nonetheless, the American guidelines recommend the use of high-intensity statin therapy, and extend its use to most people at risk of vascular diseases, particularly older people...
March 2, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29493859/effect-of-alirocumab-on-lipids-and-lipoproteins-in-individuals-with-metabolic-syndrome-without-diabetes-pooled-data-from-10-phase-3-trials
#4
Robert R Henry, Dirk Müller-Wieland, Pam R Taub, Maja Bujas-Bobanovic, Michael J Louie, Alexia Letierce, Henry N Ginsberg
AIMS: This analysis assessed the efficacy and safety of alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, in patients with or without metabolic syndrome (MetS) using pooled data from 10 phase 3 ODYSSEY trials. MATERIALS AND METHODS: Data from 4983 randomized patients (1940 with MetS; 1642 with diabetes excluded) were assessed in subgroups by MetS status. Efficacy data were analysed in 4 pools per study design: 2 placebo-controlled pools (1 using alirocumab 150 mg every 2 weeks [Q2W], 1 using 75/150 mg Q2W) with background statin, and 2 ezetimibe-controlled pools (both alirocumab 75/150 mg Q2W), 1 with and 1 without background statin...
March 1, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29493554/elevated-triglycerides-and-low-high-density-lipoprotein-cholesterol-level-as-marker-of-very-high-risk-in-type-2-diabetes
#5
Michel P Hermans, Paul Valensi
PURPOSE OF REVIEW: The aim of this review is to describe in diabetic patients the determinants underlying atherogenic dyslipidemia, a complex dyslipidemia defined as the coexistence of fasting hypertriglyceridemia and low high-density lipoprotein cholesterol level. Atherogenic dyslipidemia is often comorbid with hyperglycemia in patients with the common form of type 2 diabetes mellitus (T2DM), namely that associated with obesity, insulin resistance, hyperinsulinemia and the metabolic syndrome phenotype...
April 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29459241/the-atherogenic-dyslipidemia-complex-and-novel-approaches-to-cardiovascular-disease-prevention-in-diabetes
#6
REVIEW
Priska Stahel, Changting Xiao, Robert A Hegele, Gary F Lewis
Despite the effectiveness of low-density lipoprotein (LDL)-lowering strategies for the treatment of diabetic dyslipidemia, significant residual risk of atherosclerotic cardiovascular disease remains. Residual risk might in part be explained by lipid abnormalities that go beyond LDL cholesterol elevation, collectively termed the "atherogenic dyslipidemia complex (ADC)," consisting of hypertriglyceridemia, elevated small dense LDL particles, reduced high-density lipoprotein cholesterol, and high-density lipoprotein particle numbers, increased remnant lipoproteins, and postprandial hyperlipidemia...
December 15, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29436756/alirocumab-versus-usual-lipid-lowering-care-as-add-on-to-statin-therapy-in-individuals-with-type-2-diabetes-and-mixed-dyslipidaemia-the-odyssey-dm-dyslipidemia-randomized-trial
#7
Kausik K Ray, Lawrence A Leiter, Dirk Müller-Wieland, Bertrand Cariou, Helen M Colhoun, Robert R Henry, Francisco J Tinahones, Maja Bujas-Bobanovic, Catherine Domenger, Alexia Letierce, Rita Samuel, Stefano Del Prato
AIMS: Individuals with type 2 diabetes (T2DM) and mixed dyslipidaemia represent a high-risk and difficult-to-treat population. ODYSSEY DM-DYSLIPIDEMIA (NCT02642159) compared alirocumab, a proprotein convertase subtilisin-kexin type 9 inhibitor, with usual care (UC) in individuals with T2DM and mixed dyslipidaemia not optimally managed by maximally-tolerated statins. MATERIALS AND METHODS: UC options (no additional lipid-lowering therapy; fenofibrate; ezetimibe; omega-3 fatty acid; nicotinic acid) were selected prior to stratified randomization to open-label alirocumab 75 mg every 2 weeks (Q2W; with increase to 150 mg Q2W at Week [W]12 if W8 non-high-density lipoprotein cholesterol [non-HDL-C] was ≥2...
