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Cost ascvd

Brittany A Todd, Donald G Lamprecht, Sheila L Stadler
PURPOSE: Prescribing practices within a clinical pharmacy cardiac risk service (CPCRS) and their impact on treatment outcomes in patients with atherosclerotic cardiovascular disease (ASCVD) are described. SUMMARY: National healthcare reforms have increased the population of insured patients and placed increased demands on physicians and other providers. Pharmacists are well trained and positioned to aid in patient care by providing expertise in medication management and patient safety that can result in pharmacotherapy optimization and cost savings...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
Parth Shah, Charles J Glueck, Vybhav Jetty, Naila Goldenberg, Matan Rothschild, Rashid Riaz, Gregory Duhon, Ping Wang
BACKGROUND: PCSK9 inhibitor therapy has been approved by the FDA as an adjunct to diet-maximal tolerated cholesterol lowering drug therapy for adults with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease (ASCVD) with suboptimal LDL cholesterol (LDLC) lowering despite maximal diet-drug therapy. With an estimated ~24million of US hypercholesterolemic patients potentially eligible for PCSK9 inhibitors, costing ~ $14,300/patient/year, it is important to assess health-care savings arising from PCSK9 inhibitors vs ASCVD cost...
2016: Lipids in Health and Disease
Dhruv S Kazi, Andrew E Moran, Pamela G Coxson, Joanne Penko, Daniel A Ollendorf, Steven D Pearson, Jeffrey A Tice, David Guzman, Kirsten Bibbins-Domingo
IMPORTANCE: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were recently approved for lowering low-density lipoprotein cholesterol in heterozygous familial hypercholesterolemia (FH) or atherosclerotic cardiovascular disease (ASCVD) and have potential for broad ASCVD prevention. Their long-term cost-effectiveness and effect on total health care spending are uncertain. OBJECTIVE: To estimate the cost-effectiveness of PCSK9 inhibitors and their potential effect on US health care spending...
August 16, 2016: JAMA: the Journal of the American Medical Association
Dionicio A Galarza-Delgado, Jose R Azpiri-Lopez, Iris J Colunga-Pedraza, Jesus A Cardenas-de la Garza, Raymundo Vera-Pineda, Judith I Garcia-Colunga, Rosa I Arvizu-Rivera, Adrian Martinez-Moreno, Jesus Z Villarreal-Perez, Guillermo Elizondo-Riojas, Mario A Garza Elizondo
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in rheumatoid arthritis (RA) patients. Guidelines of the American College of Cardiology and the American Heart Association (ACC/AHA) 2013 and the Adult Treatment Panel III (ATP-III) differ in their strategies to recommend initiation of statin therapy. The presence of carotid plaque (CP) by carotid ultrasound is an indication to begin statin therapy. We aimed to compare the recommendation to initiate statin therapy according to the ACC/AHA 2013 guidelines, ATP-III guidelines, and CP by carotid ultrasound...
May 25, 2016: Clinical Rheumatology
Katrina L Ellis, Amanda J Hooper, John R Burnett, Gerald F Watts
Familial hypercholesterolaemia, familial combined hyperlipidaemia (FCH) and elevated lipoprotein(a) are common, inherited disorders of apolipoprotein B metabolism that markedly accelerate the onset of atherosclerotic cardiovascular disease (ASCVD). These disorders are frequently encountered in clinical lipidology and need to be accurately identified and treated in both index patients and their family members, to prevent the development of premature ASCVD. The optimal screening strategies depend on the patterns of heritability for each condition...
August 2016: Nature Reviews. Endocrinology
Thomas A Gaziano, Shafika Abrahams-Gessel, Sartaj Alam, Dewan Alam, Mohammed Ali, Gerald Bloomfield, Rodrigo M Carrillo-Larco, Prabhakaran Dorairaj, Laura Gutierrez, Vilma Irazola, Naomi S Levitt, J Jaime Miranda, Antonio Bernabe-Ortiz, Ankur Pandya, Adolfo Rubinstein, Krisela Steyn, Denis Xavier, Lijing L Yan
BACKGROUND: Cost-effective primary prevention of cardiovascular disease (CVD) in low- and middle-income countries requires accurate risk assessment. Laboratory-based risk tools currently used in high-income countries are relatively expensive and impractical in many settings due to lack of facilities. OBJECTIVES: This study sought to assess the correlation between a non-laboratory-based risk tool and 4 commonly used, laboratory-based risk scores in 7 countries representing nearly one-half of the world's population...
