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Michael D Miedema, Zeina A Dardari, Sina Kianoush, Salim S Virani, Joseph Yeboah, Thomas Knickelbine, Veit Sandfort, Carlos J Rodriguez, Khurram Nasir, Michael J Blaha
BACKGROUND: The potential impact of the 2016 United States Preventive Services Task Force (USPSTF) guidelines on statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) warrants further analysis. METHODS AND RESULTS: We studied participants from MESA (Multi-Ethnic Study of Atherosclerosis) aged 40 to 75 years and not on statins. We compared statin eligibility at baseline (2000-2002) and over follow-up between USPSTF and the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines...
June 13, 2018: Journal of the American Heart Association
Stephen D Wiviott, Itamar Raz, Marc P Bonaca, Ofri Mosenzon, Eri T Kato, Avivit Cahn, Michael G Silverman, Sameer Bansilal, Deepak L Bhatt, Lawrence A Leiter, Darren K McGuire, John Ph Wilding, Ingrid Am Gause-Nilsson, Anna Maria Langkilde, Peter A Johansson, Marc S Sabatine
BACKGROUND: Dapagliflozin is a sodium-glucose co-transporter-2 (SGLT-2) inhibitor that reduces blood glucose in patients with type 2 diabetes mellitus (T2DM) by promoting glycosuria via inhibiting urinary glucose reabsorption. In addition to improving blood glucose control, treatment with dapagliflozin results in glucose-induced osmotic diuresis, weight loss, and blood pressure lowering. Previous trials of SGLT-2 inhibitors showed reductions in cardiovascular (CV) events, including CV death and hospitalization for heart failure, and ischemic events in patients with atherosclerotic cardiovascular disease (ASCVD)...
June 2018: American Heart Journal
Angela Lowenstern, Shuang Li, Ann Marie Navar, Salim Virani, L Veronica Lee, Michael J Louie, Eric D Peterson, Tracy Y Wang
BACKGROUND: The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline recommends statin treatment based on patients' predicted atherosclerotic cardiovascular disease (ASCVD) risk. Whether clinician-reported guideline adoption translates to implementation into practice is unknown. OBJECTIVES: We aimed to compare clinician lipid management in hypothetical scenarios versus observed practice. METHODS: The PALM Registry asked 774 clinicians how they would treat 4 hypothetical scenarios of primary prevention patients with: (1) diabetes; (2) high 10-year ASCVD risk (≥7...
June 2018: American Heart Journal
Iqbal Fahs, Souheil Hallit, Mohamad Rahal, Diana Malaeb
<br>To assess the role of pharmacist in modifying CVDs risk factors among Lebanese adults in urban and rural areas. <br> Materials (Subjects) and Methods<br>In a prospective survey, 865 out of 1000 participants aged ≥ 45, previously interviewed, agreed to be followed at 1 and 2 year time points. Parameters including blood pressure, lipid profile, blood glucose, average number of risk factors, and atherosclerotic cardiovascular disease (ASCVD) risk were assessed and evaluated at the beginning of the study, then after 1 and 2 years...
June 13, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Neeraj Ramakrishanan, Travis Denna, Sridevi Devaraj, Beverley Adams-Huet, Ishwarlal Jialal
BACKGROUND: Metabolic Syndrome (MetS) is a cardio-metabolic cluster that confers an increased risk of developing both diabetes and atherosclerotic cardiovascular disease (ASCVD). The mechanisms governing the increased ASCVD risk remains to be elucidated. Moreover, lipidomics poses as an exciting new tool that has potential to shed more light on the pathogenesis of MetS. OBJECTIVE: The aim of this study was to explore the lipidome in an unbiased fashion in patients with nascent MetS uncomplicated by diabetes and CVD...
May 25, 2018: Journal of Diabetes and its Complications
Anish Vani, James A Underberg
Atherosclerotic cardiovascular disease (ASCVD) is the number one cause of morbidity and mortality worldwide. Low-density lipoprotein cholesterol (LDL-C) has been implicated as one of the major risk factors causing ASCVD based on multiple hierarchical levels of evidence. The advent of powerful LDL-C lowering therapies, such as the proprotein convertase subtilisin/kexin type 9 inhibitor, have raised the question of how low to target LDL-C and whether there are any adverse safety events associated with a very low LDL-C level...
June 8, 2018: Clinical Pharmacology and Therapeutics
Anthony J Viera
Hypertension affects at least 1 in 3 American adults and is a major contributor to premature mortality. Current guidelines recommend screening all adults for hypertension. Ambulatory blood pressure (BP) monitoring should be used to confirm the diagnosis of hypertension for most adults before starting antihypertensive drugs. Ambulatory BP monitoring is the preferred method but home BP monitoring is an acceptable alternative. Management of hypertension substantially reduces the risk of heart failure, stroke, and myocardial infarction...
