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lipid lowering therapy

Hayden B Bosworth, Barbara Ngouyombo, Jan Liska, Leah L Zullig, Caroline Atlani, Anne C Beal
Lipid-lowering medications have been shown to be efficacious, but adherence is suboptimal. This is a narrative, perspective review of recently published literature in the field of medication adherence research for lipid-lowering medications. We provide an overview of the impact of suboptimal adherence and use a World Health Organization framework (patient, condition, therapy, socioeconomic, and health system-related systems) to discuss factors that influence hyperlipidemia treatment adherence. Further, the review involves an evaluation of intervention strategies to increase hyperlipidemia treatment adherence with a special focus on mHealth interventions, patient reminders on packaging labels, nurse- and pharmacist-led interventions, and health teams...
2018: Patient Preference and Adherence
Anthony S Wierzbicki, Timothy M Reynolds, Adie Viljoen
PURPOSE OF REVIEW: A number of novel trials have assessed the efficacy of new lipid-lowering therapies in cardiovascular disease (CVD). RECENT FINDINGS: Proprotein convertase subtilisin kexin-9 inhibitors reduce low-density lipoprotein cholesterol (LDL-C) by 50-55%. A CVD outcome trial in patients with acute coronary syndromes with evolocumab achieved a LDL-C of 0.8 mmol/l (31 mg/dl) and a 20% relative risk reduction in CVD events in 2.2 years. Cholesterol ester transfer protein inhibitors raise high-density lipoprotein cholesterol and can lower LDL-C...
March 19, 2018: Current Opinion in Cardiology
Robert M Stoekenbroek, John J P Kastelein
PURPOSE OF REVIEW: This review describes the pivotal role of genetic insights and technologies in the discovery of proprotein convertase subtilisin/kexin type 9 (PCSK9) and the rapid development of PCSK9 inhibitors - a revolutionary new class of lipid-lowering agents. RECENT FINDINGS: PCSK9 was discovered as a the third gene implicated in familial hypercholesterolemia. Population genetics studies, enabled by technological advances, were instrumental in validating PCSK9 as a therapeutic target...
March 20, 2018: Current Opinion in Cardiology
Karen E Elkind-Hirsch, Martha S Paterson, Donna Shaler, Hanh C Gutowski
OBJECTIVE: Our pilot study examined the effectiveness of sitagliptin-metformin (SITA-MET), metformin (MET), and placebo (P) therapy on fasting and post-glucose challenge glucose levels in postpartum women with prior gestational diabetes mellitus (GDM) and impaired glucose regulation. METHODS: Prediabetic women (N = 36, age 18 to 42 years) with recent GDM were randomized to P (one pill twice a day), MET (1,000 mg twice a day), or SITA-MET (50 mg SITA, 1,000 mg MET twice a day) for 16 weeks in a single-blind fashion...
March 21, 2018: Endocrine Practice
Laurent Yvan-Charvet, Bertrand Cariou
PURPOSE OF REVIEW: Cardiovascular diseases (CVD) are the leading cause of death worldwide with over 17 million deaths every year and represent a major public health challenge. The last decade has seen the emergence of novel antiatherogenic therapies. RECENT FINDINGS: Despite intensive lipid and blood pressure interventions, the burden of CVD is expected to markedly progress because of the global aging of the population and increasing exposure to detrimental lifestyle-related risk...
March 16, 2018: Current Opinion in Lipidology
László Márk, Mária Nagy, Győző Dani, Csaba Baranyai, Marianna Borbély, András Katona, Zoltán Jambrik
INTRODUCTION: The actual guidelines of cardiovascular prevention lay special emphasis on the lipid-lowering therapy of patients suffering from acute coronary syndrome (ACS). AIM: To evaluate the occurrence of high-intensity statin therapy, recommended by guidelines, at discharge in a Hungarian county hospital with hemodynamic laboratory in patients who underwent percutaneous intervention, furthermore the LDL-cholesterol (LDL-C) levels and goal attainment rate in the first year...
March 2018: Orvosi Hetilap
Guglielmo Maulucci, Francesco Cipriani, Dolores Russo, Grazia Casavecchia, Carlo Di Staso, Luigi Di Martino, Antonio Ruggiero, Matteo Di Biase, Natale Daniele Brunetti
BACKGROUND: The reduction of cholesterol levels with cholesterol-lowering therapy may improve endothelial function. Lipid-lowering therapy has been greatly enhanced by the introduction of proprotein convertase subtilisin/kexin type 9 (PCSK9) antibodies. Less is known of the effect of PCSK9 inhibitors on endothelial function of subjects with hypercholesterolemia. OBJECTIVE: To assess whether treatment with PCSK9 inhibitors may improve endothelial function evaluated by brachial artery vasoreactivity test...
