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https://www.readbyqxmd.com/read/29777519/combination-glucose-lowering-therapy-plans-in-t2dm-case-based-considerations
#1
REVIEW
Lawrence Blonde, Susana Dipp, Daniel Cadena
Type 2 diabetes mellitus (T2DM) is a complex disease, and while lifestyle interventions remain the cornerstone of therapy, most patients will also require pharmacotherapy. Current diabetes treatment guidelines and algorithms recommend an individualized approach to setting glycemic goals and selecting treatment. Although a single antihyperglycemic agent may be appropriate as the initial T2DM pharmacotherapy, the progressive nature of the disease due to declining pancreatic β-cell function will result in the vast majority of T2DM patients eventually requiring two or more antihyperglycemic agents...
May 18, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29752194/sex-specific-relevance-of-diabetes-to-occlusive-vascular-and-other-mortality-a-collaborative-meta-analysis-of-individual-data-from-980-793-adults-from-68-prospective-studies
#2
(no author information available yet)
BACKGROUND: Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS: In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight...
May 8, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29749101/understanding-patient-adherence-and-concerns-with-statins-and-medication-discussions-with-physicians-action-a-survey-on-the-patient-perspective-of-dialogue-with-healthcare-providers-regarding-statin-therapy
#3
Eliot A Brinton
BACKGROUND: Statin therapy is used first-line for cholesterol lowering and prevention of atherosclerotic cardiovascular disease (CVD), but side effects and the potential for drug-drug interactions may complicate its use. Provider-patient communication is essential for shared decision-making, which, in turn, is recommended by guidelines to reduce or overcome these challenges. Unfortunately, relatively little is known about provider-patient communication surrounding statin use. METHOD: We conducted an online survey of 5,014 patients, U...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29731350/the-cost-effectiveness-of-pcsk9-inhibitors-the-australian-healthcare-perspective
#4
Radya Kumar, Andrew Tonkin, Danny Liew, Ella Zomer
BACKGROUND: For patients in whom statins are not tolerated or effective as monotherapy, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) represent a new class of lipid lowering therapies that may reduce low-density lipoprotein cholesterol (LDL-C) levels by up to 50% and lower cardiovascular events. While an important treatment option, the cost-effectiveness of PCSK9i in Australia remains unknown. This study aimed to determine the cost-effectiveness of PCSK9i compared to placebo in the prevention of atherosclerotic cardiovascular disease (CVD)...
April 26, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29706275/medical-apps-used-during-advanced-pharmacy-practice-experiences
#5
Krista L Donohoe, Abigale T Matulewicz, Fawaz M Alotaibi, Kelechi C Ogbonna
BACKGROUND AND PURPOSE: The purpose of this study was to determine what type of medical applications (apps) are being used by fourth-year students during advanced pharmacy practice experiences (APPEs). EDUCATIONAL ACTIVITY AND SETTING: Recent doctor of pharmacy school graduates were surveyed pertaining to their use of medical apps on APPEs, frequency of use for select apps, willingness to buy apps and at what cost, and their perceived importance on using medical apps in their pharmacy practice...
February 2018: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29700689/imaging-inflammation-in-atherosclerotic-plaques-just-make-it-easy
#6
EDITORIAL
Fabien Hyafil, Jonathan Vigne
The presence of inflammatory cells is a hallmark of unstable atherosclerotic plaques. Several imaging approaches have been developed for the noninvasive detection of inflammatory activities in atherosclerotic plaques. Positron emission tomography (PET) imaging with the injection of 18F-fluorodeoxyglucose (FDG) is currently the most widely used imaging technique to evaluate the density of activated macrophages in atherosclerotic plaques. Nevertheless, FDG-PET imaging has logistical and technical constraints that represent an important obstacle to the wider use of this approach for the evaluation of patients with atherosclerosis...
April 26, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29687330/systematic-review-of-economic-models-used-to-compare-techniques-for-detecting-peripheral-arterial-disease
#7
REVIEW
Eoin Moloney, Joanne O'Connor, Dawn Craig, Shannon Robalino, Alexandros Chrysos, Mehdi Javanbakht, Andrew Sims, Gerard Stansby, Scott Wilkes, John Allen
BACKGROUND AND OBJECTIVE: Peripheral arterial disease (PAD) is a common condition, in which atherosclerotic narrowing in the arteries restricts blood supply to the leg muscles. In order to support future model-based economic evaluations comparing methods of diagnosis in this area, a systematic review of economic modelling studies was conducted. METHODS: A systematic literature review was performed in June 2017 to identify model-based economic evaluations of diagnostic tests to detect PAD, with six individual databases searched...