March 2016: Global Heart
Shravanthi R Gandra, Guillermo Villa, Gregg C Fonarow, Mickael Lothgren, Peter Lindgren, Ransi Somaratne, Ben van Hout
Randomized trials have shown marked reductions in low-density lipoprotein cholesterol (LDL-C), a risk factor for cardiovascular disease (CVD), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC) vs SOC alone is cost-effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) or atherosclerotic CVD (ASCVD) with or without statin intolerance and LDL-C >100 mg/dL. Using a Markov cohort state transition model, primary and recurrent CVD event rates were predicted considering population-specific trial-based mean risk factors and calibrated against observed rates in the real world...
June 2016: Clinical Cardiology
Santosh Kumar Sinha, Ramesh Thakur, Mukesh Jitendra Jha, Amit Goel, Varun Kumar, Ashutosh Kumar, Vikas Mishra, Chandra Mohan Varma, Vinay Krishna, Avinash Kumar Singh, Mohit Sachan
BACKGROUND: Obesity is an important risk factor for atherosclerotic cardiovascular disease (ASCVD). Estimation of visceral adipose tissue is important and several methods are available as its surrogate. Although correlation of epicardial adipose tissue (EAT) with visceral adipose tissue as estimated by magnetic resonance imaging (MRI) and/or CT is excellent, it is costlier and cumbersome. EAT can be accurately measured by two-dimensional (2D) echocardiography. It tends to be higher in patients with acute coronary syndrome than in subjects without coronary artery disease (CAD) and in those with stable angina...
May 2016: Journal of Clinical Medicine Research
Keith L Davis, Juliana Meyers, Zhenxiang Zhao, Patrick L McCollam, Masahiro Murakami
AIM: To assess the prevalence of high-risk atherosclerotic cardiovascular disease (ASCVD, defined as history of acute coronary syndrome [hACS], cerebrovascular atherosclerotic disease [CeVAD], peripheral artery disease [PAD], or coronary artery disease w/diabetes [CADD]) and associated costs and cardiovascular (CV) events in Japan. METHODS: A retrospective analysis was conducted using the Japan Medical Data Center (JMDC) database (2006-2011). ASCVD prevalence was estimated on the basis of diagnoses for CeVAD, PAD, CADD, and hACS (ACS claim > 30-≤ 365 days after ACS-related hospitalization) during 1/1/ 2008-12/31/2009...
2015: Journal of Atherosclerosis and Thrombosis
Jing Fang, Mary G George, Yuling Hong, Fleetwood Loustalot
The effectiveness of regular aspirin therapy in reducing risk (secondary prevention) for myocardial infarction, ischemic stroke, and fatal coronary events among persons with preexisting atherosclerotic cardiovascular disease (ASCVD) is well established and recommended in current guidelines. Reported use of aspirin or other antiplatelet agents for secondary ASCVD prevention has varied widely across settings and data collection methods, from 54% of outpatient visits for those with ischemic vascular disease to 98% at the time of discharge for acute coronary syndrome...
July 17, 2015: MMWR. Morbidity and Mortality Weekly Report
Ankur Pandya, Stephen Sy, Sylvia Cho, Milton C Weinstein, Thomas A Gaziano
IMPORTANCE: The American College of Cardiology and the American Heart Association (ACC/AHA) cholesterol treatment guidelines have wide-scale implications for treating adults without history of atherosclerotic cardiovascular disease (ASCVD) with statins. OBJECTIVE: To estimate the cost-effectiveness of various 10-year ASCVD risk thresholds that could be used in the ACC/AHA cholesterol treatment guidelines. DESIGN, SETTING, AND PARTICIPANTS: Microsimulation model, including lifetime time horizon, US societal perspective, 3% discount rate for costs, and health outcomes...
July 14, 2015: JAMA: the Journal of the American Medical Association
Smriti Saraf, Kausik K Ray
PURPOSE OF REVIEW: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality in most countries. Modification of common risk factors such as dyslipidaemia can result in significant reduction of ASCVD incidence in the population and improve clinical outcomes. The purpose of this review is to discuss and compare the latest worldwide lipid guidelines, and to demonstrate the variation in practice in different parts of the world. RECENT FINDINGS: The lipid guidelines have recently been updated in different countries...