February 13, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29413998/lipid-lowering-treatment-in-peripheral-artery-disease
#8
REVIEW
Niki Katsiki, Athanasios D Giannoukas, Vasilios G Athyros, Dimitri P Mikhailidis
Peripheral artery disease (PAD) is characterized by increased cardiovascular (CV) risk, limb morbidity and all-cause mortality. According to the current guidelines (2016) of the American Heart Association/American College of Cardiology on the management of PAD patients, statin therapy is recommended for PAD patients in order to treat dyslipidemia and reduce CV risk. The present narrative review discusses the use of statins and other lipid-lowering drugs such as ezetimibe, fibrates, niacin, anacetrapib and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in PAD patients in terms of both CV and limb outcomes...
January 31, 2018: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29409336/hypolipidemic-drugs-and-diabetes-mellitus-mechanisms-and-data-from-genetic-trials
#9
Theodosios D Filippatos, Thalia Panagiotopoulou, Eleftheria Tzavella, Moses S Elisaf
Clinical trials and meta-analyses have shown that statins can dose dependently increase the incidence of new-onset diabetes mellitus (DM) especially in patients with underlying abnormalities of carbohydrate homeostasis. Mendelian randomization studies support these findings since genetic variants in the gene encoding the target of statins, the enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase, are associated with increased incidence of new-onset DM, suggesting that the so-called diabetogenic effect of statins is an "on-target effect" possibly related to their main mechanism of action, that is the increased low-density lipoprotein (LDL) receptor expression...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29397561/effect-of-ezetimibe-on-glycemic-control-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Huijin Wu, Hua Shang, Jing Wu
PURPOSE: Given the increased risk of incident diabetes and the side effects on glycemic control with statin treatment, statin and ezetimibe combination therapy has been widely used. However, whether the same concern exists in ezetimibe remains uncertain. This meta-analysis aimed to investigate the influence of ezetimibe treatment on glycemic control. METHODS: Articles were searched from PubMed, EMBASE, and Cochrane Library. Randomized controlled trials (RCTs) were included if they compared the effects of ezetimibe with placebo, ezetimibe plus statin with the same statin, or low-dose stain plus ezetimibe with high-dose statin on FBG and glycosylated hemoglobin A1c (HbA1c)...
February 3, 2018: Endocrine
https://www.readbyqxmd.com/read/29313565/utilisation-of-lipid-lowering-therapies-in-outpatient-settings-in-poland-epidemiological-survey-economedica-dyslipidaemia-2015
#11
Filip M Szymański, Anna E Płatek, Anna Ryś, Karolina Semczuk-Kaczmarek, Bartosz Krzowski, Katarzyna Wróbel, Krzysztof J Filipiak
BACKGROUND: Dyslipidaemia, especially elevated low-density lipoprotein cholesterol (LDL-C), is one of the most important cardiovascular risk factors. Treatment of dyslipidaemia and prevention of cardiovascular disease (CVD) with lipid-lowering drugs is one of the key issues in reducing cardiovascular mortality. Nevertheless, underutilisation of statins and lipid-lowering drugs is still a problem globally. AIM: The present study aimed to describe the utilisation of lipid-lowering drugs in groups of patients with indications for statin treatment and elevated LDL-C...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29276211/treatment-patterns-statin-intolerance-and-subsequent-cardiovascular-events-among-japanese-patients-with-high-cardiovascular-risk-initiating-statin-therapy
#12
Saurabh P Nagar, Pratik P Rane, Kathleen M Fox, Juliana Meyers, Keith Davis, Anne Beaubrun, Hyoe Inomata, Yi Qian, Kouji Kajinami
BACKGROUND: This study examined treatment patterns, possible statin intolerance, and incidence of cardiovascular events (CVEs) in 2 cohorts of patients with high cardiovascular risk (i.e., patients with atherosclerotic cardiovascular disease [ASCVD] and patients with diabetes mellitus).Methods and Results:A retrospective cohort study examined adults initiating either a statin or ezetimibe from 1 January 2006 to 31 May 2014 in the Japan Medical Data Center database. The first observed statin or ezetimibe prescription defined the index date...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29260404/new-treatment-options-for-lipid-lowering-therapy-in-subjects-with-type-2-diabetes
#13
Roberto Scicali, Antonino Di Pino, Viviana Ferrara, Francesca Urbano, Salvatore Piro, Agata Maria Rabuazzo, Francesco Purrello
Dyslipidemias represent a variety of quantitative and/or qualitative lipoprotein abnormalities. According to etiology, we distinguish primary dyslipidemias with strictly genetic background and secondary ones with their origin in other disease or pathological states. Diabetic dyslipidemia is a type of secondary dyslipidemia and plays an important role in determining the cardiovascular risk of subjects with type 2 diabetes. In these patients, insulin resistance is responsible for overproduction and secretion of atherogenic very low density lipoprotein...
