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https://www.readbyqxmd.com/read/28888913/the-renaissance-of-lipoprotein-a-brave-new-world-for-preventive-cardiology
#1
REVIEW
Katrina L Ellis, Michael B Boffa, Amirhossein Sahebkar, Marlys L Koschinsky, Gerald F Watts
Lipoprotein(a) [Lp(a)] is a highly heritable cardiovascular risk factor. Although discovered more than 50 years ago, Lp(a) has recently re-emerged as a major focus in the fields of lipidology and preventive cardiology owing to findings from genetic studies and the possibility of lowering elevated plasma concentrations with new antisense therapy. Data from genetic, epidemiological and clinical studies have provided compelling evidence establishing Lp(a) as a causal risk factor for atherosclerotic cardiovascular disease...
September 6, 2017: Progress in Lipid Research
https://www.readbyqxmd.com/read/28866767/the-parthenon-clinical-development-program-the-role-of-ticagrelor-in-patients-with-atherothrombotic-disease
#2
REVIEW
Paul P Dobesh, Manesh Patel
Although the rate of cardiovascular disease (CVD)-related mortality has declined over the last decade, it is still the leading cause of mortality in the USA, accounting for over 1.4 million deaths annually. In addition, total direct (primarily hospital admissions) and indirect costs of CVD in the US is over $316 billion annually and is expected to grow to over $918 billion by 2030. Much of the etiology of CVD is due to atherosclerosis and its thrombotic complications, and central to this is the role of platelets...
September 2, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28832867/cost-effectiveness-of-evolocumab-therapy-for-reducing-cardiovascular-events-in-patients-with-atherosclerotic-cardiovascular-disease
#3
Gregg C Fonarow, Anthony C Keech, Terje R Pedersen, Robert P Giugliano, Peter S Sever, Peter Lindgren, Ben van Hout, Guillermo Villa, Yi Qian, Ransi Somaratne, Marc S Sabatine
Importance: The proprotein convertase subtilisin/kexin type 9 inhibitor evolocumab has been demonstrated to reduce the composite of myocardial infarction, stroke, or cardiovascular death in patients with established atherosclerotic cardiovascular disease. To our knowledge, long-term cost-effectiveness of this therapy has not been evaluated using clinical trial efficacy data. Objective: To evaluate the cost-effectiveness of evolocumab in patients with atherosclerotic cardiovascular disease when added to standard background therapy...
August 23, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28831261/real-world-use-of-pcsk-9-inhibitors-by-early-adopters-cardiovascular-risk-factors-statin-co-treatment-and-short-term-adherence-in-routine-clinical-practice
#4
Kathleen A Fairman, Lindsay E Davis, David A Sclar
BACKGROUND: Inconsistency of real-world medication use with labeled indications may affect cost and clinical value of pharmacotherapy. PCSK-9 inhibitors are labeled in the US for use with statins to reduce low-density lipoprotein cholesterol in patients with atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH). OBJECTIVE: To assess consistency with labeled indications and treatment persistency for early (first 5 post-launch months) adopters of PCSK-9 inhibitor pharmacotherapy...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28814290/predicted-impact-of-lipid-lowering-therapy-on-cardiovascular-and-economic-outcomes-of-swedish-atherosclerotic-cardiovascular-disease-guideline
#5
Gunilla Journath, Kristina Hambraeus, Emil Hagström, Billie Pettersson, Mickael Löthgren
BACKGROUND: The effects on cardiovascular disease (CVD) by treatment recommendations on prevention of atherosclerotic CVD remain to be evaluated. The objectives were to assess treatment gap for low density lipoprotein cholesterol (LDL-C) according to guidelines, potential impact on CVD outcomes, and possible avoided economic costs, in post myocardial infarction (MI) patients, if target LDL-C levels of ≤1.8 mmol/L would be achieved. METHODS: All patients registered in the Swedish Secondary Prevention after Heart Intensive care Admission register, with one-year post-MI follow-up during 2013 were selected...