June 2018: FP Essentials
Richard D Sontheimer
It is now widely accepted that long-term aminoquinoline antimalarial therapy with hydroxychloroquine (HCQ) can mitigate one of the most important comorbidities of systemic lupus erythematosus (LE)-atherosclerotic cardiovascular disease (ASCVD). Increasing evidence suggests that idiopathic inflammatory myopathy (IIM) patients have a risk for ASCVD comorbidity that is similar to that of systemic LE. I would like to explore the primary hypothesis that long-term HCQ therapy could provide those with IIM, especially dermatomyositis (DM) patients, an ASCVD comorbidity benefit similar to that of systemic LE...
April 2018: Annals of Translational Medicine
Ying Wang, Ze-Min Kuang, Shu-Jun Feng, Long Jiang, Qiu-Xian Chen, Xiao-Yun Ji, Wen-Li Cheng, Hong-Juan Hu
INTRODUCTION: High blood pressure (BP) affects over 40% of adults over the age of 25 worldwide and is the leading global risk factor for death or disability. Hypertension is also the most important risk factor for endovascular atherosclerosis, which, when combined with other cardiovascular risk factors, leads to atherosclerotic cardiovascular disease (ASCVD). Statins are one of the most widely used drugs for the prevention of ASCVD. The recently announced study of Heart Outcomes Prevention Evaluation-3 suggests that cholesterol-lowering agents combined with antihypertensive therapy can prevent cardiovascular events and reduce the combined endpoint...
May 31, 2018: BMJ Open
Brian T Palmisano, Lin Zhu, Robert H Eckel, John M Stafford
BACKGROUND: Endogenous sex hormones are important for metabolic health in men and women. Before menopause, women are protected from atherosclerotic cardiovascular disease (ASCVD) relative to men. Women have fewer cardiovascular complications of obesity compared to men with obesity. Endogenous estrogens have been proposed as a mechanism that lessens ASCVD risk, as risk of glucose and lipid abnormalities increases when endogenous estrogens decline with menopause. While baseline risk is higher in males than females, endogenously produced androgens are also protective against fatty liver, diabetes and ASCVD, as risk goes up with androgen deprivation and with the decline in androgens with age...
May 16, 2018: Molecular Metabolism
Yuchao Wu, Lizhi Tang, Fang Zhang, Zhe Yan, Jing Li, Nanwei Tong
Background: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of death among patients with diabetes but can be improved by certain hypoglycemic agents. However, adjudicating criteria on whether improvements are a glycemic or nonglycemic effect of these agents remain unclear. Methods: Hypoglycemic agents that produce a cardiovascular benefit in nondiabetic patients are considered to do so via a nonglycemic effect. We performed a subgroup analysis for primary and secondary prevention or very high risk of ASCVD in patients with type 2 diabetes (T2DM)...
2018: International Journal of Endocrinology
Donald G Lamprecht, Paul B Shaw, Jordan B King, Keri N Hogan, Kari L Olson
BACKGROUND: Although high-intensity statin therapy (HIST) is recommended for most patients between 21 and 75 years of age with atherosclerotic cardiovascular disease (ASCVD), several recent analyses examining contemporary statin use trends have identified a clinical care gap in the utilization of HIST. OBJECTIVE: The objective of this study was to assess secular trends in lipid management for patients with ASCVD enrolled in a clinical pharmacy program within an integrated health care delivery system...
April 26, 2018: Journal of Clinical Lipidology
Om P Ganda, Jorge Plutzky, Santosh K Sanganalmath, Maja Bujas-Bobanovic, Andrew Koren, Jonas Mandel, Alexia Letierce, Lawrence A Leiter
AIMS: Individuals with both diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD) are at very high risk of cardiovascular events. This post-hoc analysis evaluated efficacy and safety of the PCSK9 inhibitor alirocumab among 984 individuals with DM and ASCVD pooled from 9 ODYSSEY Phase 3 trials. MATERIALS AND METHODS: Changes in low-density lipoprotein cholesterol (LDL-C) and other lipids from baseline to Week 24 were analysed (intention-to-treat) in 4 pools by alirocumab dosage (150 mg every 2 weeks [150] or 75 mg with possible increase to 150 mg every 2 weeks [75/150]), control (placebo/ezetimibe) and background statin usage (yes/no)...
May 26, 2018: Diabetes, Obesity & Metabolism
Sara Lee, Christopher P Cannon
PURPOSE OF REVIEW: There has been confusion following the 2013 American College of Cardiology/American Heart Association (ACC/AHA) Lipid guidelines on the role of non-statin medications for cardiovascular prevention. RECENT FINDINGS: Several recent large trials have also now shown that lowering LDL with non-statins reduces cardiovascular events. In ASCVD patients on statins, adding ezetimibe or a PCSK9 inhibitor led to reductions in CV events in the IMPROVE IT, FOURIER, and most recently the ODYSSEY-OUTCOMES trials...