February 14, 2018: Journal of Clinical Lipidology
George Hindy, Gunnar Engström, Susanna C Larsson, Matthew Traylor, Hugh S Markus, Olle Melander, Marju Orho-Melander
BACKGROUND AND PURPOSE: Statin therapy is associated with a lower risk of ischemic stroke supporting a causal role of low-density lipoprotein (LDL) cholesterol. However, more evidence is needed to answer the question whether LDL cholesterol plays a causal role in ischemic stroke subtypes. In addition, it is unknown whether high-density lipoprotein cholesterol and triglycerides have a causal relationship to ischemic stroke and its subtypes. Our aim was to investigate the causal role of LDL cholesterol, high-density lipoprotein cholesterol, and triglycerides in ischemic stroke and its subtypes through Mendelian randomization (MR)...
March 13, 2018: Stroke; a Journal of Cerebral Circulation
Chou-Yueh Chang, Horng-Rong Chang, Hsing-Chun Lin, Han-Hsin Chang
Objective Vegetarian diets have been shown to increase the risk of certain nutritional deficiencies, such as iron. As a number of patients with chronic kidney disease (CKD) in Taiwan are lacto-ovo vegetarians, the aim of this study was to investigate the effects of different proportions and sources of protein in lacto-ovo vegetarian and omnivorous diets, as well as the influence of adequate dietary protein intake, on renal function and nutritional status of Taiwanese patients with stage 3 to stage 5 CKD. Methods This is a cross-sectional study...
March 13, 2018: Journal of the American College of Nutrition
Elisa Covolo, Claudio Bilato
Hyperlipidemia is a major risk factor for cardiovascular morbidity and mortality. Treatment strategies include both lifestyle modification and pharmacological therapy. Statins are among the most effective agents to achieve optimal LDL-cholesterol levels, but, not infrequently, patients suffer from myalgia or other side effects. The proven or perceived intolerance to statins requires, therefore, alternative lipid-lowering strategies. In recent years, nutraceuticals have become extensively accepted, and a growing number of molecules with hypothetical cholesterol-lowering activity have been proposed, sometimes with no scientific evidence and/or no methodological accuracy, based only on the belief that these agents are "natural" and do not show side effects...
February 2018: Giornale Italiano di Cardiologia
Shuli Yang, Lihui Si, Limei Fan, Wenwen Jian, Huilin Pei, Ruixin Lin
Lycium barbarum L . (LBL) has beneficial effects on gestational diabetes mellitus (GDM) but the related mechanism remains unclear. Polysaccharides of LBL (LBLP) are the main bioactive components of LBL. miR-33, ATP-binding cassette transporter A1 (ABCA1) and sterol regulatory element-binding transcription 1 (SREBF1) affect lipid profiles, which are associated with GDM risk. LBLP may exert protective against GDM by affecting these molecules. Four LBLP fractions: LBLP-I, LBLP-II, LBLP-III, and LBLP-IV were isolated from LBL and further purified by using DEAE-Sephadex column...
2018: Frontiers in Endocrinology
Yu Kataoka
No abstract text is available yet for this article.
March 10, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Peter P Toth, Jamie P Dwyer, Christopher P Cannon, Helen M Colhoun, Daniel J Rader, Ashish Upadhyay, Michael J Louie, Andrew Koren, Alexia Letierce, Jonas Mandel, Maciej Banach
Individuals with chronic kidney disease are at increased risk of premature cardiovascular disease. Among them, many with elevated low-density lipoprotein cholesterol (LDL-C) are unable to achieve optimal LDL-C on statins and require additional lipid-lowering therapy. To study this, we compared the LDL-C-lowering efficacy and safety of alirocumab in individuals with hypercholesterolemia with impaired renal function, defined as eGFR 30-59 ml/min/1.73 m2 , to those without impaired renal function eGFR ≥60 ml/min/1...
March 8, 2018: Kidney International
Charles J Glueck, Alan Brown, Anne C Goldberg, James M McKenney, Louis Kantaros, John Stewart, Joseph Elassal, Andrew Koren
BACKGROUND: The alirocumab expanded use program provided open-label access to alirocumab before its commercial availability to patients with severe hypercholesterolemia not controlled with maximally tolerated doses of standard-of-care lipid-lowering therapy. OBJECTIVE: To describe the safety and lipid-lowering efficacy of alirocumab in high-risk patients who were likely to be early users of proprotein convertase subtilisin/kexin type 9 inhibitors after approval...