August 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28797417/implications-of-coronary-artery-calcium%C3%A2-testing-for-treatment-decisions-among-statin-candidates-according-to%C3%A2-the%C3%A2-acc-aha-cholesterol-management%C3%A2-guidelines-a-cost-effectiveness-analysis
#6
REVIEW
Jonathan C Hong, Ron Blankstein, Leslee J Shaw, William V Padula, Alejandro Arrieta, Jonathan A Fialkow, Roger S Blumenthal, Michael J Blaha, Harlan M Krumholz, Khurram Nasir
This review evaluates the cost-effectiveness of using coronary artery calcium (CAC) to guide long-term statin therapy compared with treating all patients eligible for statins according to 2013 American College of Cardiology/American Heart Association cholesterol management guidelines for atherosclerotic cardiovascular disease. The authors used a microsimulation model to compare costs and effectiveness from a societal perspective over a lifetime horizon. Both strategies resulted in similar costs and quality-adjusted life years (QALYs)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28780579/a-policy-model-of-cardiovascular-disease-in-moderate-to-advanced-chronic-kidney-disease
#7
Iryna Schlackow, Seamus Kent, William Herrington, Jonathan Emberson, Richard Haynes, Christina Reith, Christoph Wanner, Bengt Fellström, Alastair Gray, Martin J Landray, Colin Baigent, Borislava Mihaylova
OBJECTIVE: To present a long-term policy model of cardiovascular disease (CVD) in moderate-to-advanced chronic kidney disease (CKD). METHODS: A Markov model with transitions between CKD stages (3B, 4, 5, on dialysis, with kidney transplant) and cardiovascular events (major atherosclerotic events, haemorrhagic stroke, vascular death) was developed with individualised CKD and CVD risks estimated using the 5 years' follow-up data of the 9270 patients with moderate-to-severe CKD in the Study of Heart and Renal Protection (SHARP) and multivariate parametric survival analysis...
August 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28740397/eligibility-for-alirocumab-or-evolocumab-treatment-in-1090-hypercholesterolemic-patients-referred-to-a-regional-cholesterol-treatment-center-with-ldl-cholesterol-%C3%A2-70-mg-dl-despite-maximal-tolerated-ldl-cholesterol-lowering-therapy
#8
Vybhav Jetty, Charles J Glueck, Kevin Lee, Naila Goldenberg, Marloe Prince, Ashwin Kumar, Michael Goldenberg, Ishan Anand, Ping Wang
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 inhibitors, Praluent (alirocumab [ALI]) and Repatha (evolocumab [EVO]) have been approved as adjuncts to the standard-of-care maximal-tolerated dose (MTD) of low-density lipoprotein cholesterol (LDLC)-lowering therapy (LLT), statin therapy, in heterozygous (HeFH) (ALI or EVO) or homozygous (EVO) familial hypercholesterolemia, or clinical atherosclerotic cardiovascular disease (CVD) where LDLC lowering is insufficient (both). Since LDLC lowering has been revolutionized by ALI and EVO, specialty pharmaceutical pricing models will be applied to a mass market...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28736830/pcsk9-in-context-a-contemporary-review-of-an-important-biological-target-for-the-prevention-and-treatment-of-atherosclerotic-cardiovascular-disease
#9
REVIEW
Michael M Page, Gerald F Watts
Proprotein convertase subtilisin/kexin type 9 (PCSK9) and the identification of its critical role in lipoprotein metabolism has rapidly led to the development of PCSK9 inhibition with monoclonal antibodies (mAbs). PCSK9 mAbs are already in limited clinical use and are the subject of major cardiovascular outcomes trials, which if universally positive could see much wider clinical application of these agents. Patients with familial hypercholesterolaemia are the most obvious candidates for these drugs, but other patients with elevated cardiovascular risk, statin intolerance or hyperlipoproteinaemia(a) may also benefit...