May 25, 2018: Current Cardiology Reports
Annabelle Santos Volgman, Latha S Palaniappan, Neelum T Aggarwal, Milan Gupta, Abha Khandelwal, Aruna V Krishnan, Judith H Lichtman, Laxmi S Mehta, Hena N Patel, Kevin S Shah, Svati H Shah, Karol E Watson
South Asians (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) make up one quarter of the world's population and are one of the fastest-growing ethnic groups in the United States. Although native South Asians share genetic and cultural risk factors with South Asians abroad, South Asians in the United States can differ in socioeconomic status, education, healthcare behaviors, attitudes, and health insurance, which can affect their risk and the treatment and outcomes of atherosclerotic cardiovascular disease (ASCVD)...
May 24, 2018: Circulation
Johann Auer, Robert Berent
Atherosclerotic cardiovascular diseases (ASCVDs) are associated with a substantial mortality, physical morbidity, and mental disability. Elevated plasma low-density lipoprotein cholesterol (LDL-C) levels play a major role in the pathophysiology of ASCVDs. Statins have been shown to reduce ASCVD risk and associated events and are recommended as first-line therapy for treatment of hypercholesterolemia by current international guidelines. The key issue is to attain guideline-recommended LDL-C levels (below 70 mg/dl) for patients at very high cardiovascular risk...
May 1, 2018: Therapeutic Advances in Cardiovascular Disease
Mun Hee Kim, Young Sang Kim, Hye Jin Oh, Yu Ri Kwon, Hye Won Kim
BACKGROUND: We examined the relationship between 10-year predicted atherosclerosis cardiovascular disease (ASCVD) risk score and 25-hydroxyvitamin D in Koreans aged 40-79 years. METHODS: A population-based, cross-sectional design was used from data based on the Korea National Health and Nutrition Examination Survey 2014. RESULTS: A total of 1,134 healthy Koreans aged 40-79 years were included. A positive relationship between serum 25-hydroxyvitamin D level and ASCVD score was shown in women (β=0...
May 2018: Korean Journal of Family Medicine
Rabia Nabi, Sahir Sultan Alvi, Rizwan Khan, Shafeeque Ahmad, Saheem Ahmad, M Salman Khan
Non-enzymatic glycation mediated advanced glycation end products (AGEs) generation results in the pathogenesis of diabetic complications and atherosclerotic cardiovascular disease (ASCVD) which is greatly influenced by 3-hydroxy-3-methyl-glutaryl Co-A reductase (HMG-R) activity. HMG-R inhibitors, statins, are well known for reducing mortality and morbidity of ASCVD in patients with diabetes due to their pleiotropic effects independent of cholesterol lowering. Due to distinct chemical structures, various statins may play important role in the inhibition of AGEs mediated pathologies...
May 18, 2018: International Journal of Biological Macromolecules
Yiting Xu, Xiaojing Ma, Qin Xiong, Xueli Zhang, Yun Shen, Yuqian Bao
BACKGROUND: Our study examined whether osteocalcin contributed to identifying carotid intima-media thickness (C-IMT) over the atherosclerotic cardiovascular disease (ASCVD) risk score. METHODS: We recruited 618 middle-aged and elderly men from communities in Shanghai. Serum osteocalcin levels were determined using an electrochemiluminescence immunoassay. C-IMT was measured by ultrasonography. RESULTS: The study included 245 men with low ASCVD risk and 373 men with moderate-to-high ASCVD risk...
May 19, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Miguel Cainzos-Achirica, Michael D Miedema, John W McEvoy, Mary Cushman, Zeina Dardari, Philip Greenland, Khurram Nasir, Matthew J Budoff, Mouaz H Al-Mallah, Joseph Yeboah, Roger S Blumenthal, Josep Comin-Colet, Michael J Blaha
BACKGROUND: The prognostic value of hsCRP in contemporary multi-ethnic populations is unclear, particularly in statin users. The aim of this study was to characterize the prognostic utility of hsCRP for atherosclerotic CVD (ASCVD) risk prediction in a multi-ethnic population including non-users and users of statins followed for >13 years. Associations with heart failure (HF), atrial fibrillation (AF), venous thromboembolism (VTE), cancer, and all-cause death were also examined. METHODS AND RESULTS: We evaluated 6757 participants from the Multi-Ethnic Study of Atherosclerosis (MESA; 1002 using statins at baseline), median follow-up 13...
August 1, 2018: International Journal of Cardiology
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