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statin veterans

Nora T Oliver, Christine M Hartman, Jennifer R Kramer, Elizabeth Y Chiao
INTRODUCTION: Chronic HIV/hepatitis C virus (HCV) coinfection carries increased risk of cirrhosis, hepatocellular carcinoma, and death. Due to anti-inflammatory properties, 3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) inhibitors (statins) may be useful adjunctive therapy to reduce liver disease progression. METHODS: Clinical information was extracted from the Veterans Affairs HIV and HCV Clinical Case Registries (1999-2010). HIV-related variables included combination antiretroviral therapy era of diagnosis, CD4 cell count, and percentage time with undetectable HIV viral load...
October 23, 2016: AIDS
Maju Mathew Koola, John D Sorkin, Molly Fargotstein, W Virgil Brown, Bruce Cuthbert, Jeffrey Hollis, Jeffrey K Raines, Erica J Duncan
BACKGROUND: Peripheral arterial compliance (PAC) is a measure of the ability of the vascular tree to dilate in response to a pressure wave. Reduced PAC is seen in patients with psychiatric diagnoses and has been associated with increased risk for stroke, myocardial infarction, and mortality. The objective of this pilot study was to identify predictors of reduced PAC in subjects with psychiatric diagnoses. METHODS: Male psychiatric subjects (N = 77) were studied in a cross-sectional study of medication effects on PAC conducted from August 2005 to February 2010...
2016: Primary Care Companion to CNS Disorders
Ashley Pender, Donald M Lloyd-Jones, Neil J Stone, Philip Greenland
Guidelines from the American College of Cardiology/American Heart Association, as well as those from the Veterans Affairs/Department of Defense and the Joint British Societies all recommended treating more people with statins than previous guidelines. In each guideline, the decision-making process began with an assessment of overall cardiovascular risk. Each group proposed updated treatment thresholds, and all of them lowered the threshold compared with earlier guidelines. Since release of these new guidelines in 2013 and 2014, additional evidence has emerged to suggest a rationale for extending statin consideration to an even larger proportion of asymptomatic adults-even those with a 10-year atherosclerotic cardiovascular disease risk below 7...
October 11, 2016: Journal of the American College of Cardiology
Kristen Marie Sanfilippo, Jesse Keller, Brian F Gage, Suhong Luo, Tzu-Fei Wang, Gerald Moskowitz, Jason Gumbel, Brandon Blue, Katiuscia O'Brian, Kenneth R Carson
PURPOSE: The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) have activity in one of the pathways influenced by nitrogen-containing bisphosphonates, which are associated with improved survival in multiple myeloma (MM). To understand the benefit of statins in MM, we evaluated the association between statin use and mortality in a large cohort of patients with MM. PATIENTS AND METHODS: From the Veterans Administration Central Cancer Registry, we identified patients diagnosed with MM between 1999 and 2013...
September 19, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Ashok Reddy, Tiffany L Huseman, Anne Canamucio, Steven C Marcus, David A Asch, Kevin Volpp, Judith A Long
BACKGROUND: Simple nudges such as reminders and feedback reports to either a patient or a partner may facilitate improved medication adherence. OBJECTIVE: To test the impact of a pill bottle used to monitor adherence, deliver a daily alarm, and generate weekly medication adherence feedback reports on statin adherence. DESIGN: Three-month, three-arm randomized clinical trial ( identifier: NCT02480530). PARTICIPANTS: One hundred and twenty-six veterans with known coronary artery disease and poor adherence (medication possession ratio <80 %)...
September 9, 2016: Journal of General Internal Medicine
Ravi S Hira, Jennifer B Cowart, Julia M Akeroyd, David J Ramsey, Yashashwi Pokharel, Vijay Nambi, Hani Jneid, Anita Deswal, Ali Denktas, Addison Taylor, Khurram Nasir, Christie M Ballantyne, Laura A Petersen, Salim S Virani
Cardiovascular disease (CVD) is a systemic process involving multiple vascular beds and includes coronary heart disease (CHD), ischemic cerebrovascular disease (ICVD), and peripheral arterial disease (PAD). All these manifestations are associated with an increased risk of subsequent myocardial infarction, stroke, and death. Guideline-directed medical therapy is recommended for all patients with CVD. In a cohort of US veterans, we identified 1,242,015 patients with CVD receiving care in 130 Veterans Affairs facilities from October 1, 2013 to September 30, 2014...