March 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29180351/proprotein-convertase-subtilisin-kexin-type-9-pcsk9-inhibitors-and-incident-type-2-diabetes-a-systematic-review-and-meta-analysis-with-over-96-000-patient-years
#14
Luiz Sérgio F de Carvalho, Alessandra M Campos, Andrei C Sposito
OBJECTIVE: Like mutations with loss of function in the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene, inhibitors of PCSK9 (PCSK9i) may potentially favor the manifestation of diabetes. RESEARCH DESIGN AND METHODS: A meta-analysis of phase 2/3 randomized clinical trials (RCTs) assessed PCSK9i versus placebo in the primary hypercholesterolemia setting. Statins and ezetimibe were used in 98.4% of these studies and balanced between PCSK9i and placebo. We calculated relative risks (RRs) and 95% CIs using random- and fixed-effect models...
February 2018: Diabetes Care
https://www.readbyqxmd.com/read/29056268/successful-treatment-of-a-patient-with-statin-induced-myopathy-and-myotonic-dystrophy-type-ii-with-proprotein-convertase-subtilisin-kexin-type-9-inhibitor-alirocumab-praluent
#15
Mohamed K M Shakir, Terry Shin, Thanh D Hoang, Vinh Q Mai
Presently there are limited treatment options for hypercholesterolemia in patients with statin intolerance and myotonic dystrophy. A 74 year-old male presented to endocrine clinic with hypercholesterolemia (serum LDL-C 210 mg/dL), hypogonadism, insulin-controlled type 2 diabetes mellitus, and minimally elevated serum creatine kinase (CK) levels (184 U/L, ref. range 38-174). Shortly after simvastatin treatment, patient developed severe myalgias in the proximal lower and upper extremities; and serum CK increased to 317 U/L...
September 4, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28972004/prevention-of-stroke-with-the-addition-of-ezetimibe-to-statin-therapy-in-patients-with-acute-coronary-syndrome-in-improve-it-improved-reduction-of-outcomes-vytorin-efficacy-international-trial
#16
RANDOMIZED CONTROLLED TRIAL
Erin A Bohula, Stephen D Wiviott, Robert P Giugliano, Michael A Blazing, Jeong-Gun Park, Sabina A Murphy, Jennifer A White, Francois Mach, Frans Van de Werf, Anthony J Dalby, Harvey D White, Andrew M Tershakovec, Christopher P Cannon, Eugene Braunwald
BACKGROUND: Patients who experience an acute coronary syndrome are at heightened risk of recurrent ischemic events, including stroke. Ezetimibe improved cardiovascular outcomes when added to statin therapy in patients stabilized after acute coronary syndrome. We investigated the efficacy of the addition of ezetimibe to simvastatin for the prevention of stroke and other adverse cardiovascular events in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), with a focus on patients with a stroke before randomization...
