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https://www.readbyqxmd.com/read/28644091/prevention-of-cardiovascular-disease-in-patients-with-familial-hypercholesterolaemia-the-role-of-pcsk9-inhibitors
#1
Ivan Pećin, Merel L Hartgers, G Kees Hovingh, Ricardo Dent, Željko Reiner
Familial hypercholesterolaemia is an autosomal dominant inherited disorder characterised by elevated low-density lipoprotein cholesterol levels and consequently an increased risk of atherosclerotic cardiovascular disease (ASCVD). Familial hypercholesterolaemia is relatively common, but is often underdiagnosed and undertreated. Cardiologists are likely to encounter many individuals with familial hypercholesterolaemia; however, patients presenting with premature ASCVD are rarely screened for familial hypercholesterolaemia and fasting lipid levels are infrequently documented...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28626106/-seedi-basic-strategies-for-the-primary-and-secondary-prevention-of-atherosclerotic-cardiovascular-disease
#2
Chunsong Hu
ABCDE strategy, mainly based on drugs or medications and the lifestyle modification (named as "main medical strategy"), is popular in the guideline for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in China and foreign countries. Here, the author recommends a non-invasive and non-pharmacologic "Zhongzi" rule, which includes 4 healthy elements: Sleep, emotion, exercise, and diet (SEED), and also called SEED intervention (SEEDi) strategy. It is the basic strategy for primary and secondary prevention of non-infectious diseases, especially for ASCVD...
May 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28600400/association-between-modifiable-risk-factors-and-pharmaceutical-expenditures-among-adults-with-atherosclerotic-cardiovascular-disease-in-the-united-states-2012-2013-medical-expenditures-panel%C3%A2-survey
#3
Joseph A Salami, Javier Valero-Elizondo, Oluseye Ogunmoroti, Erica S Spatz, Jamal S Rana, Salim S Virani, Ron Blankstein, Adnan Younus, Alejandro Arrieta, Michael J Blaha, Emir Veledar, Khurram Nasir
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) causes most deaths in the United States and accounts for the highest healthcare spending. The association between the modifiable risk factors (MRFs) of ASCVD and pharmaceutical expenditures are largely unknown. METHODS AND RESULTS: We examined the association between MRFs and pharmaceutical expenditures among adults with ASCVD using the 2012 and 2013 Medical Expenditure Panel Survey. A 2-part model was used while accounting for the survey's complex design to obtain nationally representative results...
June 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28550993/barriers-to-pcsk9-inhibitor-prescriptions-for-patients-with-high-cardiovascular-risk-results-of-a-healthcare-provider-survey-conducted-by-the-national-lipid-association
#4
Jerome D Cohen, Mark J Cziraky, Terry A Jacobson, Kevin C Maki, Dean G Karalis
BACKGROUND: Statin therapy is recommended for reducing atherosclerotic cardiovascular disease (ASCVD) risk. Significant risk can remain because of insufficient clinical response or statin intolerance. Proprotein convertase subtilisin/kexin type-9 (PCSK9) therapy lowers low-density lipoprotein cholesterol and has recently been shown to lower ASCVD events. OBJECTIVE: The aim of the study was to assess the barriers and challenges experienced with the access and approval reimbursement process for PCSK9 inhibitor prescriptions...
May 23, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28465771/clinical-characteristics-and-unmet-need-among-patients-with-atherosclerotic-cardiovascular-disease-stratified-by-statin-use
#5
Qing Huang, Michael Grabner, Robert J Sanchez, Vincent J Willey, Mark J Cziraky, Swetha R Palli, Thomas P Power
BACKGROUND: The American College of Cardiology (ACC)/American Heart Association (AHA) 2013 guidelines for blood cholesterol treatment recommend high-intensity statins for adults with atherosclerotic cardiovascular disease (ASCVD). Currently, little is known about the real-world patient characteristics of ASCVD, as well as the clinical and economic consequences of different treatment options for this disease. OBJECTIVES: To compare the demographic, clinical, and economic characteristics of patients with clinical ASCVD who started therapy with high-intensity statins, low-/moderate-intensity statins, or no statins in usual-care settings based on data primarily before the release of the ACC/AHA 2013 guidelines...
