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Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
Ishwarlal Jialal, Michael Inn, David Siegel, Sridevi Devaraj
Background: Low-density lipoprotein cholesterol (LDL-C) concentrations are the primary therapeutic target in patients with atherosclerotic cardiovascular disease (ASCVD). However, at low LDL-C concentrations, there is a significant underestimation using the Friedewald equation compared with ultracentrifugation. Methods: In this pilot study, we compared LDL-C concentrations obtained using the Friedewald equation (LDL-F) vs those concentrations from a direct LDL-C (LDL-D) assay in 152 consecutive specimens from patients with triglyceride levels between 200-399 mg/dL and LDL-F <100 mg/dL...
April 8, 2017: Laboratory Medicine
Ehete Bahiru, Angharad N de Cates, Matthew Rb Farr, Morag C Jarvis, Mohan Palla, Karen Rees, Shah Ebrahim, Mark D Huffman
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death and disability worldwide, yet ASCVD risk factor control and secondary prevention rates remain low. A fixed-dose combination of blood pressure- and cholesterol-lowering and antiplatelet treatments into a single pill, or polypill, has been proposed as one strategy to reduce the global burden of ASCVD. OBJECTIVES: To determine the effect of fixed-dose combination therapy on all-cause mortality, fatal and non-fatal ASCVD events, and adverse events...
March 6, 2017: Cochrane Database of Systematic Reviews
Quanhe Yang, Yuna Zhong, Cathleen Gillespie, Robert Merritt, Barbara Bowman, Mary G George, W Dana Flanders
OBJECTIVE: New cholesterol treatment guidelines from American College of Cardiology/American Heart Association recommend statin treatment for more of US population to prevent atherosclerotic cardiovascular disease (ASCVD). It is important to assess how new guidelines may affect population-level health. This study assessed the impact of statin use for primary prevention of ASCVD under the new guidelines. METHODS: We used data from 2010 US Multiple Cause Mortality, Third National Health and Nutrition Examination Survey (NHANES III) Linked Mortality File (1988-2006, n=8941) and NHANES 2005-2010 (n=3178) participants 40-75 years of age for the present study...
January 24, 2017: BMJ Open
Peter P Toth, Mark Danese, Guillermo Villa, Yi Qian, Anne Beaubrun, Armando Lira, Jeroen P Jansen
AIM: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population. MATERIALS AND METHODS: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into four cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (n = 1448), acute coronary syndrome (ACS) (n = 602), ischemic stroke (IS) (n = 151), and heart failure (HF) (n = 291) incident cohorts...
January 25, 2017: Journal of Medical Economics
Jennifer G Robinson, Roeland Huijgen, Kausik Ray, Jane Persons, John J P Kastelein, Michael J Pencina
BACKGROUND: Costs and uncertainty about the benefits of nonstatin therapies limit their use. OBJECTIVES: The authors sought to identify patients who might benefit from the addition of a nonstatin to background statin therapy. METHODS: We performed systematic reviews of subgroup analyses from randomized trials and observational studies with statin-treated participants to determine estimated 10-year absolute risk of atherosclerotic cardiovascular disease (ASCVD) and to define high-risk and very high-risk patients...
December 6, 2016: Journal of the American College of Cardiology
Maryam Zaid, Akira Fujiyoshi, Aya Kadota, Robert D Abbott, Katsuyuki Miura
Atherosclerosis begins in early life and has a long latent period prior to onset of clinical disease. Measures of subclinical atherosclerosis, therefore, may have important implications for research and clinical practice of atherosclerotic cardiovascular disease (ASCVD). In this review, we focus on coronary artery calcium (CAC) and carotid artery intima-media thickness (cIMT) and plaque as many population-based studies have investigated these measures due to their non-invasive features and ease of administration...
March 1, 2017: Journal of Atherosclerosis and Thrombosis
Maryam Kavousi, Chintan S Desai, Colby Ayers, Roger S Blumenthal, Matthew J Budoff, Amir-Abbas Mahabadi, M Arfan Ikram, Aad van der Lugt, Albert Hofman, Raimund Erbel, Amit Khera, Marie H Geisel, Karl-Heinz Jöckel, Nils Lehmann, Udo Hoffmann, Christopher J O'Donnell, Joseph M Massaro, Kiang Liu, Stefan Möhlenkamp, Hongyan Ning, Oscar H Franco, Philip Greenland
Importance: The role of coronary artery calcium (CAC) testing for guiding preventive strategies among women at low cardiovascular disease (CVD) risk based on the American College of Cardiology and American Heart Association CVD prevention guidelines is unclear. Objective: To assess the potential utility of CAC testing for CVD risk estimation and stratification among low-risk women. Design, Setting, and Participants: Women with 10-year atherosclerotic CVD (ASCVD) risk lower than 7...
November 22, 2016: JAMA: the Journal of the American Medical Association
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...
August 18, 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...
November 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
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