April 23, 2018: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29686026/favorable-modifiable-cardiovascular-risk-profile-is-associated-with-lower-healthcare-costs-among-cancer-patients-the-2012-2013-medical-expenditure-panel-survey
#8
Jai Singh, Javier Valero-Elizondo, Joseph A Salami, Haider J Warraich, Oluseye Ogunmoroti, Erica S Spatz, Nihar Desai, Jamal S Rana, Salim S Virani, Ron Blankstein, Michael J Blaha, Khurram Nasir
BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) and cancer are among the leading causes of economic burden, morbidity, and mortality in the United States. We aimed to quantify the overall impact of cardiovascular modifiable risk factor (CRF) profile on healthcare expenditures among those with and without ASCVD and/or cancer. METHODS AND RESULTS: The 2012-2013 Medical Expenditure Panel Survey, a nationally representative adult sample (≥40 years), was utilized for the study...
April 23, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29679023/interventions-for-lower-extremity-peripheral-artery-disease
#9
REVIEW
Jade S Hiramoto, Martin Teraa, Gert J de Borst, Michael S Conte
Peripheral artery disease (PAD) of the lower extremities is a common manifestation of atherosclerosis that is increasing in global prevalence and in the associated public health costs. Ageing of the general population, combined with the pandemics of diabetes mellitus, metabolic syndrome, and tobacco use, is a major underlying factor. A broad range of care providers are involved in the management of patients with PAD, and all health-care professionals require familiarity with the risk factors, diagnosis, and treatment options for this common disease...
April 20, 2018: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29650716/cardiovascular-genetic-risk-testing-for-targeting-statin-therapy-in-the-primary-prevention-of-atherosclerotic-cardiovascular-disease-a-cost-effectiveness-analysis
#10
Jamie Jarmul, Mark J Pletcher, Kristen Hassmiller Lich, Stephanie B Wheeler, Morris Weinberger, Christy L Avery, Daniel E Jonas, Stephanie Earnshaw, Michael Pignone
BACKGROUND: It is unclear whether testing for novel risk factors, such as a cardiovascular genetic risk score (cGRS), improves clinical decision making or health outcomes when used for targeting statin initiation in the primary prevention of atherosclerotic cardiovascular disease (ASCVD). Our objective was to estimate the cost-effectiveness of cGRS testing to inform clinical decision making about statin initiation in individuals with low-to-intermediate (2.5%-7.5%) 10-year predicted risk of ASCVD...
April 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29526986/towards-effective-cost-effectiveness-analysis-in-atherosclerotic-cardiovascular-disease-prevention
#11
Kouji Kajinami
No abstract text is available yet for this article.
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29512936/pcsk9-inhibitor-valuation-a-science-based-review-of-the-two-recent-models
#12
REVIEW
Seth J Baum, Christopher P Cannon
Low-density lipoprotein cholesterol (LDL-C) has been extensively evaluated. Prospective cohort studies, randomized controlled trials, biology, pathophysiology, genetics, and Mendelian randomization studies, have clearly taught us that LDL-C causes atherosclerotic cardiovascular disease. The newest class of drugs to lower LDL-C, the proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies, have been found to safely reduce LDL-C approximately 60% when added to high-intensity statin therapy...
April 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29507560/evaluation-of-abdominal-fat-index-by-ultrasonography-and-its-relationship-with-psoriasis-and-metabolic-syndrome
#13
Müzeyyen Gönül, İdil Tatar, Filiz Canpolat, Gökçe Işıl Kurmus, Can Ergin, Baki Hekimoğlu
Introduction: Accumulating evidence indicates that psoriasis is associated with obesity and metabolic syndrome. Psoriasis and obesity share similar inflammatory mediators, and obesity may potentiate some inflammatory cytokines seen in psoriasis. Body fat distribution, particularly visceral adipose tissue (VAT), is an important factor in metabolic syndrome and atherosclerotic diseases. An association has been demonstrated between psoriasis and abdominal VAT measured by computed tomography (CT)...
October 2017: Postȩpy Dermatologii i Alergologii
https://www.readbyqxmd.com/read/29501593/directional-atherectomy-is-associated-with-better-long-term-efficiency-compared-to-angioplasty-for-common-femoral-artery-occlusive-disease-in-rutherford-2-to-4-patients
#14
Jianming Guo, Lianrui Guo, Zhu Tong, Xixiang Gao, Zhonggao Wang, Yongquan Gu
BACKGROUND: Despite increased interest in treating common femoral artery (CFA) with endovascular technology, there is little data regarding the long-term outcomes of different endovascular treatment modalities. We report the results after endovascular therapy of symptomatic obstructions of the CFA in a single center. METHODS: We retrospectively reviewed the records of consecutive patients with eligible CFA lesions who were treated with endovascular methods between 2011 and 2013...