February 7, 2018: Journal of Clinical Lipidology
W Masson, M Lobo, D Siniawski, M Huerín, G Molinero, R Valéro, J P Nogueira
BACKGROUND: Cholesteryl ester transfer protein (CETP) inhibitors are a class of drugs that targets the CETP enzyme to significantly increase serum high-density lipoprotein cholesterol (HDL-C) and decrease low-density lipoprotein cholesterol (LDL-C) levels. As HDL-C has potential antidiabetic properties, and the beneficial effects of CETP drugs on glucose homoeostasis have not been sufficiently studied, the aims of this study were: (1) to evaluate the effect of CETP inhibitors on the incidence of diabetes; and (2) to assess the association between CETP inhibitor-induced changes in HDL-C levels and incidence of diabetes...
February 20, 2018: Diabetes & Metabolism
Caio Mauricio Mendes de Cordova, Ernani Tiarajú de Santa Helena, Caroline Galgowski, Vitor Holmo Figueira, Gabrielle Bortoli Setter, Marcello Ricardo Paulista Markus, Carsten Oliver Schmidt, Henry Völzke, Till Ittermann
A simple equation established by Cordova & Cordova (LDL-COR) was developed to provide an improved estimation of LDL-cholesterol in a large Brazilian laboratory database. We evaluated this new equation in a general population cohort in Pomerania, north-eastern Germany (SHIP Study) compared to other existing formulas (Anandaraja, Teerakanchana, Chen, Hattori, Martin, Friedewald and Ahmadi), and its power in the prediction of death by atherosclerosis related events as the primary outcome. Analysis was conducted on a cohort of 4075 individuals considering age, gender, use of lipid lowering therapy and associated co-morbidities such as diabetes, hepatic, kidney and thyroid disease...
March 8, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
Cori Russell, Samip Sheth, Douglas Jacoby
PURPOSE OF REVIEW: We provide an overview of our current understanding of combination lipid-lowering therapies intended for dyslipidemia treatment and cardiovascular disease prevention. First, we analyze recent statin and non-statin combination therapy guidelines and clinical studies since the publication of 2013 American College of Cardiology Cholesterol Guidelines. Second, we examine the clinical utility of non-statin agents alone and in combination in terms of LDL-C lowering and ASCVD risk reduction...
March 7, 2018: Current Atherosclerosis Reports
Barbara S Wiggins, Jeffrey Senfield, Helina Kassahun, Armando Lira, Ransi Somaratne
PURPOSE OF REVIEW: To review the efficacy, safety, pharmacology, and pharmacokinetics of evolocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor. RECENT FINDINGS: PCSK9 inhibitors are a class of lipid-lowering agents that significantly reduce low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease and hyperlipidemia. Evolocumab is a monoclonal antibody that inhibits PCSK9 and has been evaluated in phase II and III studies as monotherapy, in combination with statins and other lipid-lowering therapies, in patients who are statin intolerant, and in patients with heterozygous and homozygous familial hypercholesterolemia...
March 6, 2018: Current Atherosclerosis Reports
Runqi Wangqin, Xianwei Wang, Yilong Wang, Ying Xian, Xingquan Zhao, Liping Liu, Hao Li, Xia Meng, Yongjun Wang
Objective: Many patients receiving dual antiplatelet therapy still had recurrent strokes. We aimed to identify factors associated with recurrent stroke at 90 days in patients receiving dual antiplatelet therapy in Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events trial. Methods: Patients with transient ischaemic attack or minor stroke receiving clopidogrel and aspirin in the trial were analysed in the study. The primary outcome was recurrent stroke within 90 days after the index event...
December 2017: Stroke and Vascular Neurology
Vasanth Sathiyakumar, Jihwan Park, Renato Quispe, Mohamed B Elshazly, Erin D Michos, Maciej Banach, Peter P Toth, Seamus P Whelton, Roger S Blumenthal, Steven R Jones, Seth S Martin
Background -Selected dyslipidemia guidelines recommend non-high-density lipoprotein-cholesterol (non-HDL-C) and apolipoprotein B (apoB) as secondary targets to the primary target of low-density lipoprotein-cholesterol (LDL-C). We examined, after considering two LDL-C estimates that differ in accuracy: (1) how frequently non-HDL-C guideline targets could change management; and (2) utility of apoB targets after meeting LDL-C and non-HDL-C targets. Methods -We analyzed 2,518 adults representative of the U.S. population from the 2011-2012 National Health and Nutrition Examination Survey and 126,092 patients from the Very Large Database of Lipids study with apoB...
March 5, 2018: Circulation
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