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28465286/estimation-of-eligibility-for-pcsk9-inhibitors-and-associated-costs-based-on-the-fourier-trial-insights-from-the-department-of-veterans-affairs
#6
Salim S Virani, Julia M Akeroyd, Vijay Nambi, Paul A Heidenreich, Pamela B Morris, Khurram Nasir, Erin D Michos, Vera A Bittner, Laura A Petersen, Christie M Ballantyne
In the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial,1 treatment with evolocumab resulted in a 15% relative (1.5% absolute) risk reduction of major cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD) at a median follow-up of 2.2 years. This trial included patients with LDL-C≥70mg/dL or non-HDL-C ≥100mg/dL on at least moderate-intensity statins. It is not known what proportion of ASCVD patients would qualify for evolocumab based on FOURIER entry criteria and how eligibility would change if maximal doses of evidence-based lipid lowering therapies were required...
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#7
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
https://www.readbyqxmd.com/read/28398496/underestimation-of-low-density-lipoprotein-cholesterol-with-the-friedewald-equation-versus-a-direct-homogenous-low-density-lipoprotein-cholesterol-assay
#8
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
https://www.readbyqxmd.com/read/28263370/fixed-dose-combination-therapy-for-the-prevention-of-atherosclerotic-cardiovascular-diseases
#9
REVIEW
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
https://www.readbyqxmd.com/read/28119384/assessing-potential-population-impact-of-statin-treatment-for-primary-prevention-of-atherosclerotic-cardiovascular-diseases-in-the-usa-population-based-modelling-study
#10
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
https://www.readbyqxmd.com/read/28097904/estimated-burden-of-cardiovascular-disease-and-value-based-price-range-for-evolocumab-in-a-high-risk-secondary-prevention-population-in-the-us-payer-context
#11
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
https://www.readbyqxmd.com/read/27908345/determining-when-to-add-nonstatin-therapy-a-quantitative-approach
#12
REVIEW
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
https://www.readbyqxmd.com/read/27904029/coronary-artery-calcium-and-carotid-artery-intima-media-thickness-and-plaque-clinical-use-in-need-of-clarification
#13
REVIEW
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
https://www.readbyqxmd.com/read/27846641/prevalence-and-prognostic-implications-of-coronary-artery-calcification-in-low-risk-women-a-meta-analysis
#14
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
https://www.readbyqxmd.com/read/27605323/pharmacist-prescribing-practices-in-a-clinical-pharmacy-cardiac-risk-service
#15
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
https://www.readbyqxmd.com/read/27538393/pharmacoeconomics-of-pcsk9-inhibitors-in-103-hypercholesterolemic-patients-referred-for-diagnosis-and-treatment-to-a-cholesterol-treatment-center
#16
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
https://www.readbyqxmd.com/read/27533159/cost-effectiveness-of-pcsk9-inhibitor-therapy-in-patients-with-heterozygous-familial-hypercholesterolemia-or-atherosclerotic-cardiovascular-disease
#17
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
https://www.readbyqxmd.com/read/27222044/comparison-of-statin-eligibility-according-to-the-adult-treatment-panel-iii-acc-aha-blood-cholesterol-guideline-and-presence-of-carotid-plaque-by-ultrasound-in-mexican-mestizo-patients-with-rheumatoid-arthritis
#18
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
https://www.readbyqxmd.com/read/27199287/progress-in-the-care-of-common-inherited-atherogenic-disorders-of-apolipoprotein-b-metabolism
#19
REVIEW
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
https://www.readbyqxmd.com/read/27102021/comparison-of-nonblood-based-and-blood-based-total-cv-risk-scores-in-global-populations
#20
COMPARATIVE STUDY
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
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