February 28, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29441745/evaluation-of-atherosclerotic-plaque-in-non-invasive-coronary-imaging
#15
REVIEW
Aeshita Dwivedi, Subhi J Al'Aref, Fay Y Lin, James K Min
Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. Over the last decade coronary computed tomography angiography (CCTA) has gained wide acceptance as a reliable, cost-effective and non-invasive modality for diagnosis and prognostication of CAD. Use of CCTA is now expanding to characterization of plaque morphology and identification of vulnerable plaque. Additionally, CCTA is developing as a non-invasive modality to monitor plaque progression, which holds future potential in individualizing treatment...
February 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29440909/clinical-characteristics-patterns-of-lipid-lowering-medication-use-and-health-care-resource-utilization-and-costs-among-patients-with-atherosclerotic-cardiovascular-disease
#16
Thomas P Power, Xuehua Ke, Zhenxiang Zhao, Nicole Gidaya Bonine, Mark J Cziraky, Michael Grabner, John J Barron, Ralph Quimbo, Burkhard Vangerow, Peter P Toth
Purpose: The aim of this study was to investigate real-world patient characteristics, medication use, and health care resource utilization (HCRU) and costs among patients with clinical atherosclerotic cardiovascular disease (ASCVD) as defined by 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, to examine burden of disease and unmet needs, such as potential undertreatment. Patients and methods: This retrospective cohort study utilized a nationally representative managed care database to identify newly diagnosed ASCVD patients between January 1, 2007, and November 30, 2012 (index = first ASCVD diagnosis date) in the USA...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29401328/implications-of-new-cholesterol-treatment-guidelines-on-statin-utilization-intensity-and-costs-in-active-duty-service-members
#17
Michael S Cahill, Rebecca M Seifried, Julia H Cheringal, Nicholas R Fiacco, Patrick S Moon, Michael K Cheezum, Todd C Villines
Background: The recommendations in the 2013 American College of Cardiology/American Heart Association (ACC/AHA) blood cholesterol guidelines expanded the indications and level of intensity of statin therapy for the primary prevention of cardiovascular disease. We assessed the treatment and cost implications of theseguidelines within a cohort of active duty service members. Methods: Using the military electronic medical record system, the Armed Forces Health Longitudinal Technology Application, we randomly selected 1,000 active duty persons aged 40 yr or older and reviewed their lipid profiles and medical records to identify risk factors for atherosclerotic cardiovascular disease...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29397274/enhanced-coronary-calcium-visualization-and-detection-from-dual-energy-chest-x-rays-with-sliding-organ-registration
#18
Di Wen, Katelyn Nye, Bo Zhou, Robert C Gilkeson, Amit Gupta, Shiraz Ranim, Spencer Couturier, David L Wilson
We have developed a technique to image coronary calcium, an excellent biomarker for atherosclerotic disease, using low cost, low radiation dual energy (DE) chest radiography, with potential for widespread screening from an already ordered exam. Our dual energy coronary calcium (DECC) processing method included automatic heart silhouette segmentation, sliding organ registration and scatter removal to create a bone-image-like, coronary calcium image with significant reduction in motion artifacts and improved calcium conspicuity compared to standard, clinically available DE processing...
March 2018: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/29358195/national-trends-in-nonstatin-use-and-expenditures-among-the-us-adult-population-from-2002-to-2013-insights-from-medical-expenditure-panel-survey
#19
Joseph A Salami, Haider J Warraich, Javier Valero-Elizondo, Erica S Spatz, Nihar R Desai, Jamal S Rana, Salim S Virani, Ron Blankstein, Amit Khera, Michael J Blaha, Roger S Blumenthal, Barry T Katzen, Donald Lloyd-Jones, Harlan M Krumholz, Khurram Nasir
BACKGROUND: Evidence supporting nonstatin lipid-lowering therapy in atherosclerotic cardiovascular disease risk reduction is variable. We aim to examine nonstatin utilization and expenditures in the United States between 2002 and 2013. METHODS AND RESULTS: We used the Medical Expenditure Panel Survey database to estimate national trends in nonstatin use and cost (total and out-of-pocket, adjusted to 2013 US dollars using a gross domestic product deflator) among adults 40 years or older...
January 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29326146/prior-authorization-requirements-for-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-across-us-private-and-public-payers
#20
Jalpa A Doshi, Justin T Puckett, Michael S Parmacek, Daniel J Rader
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an innovative treatment option for patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require further lowering of low-density lipoprotein cholesterol. However, the high costs of these agents have spurred payers to implement utilization management policies to ensure appropriate use. We examined prior authorization (PA) requirements for PCSK9is across private and public US payers...
January 2018: Circulation. Cardiovascular Quality and Outcomes
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