July 24, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28687710/evaluating-the-impact-and-cost-effectiveness-of-statin-use-guidelines-for-primary-prevention-of-coronary-heart-disease-and-stroke
#10
David J Heller, Pamela G Coxson, Joanne Penko, Mark J Pletcher, Lee Goldman, Michelle C Odden, Dhruv S Kazi, Kirsten Bibbins-Domingo
Background -Statins are effective in primary prevention of atherosclerotic cardiovascular disease. The 2013 American College of Cardiology/American Heart Association (ACC-AHA) guideline expands recommended statin use, but its cost-effectiveness has not been compared with other guidelines. Methods -We used the Cardiovascular Disease (CVD) Policy Model to estimate the cost-effectiveness of the ACC-AHA, relative to current use, Adult Treatment Panel III (ATP III) guidelines, and universal statin use in all men age 45-74 years and women age 55-74 years over a 10-year horizon from 2016 to 2025...
July 7, 2017: Circulation
https://www.readbyqxmd.com/read/28644091/prevention-of-cardiovascular-disease-in-patients-with-familial-hypercholesterolaemia-the-role-of-pcsk9-inhibitors
#11
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...
September 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
#12
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/28617192/emerging-biologic-therapies-for-hypercholesterolaemia
#13
Giacomo Pucci, Arrigo F Cicero, Claudio Borghi, Giuseppe Schillaci
LDL-cholesterol (LDL-C) is one of the most well-established risk factors for CV disease. Indeed, therapies that decrease LDL-C are proven to effectively reduce the risk of atherosclerotic CV disease. Monoclonal antibodies (mAbs) that target proprotein convertase subtilisin/kexin type 9 (PCSK9) have recently gained traction as a promising therapeutic strategy. Areas covered: In this review, the authors discuss the effectiveness of mAbs against PCSK9 in lowering low-density lipoprotein cholesterol (LDL-C) and other atherogenic lipid fractions...
June 15, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28606343/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#14
REVIEW
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
July 1, 2017: American Journal of Cardiology
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
#15
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/28596304/pcsk9-inhibition-and-atherosclerotic-cardiovascular-disease-prevention-does-reality-match-the-hype
#16
REVIEW
Savvas Hadjiphilippou, Kausik K Ray
Within this review we look at whether the potential provided by proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition for prevention of atherosclerotic cardiovascular disease matches the excitement generated. Two fully human monoclonal antibodies to PCSK9 are currently licenced for clinical use both in the USA and the European Union: evolocumab and alirocumab. These reduce low-density lipoprotein cholesterol by over 50% across a range of populations and were generally found to have a safety profile comparable with placebo...
June 8, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28577620/statins-for-primary-prevention-of-cardiovascular-disease-review-of-evidence-and-recommendations-for-clinical-practice
#17
REVIEW
Dhruv S Kazi, Joanne M Penko, Kirsten Bibbins-Domingo
Numerous large randomized clinical trials have shown that statin therapy is effective and safe for primary prevention of atherosclerotic cardiovascular disease (CVD) for adults aged 40 to 75 years and support the use of 10-year CVD risk as a means to identify individuals for treatment. Uncertainty exists in those older than 75 years who may be more likely to benefit because of their underlying CVD risk, but also face uncertain harms. Several high-quality mathematical simulation models have shown that statin therapy is cost-effective for primary prevention of atherosclerotic CVD...
July 2017: Medical Clinics of North America
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
#18
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/28527818/predictors-associated-with-increased-prevalence-of-abdominal-aortic-aneurysm-in-chinese-patients-with-atherosclerotic-risk-factors
#19
W Li, S Luo, J Luo, Y Liu, B Ning, W Huang, L Xue, J Chen
OBJECTIVE/BACKGROUND: Epidemiological screening studies have demonstrated that the prevalence of abdominal aortic aneurysm (AAA) of Asian origin appears to be low and so increases uncertainty about the cost effectiveness of screening for AAAs in Chinese people. Some studies have demonstrated a higher prevalence of AAA in patients with atherosclerotic risk factors. The purpose of the study was to determine the prevalence of AAA and to explore the high risk group of AAA in Chinese patients with atherosclerotic risk factors...
May 17, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28526182/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#20
REVIEW
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
June 2017: American Journal of Medicine
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