October 15, 2016: American Journal of Cardiology
Nora T Oliver, Christine M Hartman, Jennifer R Kramer, Elizabeth Y Chiao
INTRODUCTION: Chronic HIV/HCV co-infection carries increased risk of cirrhosis, hepatocellular carcinoma, and death. Due to anti-inflammatory properties, HMG co-A inhibitors (statins) may be useful adjunctive therapy to reduce liver disease progression. METHODS: Clinical information was extracted from the Veterans Affairs HIV and HCV Clinical Case Registries (1999 - 2010). HIV-related variables included combination anti-retroviral therapy (cART) era of diagnosis, CD4 cell count, and percent time with undetectable HIV viral load...
August 3, 2016: AIDS
Teresa M Damush, Laura Myers, Jane A Anderson, Zhangsheng Yu, Susan Ofner, Gloria Nicholas, Barbara Kimmel, Arlene A Schmid, Thomas Kent, Linda S Williams
We targeted stroke/transient ischemic attack (TIA) survivors to engage in self-management practices to manage secondary stroke risk factors. We conducted a randomized, regional pilot trial of a locally adapted, secondary stroke prevention program. We implemented the program at two Veterans Administration Medical Centers. Program sessions targeted stroke risk factor self-management. Specifically, we evaluated the effect of the program on the reach, implementation, and effectiveness on patient self-efficacy; stroke-specific, health-related quality of life; and medication adherence for the prevalent stroke risk factors: (1) diabetes, (2) hypertension, and (3) hyperlipidemia...
September 2016: Translational Behavioral Medicine
Javier A Valle, Colin I O'Donnell, Ehrin J Armstrong, Steven M Bradley, Thomas M Maddox, P Michael Ho
BACKGROUND: Stigma against the obese is well described in health care and may contribute to disparities in medical decision-making. It is unknown whether similar disparity exists for obese patients in cardiovascular care. We evaluated the association between body mass index (BMI) and prescription of guideline-recommended medications in patients undergoing elective percutaneous coronary intervention. METHODS AND RESULTS: Using data from the Veterans Affairs Clinical Assessment, Reporting, and Tracking System Program, we identified patients undergoing elective percutaneous coronary intervention from 2007 to 2012, stratifying them by category of BMI...
May 2016: Journal of the American Heart Association
Catherine S Bennet, Chanukya R Dahagam, Salim S Virani, Seth S Martin, Roger S Blumenthal, Erin D Michos, John W McEvoy
In December 2014, the US Department of Veterans Affairs and Department of Defense (VA/DoD) published an independent clinical practice guideline for the management of dyslipidemia and cardiovascular disease risk, adding to the myriad of recently published guidelines on this topic. The VA/DoD guidelines differ from major US guidelines published by the American College of Cardiology/American Heart Association in 2013 in the following ways: recommending moderate-intensity statins for the majority of patients with statin indications regardless of atherosclerotic cardiovascular disease risk; advocating for limited on-treatment lipid monitoring; and deemphasizing ancillary data, such as coronary artery calcium testing, to improve atherosclerotic cardiovascular disease risk estimation...
September 2016: American Journal of Medicine
Meredith E Clement, Lawrence P Park, Ann Marie Navar, Nwora Lance Okeke, Michael J Pencina, Pamela S Douglas, Susanna Naggie
BACKGROUND: Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections are associated with increased risk of cardiovascular disease (CVD). The potential impact of recently updated cholesterol guidelines on treatment of HIV- and HCV-infected veterans is unknown. METHODS: We performed a retrospective cohort study to assess statin use and recommendations among 13 579 HIV-infected, 169 767 HCV-infected, and 6628 HIV/HCV-coinfected male veterans aged 40-75 years...
August 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Yashashwi Pokharel, Julia M Akeroyd, David J Ramsey, Ravi S Hira, Vijay Nambi, Tina Shah, LeChauncy D Woodard, David E Winchester, Christie M Ballantyne, Laura A Petersen, Salim S Virani
We sought to determine use of any and at least moderate-intensity statin therapy in a national sample of patients with diabetes mellitus (DM), with the hypothesis that nationwide frequency and facility-level variation in statin therapy are suboptimal. We sampled patients with DM age 40 to 75 years receiving primary care between October 1, 2012, and September 30, 2013, at 130 parent facilities and associated community-based outpatient clinics in the Veterans Affairs Health Care System. We examined frequency and facility-level variation in use of any or at least moderate-intensity statin therapy (mean daily dose associated with ≥30% low-density lipoprotein cholesterol lowering)...
April 2016: Clinical Cardiology
Chen-Pin Wang, Donna M Lehman, Yui Wing F Lam, John G Kuhn, Devalingam Mahalingam, Steven Weitman, Lorenzo Carlos, John R Downs, Elizabeth Stuart, Javier Hernandez, Ian M Thompson, Amelie Ramirez
Racial/ethnic disparity in prostate cancer (PCa) is under studied in men with diabetes who are at higher risk for aggressive PCa. This study assessed the race/ethnic disparity in PCa incidence for men with type 2 diabetes (T2D), and whether the impact of metformin on PCa incidence varied by race/ethnicity. We conducted a retrospective study in 76,733 male veterans with T2D during 2003-2012. Cox proportional hazard model adjusting for covariates and propensity scores of metformin use and race/ethnic group membership were utilized to compute the hazard ratio (HR) of PCa incidence associated with race/ethnicity, and compare HR associated with metformin use between race/ethnic groups...