December 19, 2017: Circulation
https://www.readbyqxmd.com/read/28940978/effects-of-short-term-add-on-ezetimibe-to-statin-treatment-on-expression-of-adipokines-and-inflammatory-markers-in-diabetic-and-dyslipidemic-patients
#17
Elizandra Silva Guimarães, Alvaro Cerda, Egidio Lima Dorea, Marcia Martins Silveira Bernik, Maria Cecilia Gusukuma, Gelba Almeida Pinto, Cristina Moreno Fajardo, Mario Hiroyuki Hirata, Rosario Dominguez Crespo Hirata
AIM: The influence of short-term add-on ezetimibe to simvastatin treatment on expression of adipokines and inflammatory markers was investigated in diabetic and nondiabetic patients with hypercholesterolemia. METHOD: Hypercholesterolemic nondiabetic (HC, n = 37) and diabetic (DM, n = 47) patients were treated with simvastatin (SV, 10 or 20 mg/d/8-wk) and then SV plus ezetimibe (SV + EZ, 10 mg each/d/4 wk). Serum lipids, glycemic profile, and inflammatory markers (hsCRP, adiponectin, resistin, VCAM-1, and ICAM-1) were evaluated before and after the add-on ezetimibe therapy...
September 21, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28886926/2017-focused-update-of-the-2016-acc-expert-consensus-decision-pathway-on-the-role-of-non-statin-therapies-for-ldl-cholesterol-lowering-in-the-management-of-atherosclerotic-cardiovascular-disease-risk-a-report-of-the-american-college-of-cardiology-task-force
#18
Donald M Lloyd-Jones, Pamela B Morris, Christie M Ballantyne, Kim K Birtcher, David D Daly, Sondra M DePalma, Margo B Minissian, Carl E Orringer, Sidney C Smith
In 2016, the American College of Cardiology published the first expert consensus decision pathway (ECDP) on the role of non-statin therapies for low-density lipoprotein (LDL)-cholesterol lowering in the management of atherosclerotic cardiovascular disease (ASCVD) risk. Since the publication of that document, additional evidence and perspectives have emerged from randomized clinical trials and other sources, particularly considering the longer-term efficacy and safety of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors in secondary prevention of ASCVD...
October 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28858387/effect-of-combination-therapy-of-ezetimibe-and-atorvastatin-on-remnant-lipoprotein-versus-double-atorvastatin-dose-in-egyptian-diabetic-patients
#19
Mona Mohammed El-Tamalawy, Osama Mohamed Ibrahim, Timour Mostafa Hassan, Ali Ali El-Barbari
A high level of remnant lipoprotein cholesterol (RLP-C) is a predominant feature in diabetic patients with atherosclerosis. This study aimed to investigate the effect of ezetimibe added to statin therapy compared to doubling standard statin dose. Sixty-five eligible patients were recruited then prospectively randomized to receive ezetimibe 10 mg/day plus their 40 mg daily atorvastatin dose (group 1) or atorvastatin 80 mg/day (group 2) for 3 months. Efficacy was evaluated using plasma levels of RLP-C, apolipoprotein B, non-high-density lipoprotein cholesterol (non-HDL), percentage of brachial artery flow-mediated dilation, and lipid profile...
January 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28799203/efficacy-and-safety-of-alirocumab-in-people-with-prediabetes-vs-those-with-normoglycaemia-at-baseline-a-pooled-analysis-of-10-phase-iii-odyssey-clinical-trials
#20
L A Leiter, D Müller-Wieland, M T Baccara-Dinet, A Letierce, R Samuel, B Cariou
AIM: To assess the lipid-lowering efficacy and safety of alirocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, in people with hypercholesterolaemia and prediabetes at baseline vs people with normoglycaemia at baseline in a pooled analysis of 10 ODYSSEY phase III trials. METHODS: People classified as having prediabetes had baseline HbA1c ≥39 mmol/mol (5.7%) and <48 mmol/mol (6.5%), or two baseline fasting plasma glucose values ≥5.6 mmol/l (100 mg/dl) but no more than one fasting plasma glucose value ≥7...
January 2018: Diabetic Medicine: a Journal of the British Diabetic Association
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