July 2015: Current Opinion in Cardiology
Peter Alagona, Tariq Ali Ahmad
Even after decades of progress in understanding atherosclerotic cardiovascular disease (ASCVD) and improved cardiovascular event prevention, the incidence, consequences and cost of cardiovascular disease (CVD) remain a significant public health issue. Observational studies have identified major ASCVD risk factors and lead to the development of a number of risk assessment systems/scores now in use. However many patients who will develop clinically important CVD are not identified by current systems or approaches and significant numbers of recurrent cardiovascular events continue to occur even after aggressive secondary prevention treatment strategies are utilized...
July 2015: Medical Clinics of North America
Dhaval Desai, Haitham M Ahmed, Erin D Michos
Diabetics are at high risk for atherosclerotic cardiovascular disease (ASCVD) and are considered a coronary heart disease risk equivalent. The utility of aspirin in primary prevention of ASCVD in diabetic patients has been widely studied and is still debated. Overall, the current evidence suggests a modest benefit for reduction in ASCVD events with the greatest benefit among those with higher baseline risk, but at the cost of increased risk of gastrointestinal bleeding. Diabetic patients at higher risk (with 10-year ASCVD risk >10 %) are generally recommended for aspirin therapy if bleeding risk is felt to be low...
March 2015: Current Cardiology Reports
Pratik B Sandesara, Cameron T Lambert, Neil F Gordon, Gerald F Fletcher, Barry A Franklin, Nanette K Wenger, Laurence Sperling
Atherosclerotic cardiovascular disease (ASCVD) continues to increase annually in the United States along with its associated enormous costs. A multidisciplinary cardiac rehabilitation (CR) and risk reduction program is an essential component of ASCVD prevention and management. Despite the strong evidence for CR in the secondary prevention of ASCVD, it remains vastly underutilized due to significant barriers. The current model of CR delivery is unsustainable and needs significant improvement to provide cost-effective, patient-centered, comprehensive secondary ASCVD prevention...
February 3, 2015: Journal of the American College of Cardiology
Jennifer G Robinson
The 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults was based on a systematic review of randomized trials with atherosclerotic cardiovascular disease (ASCVD) outcomes and meta-analyses of these trials published through 2011. With evidence of an ASCVD risk reduction benefit greatly outweighing the potential for adverse effects, the guideline recommends statin therapy for primary prevention in those with ≥7...
November 1, 2014: American Journal of Cardiology
S M Grundy
The metabolic syndrome is a constellation of metabolic risk factors for atherosclerotic cardiovascular disease (ASCVD) occurring in one individual. There are five cardiovascular risk factors that accompany the metabolic syndrome: atherogenic dyslipidemia [elevated apolipoprotein B (apo B), elevated triglyceride, small low-density lipoprotein (LDL) particles, and low high-density lipoprotein (HDL)cholesterol], elevated blood pressure, elevated glucose, a prothrombotic state, and a proinflammatory state. The likelihood of an individual developing metabolic syndrome is enhance by underlying risk factors, notably, obesity, insulin resistance, lack of physical activity, advancing age, and hormonal factors (e...
2005: Handbook of Experimental Pharmacology
G F Lewis
Patients with diabetes mellitus have a two- to fourfold increase in clinical manifestations of atherosclerotic cardiovascular disease (ASCVD). Traditional risk factors such as age, hypertension, left ventricular hypertrophy, hyperlipidemia and smoking are still operative in diabetes but do not account for the total increase in ASCVD risk associated with diabetes. The most common lipid abnormalities in noninsulin-dependent diabetes mellitus and poorly controlled insulin-dependent diabetes mellitus are hypertriglyceridemia and low high density lipoprotein cholesterol...
May 1995: Canadian Journal of Cardiology
C K Lardinois, S L Neuman
Hypertension is a major risk factor for arteriosclerotic vascular disease. Despite intensive antihypertensive intervention, the risk of cardiovascular disease has not declined appreciably. Many of the antihypertensive agents have been shown to elevate total serum cholesterol and triglyceride levels or lower the high-density lipoprotein-cholesterol level. Thus, the antihypertensive agents chosen may negate the beneficial effects of a lower blood pressure. Our purpose is to review all available antihypertensive medications and their influence on lipoprotein metabolism...
June 1988: Archives of Internal Medicine
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