March 29, 2016: Cancer Prevention Research
Kate E Shipman, Richard C Strange, Sudarshan Ramachandran
The use of fibrates in the treatment of dyslipidaemia has changed significantly over recent years. Their role appeared clear at the start of this century. The Helsinki Heart Study and Veterans Affairs High-Density Cholesterol Intervention Trial suggested significant benefit, especially in patients with atherogenic dyslipidaemia. However, this clarity disintegrated following the negative outcomes reported by the Bezafibrate Infarction Prevention, Fenofibrate Intervention and Event Lowering in Diabetes and Action to Control Cardiovascular Risk in Diabetes randomised controlled trials...
March 10, 2016: World Journal of Diabetes
Benjamin Bowe, Yan Xie, Hong Xian, Sumitra Balasubramanian, Ziyad Al-Aly
Available experimental evidence suggests a role for high-density lipoprotein cholesterol (HDL-C) in incident chronic kidney disease (CKD) and its progression. However, clinical studies are inconsistent. We therefore built a cohort of 1,943,682 male US veterans and used survival models to examine the association between HDL-C and risks of incident CKD or CKD progression (doubling of serum creatinine, eGFR decline of 30% or more), or a composite outcome of ESRD, dialysis, or renal transplantation. Models were adjusted for demographics, comorbid conditions, eGFR, body mass index, lipid parameters, and statin use over a median follow-up of 9 years...
April 2016: Kidney International
Rashi Chandra, Nicole M Dolder, Christian R Dolder, LeAnn W O'Neill, Camille Robinette
OBJECTIVE: The purpose of this study was to describe the current use of statins in United States (US) veterans at W. G. Hefner Veterans Affairs Medical Center (VA Salisbury) with chronic hepatitis C virus (HCV) compared to those without chronic HCV and to examine why statin use may be avoided in this population. METHODS: In this retrospective chart review, eligible participants were veterans enrolled in VA Salisbury primary care services who were at least 18 years of age with a diagnosis of dyslipidemia...
March 1, 2016: American Journal of Health-system Pharmacy: AJHP
Tracey G Simon, Hector Bonilla, Peng Yan, Raymond T Chung, Adeel A Butt
UNLABELLED: Statins are associated with delayed fibrosis progression and a reduced risk of hepatocellular carcinoma (HCC) in chronic hepatitis C virus (HCV). Limited data exist regarding the most effective type and dose of statin in this population. We sought to determine the impact of statin type and dose upon fibrosis progression and HCC in patients with HCV. Using the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES) database, we identified all subjects initiated on HCV antibody (anti-HCV) therapy from 2001 to 2014, and all incident cases of cirrhosis and HCC...
July 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Pierre Blais, Michael Lin, Jennifer R Kramer, Hashem B El-Serag, Fasiha Kanwal
BACKGROUND: Cardiovascular disease provides the greatest mortality risk in patients with nonalcoholic fatty liver disease (NAFLD). Clinical practice guidelines recommend statins to treat dyslipidemia in patients with NAFLD; however, the extent to which such patients receive statins has not been studied. METHODS: We conducted a structured medical record review to assess for appropriate statin use in patients in a Veterans Administration facility with dyslipidemia and NAFLD as well as a parallel cohort without NAFLD...
June 2016: Digestive Diseases and Sciences
Arpan Mohanty, Janet P Tate, Guadalupe Garcia-Tsao
BACKGROUND & AIMS: Statins decrease portal pressure in patients with cirrhosis and increase survival times of patients who have bled from varices. However, statins can be hepatotoxic. It is important to determine whether long-term statin use will be beneficial or detrimental for patients with cirrhosis because physicians are reluctant to prescribe statins to patients with liver disease. We investigated the effects of statins on decompensation and survival times in patients with compensated cirrhosis...
February 2016: Gastroenterology
M D Stillman, C E Aston, M H Rabadi
STUDY DESIGN: An observational study based on retrospective review of the medical charts and death records of 163 individuals with traumatic spinal cord injuries (SCI). OBJECTIVES: To determine whether HMG coA Reductase Inhibitor ('statin') use in a cohort of patients with traumatic SCI reduced overall and cause-specific mortality. SETTING: An outpatient clinic designated for veterans with SCI at the Oklahoma City Veterans Administration Hospital...
April 2016: Spinal Cord
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