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statin in acute coronary syndrome

Mario Iannaccone, Fabrizio D Ascenzo, Ovidio De Filippo, Marco Gagliardi, Danielle A Southern, Sergio Raposeiras-Roubín, Emad Abu-Assi, Jose Paulo Simao Henriques, Jorge Saucedo, José Ramón González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-Aki Kawashiri, José María García-Acuña, Emilio Alfonso, Belén Terol, Alberto Garay, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahashi, Kenji Sakata, Masakazu Yamagishi, Claudio Moretti, Fiorenzo Gaita, Oliver Kalpak, Sasko Kedev
OBJECTIVE: Our objective was to define the most appropriate treatment for acute coronary syndrome (ACS) in patients with malignancy. METHODS AND RESULTS: The BleeMACS project is a worldwide multicenter observational prospective registry in 16 hospitals enrolling patients with ACS undergoing percutaneous coronary intervention. Primary endpoints were death, re-infarction, and major adverse cardiac events (MACE; composite of death and re-infarction) after 1 year of follow-up...
October 13, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Shuhei Takahashi, Kazunori Shimada, Katsumi Miyauchi, Tetsuro Miyazaki, Eiryu Sai, Manabu Ogita, Shuta Tsuboi, Hiroshi Tamura, Shinya Okazaki, Tomoyuki Shiozawa, Shohei Ouchi, Tatsuro Aikawa, Tomoyasu Kadoguchi, Hamad Al Shahi, Takuma Yoshihara, Makoto Hiki, Kikuo Isoda, Hiroyuki Daida
BACKGROUND: Postprandial hyperglycemia plays an important role in the pathogenesis of coronary artery disease and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of postprandial hyperglycemia. However, the impact of 1,5-AG level on cardiovascular events has not been fully investigated. METHODS: We enrolled 240 consecutive patients who had undergone first-time elective percutaneous coronary intervention (PCI) with follow-up angiography within 1 year...
October 11, 2016: Cardiovascular Diabetology
Michael G Silverman, Brian A Ference, Kyungah Im, Stephen D Wiviott, Robert P Giugliano, Scott M Grundy, Eugene Braunwald, Marc S Sabatine
IMPORTANCE: The comparative clinical benefit of nonstatin therapies that reduce low-density lipoprotein cholesterol (LDL-C) remains uncertain. OBJECTIVE: To evaluate the association between lowering LDL-C and relative cardiovascular risk reduction across different statin and nonstatin therapies. DATA SOURCES AND STUDY SELECTION: The MEDLINE and EMBASE databases were searched (1966-July 2016). The key inclusion criteria were that the study was a randomized clinical trial and the reported clinical outcomes included myocardial infarction (MI)...
September 27, 2016: JAMA: the Journal of the American Medical Association
Paweł Burchardt, Janusz Rzeźniczak, Joanna Dudziak, Anna Dzumak, Tomasz Marchlewski, Teresa Ganowicz-Kaatz, Monika Popiak, Marek Słomczyński, Marcin Jezierski, Witold Laskowski, Tomasz Łuczak, Robert Plewa
BACKGROUND: Before our study, there were no data concerning complex evaluation of: plasma PCSK9 concentrations, transcript LDL receptor (LDLR), as well as the total amount of monocytes' LDLR in acute coronary syndrome (ACS) patients. PCSK9 levels in a few cohort studies were found to correlate with the number of white blood cells or platelets. The study aims to evaluate PCSK9-LDLR concentrations, as well as to find any association between PCSK9 and white blood cells (WBC) or platelets (PLT)...
September 26, 2016: Cardiology Journal
Alon Eisen, Robert P Giugliano
PURPOSE OF REVIEW: Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors are promising therapies that inhibit the degradation of low-density lipoprotein (LDL) receptors in the hepatocyte and thus increase LDL cholesterol (LDL-C) uptake from the blood. This review summarizes main findings in the field of PCSK9 inhibitors, from basic mechanism to clinical studies, and aims to provide a contemporary and practical overview of the clinical implication and future directions with PCSK9 inhibitors...
November 2016: Current Opinion in Cardiology
Min Li, Yubei Huang, Xin Du, Shenshen Li, Jiachao Ji, Anushka Patel, Runlin Gao, Yangfeng Wu
BACKGROUND: It is widely reported that long-term use of four preventive medications (antiplatelet agents, angiotensin converting enzyme inhibitor / angiotensin receptor blocker, statin and beta-blockers) reduce the risk of subsequent acute coronary syndromes (ACS). It is unclear whether these four medications benefit patients who develop ACS despite its use. METHODS AND RESULTS: Logistic regression and propensity-score was applied among 14790 ACS patients to assess the association between prior use of four preventive medications and in-hospital outcomes including severity of disease at presentation (type of ACS, systolic blood pressure <90 mmHg, and heart rate> = 100 beats/min), complicating arrhythmia and major adverse cardiovascular events (MACEs, including all deaths, non-fatal myocardial infarction or re-infarction, and non-fatal stroke)...
2016: PloS One
Michael C Turner
The increased use of cardiac computed tomography angiography in the emergency room to triage patients who present with chest pain syndrome has led to the identification of individuals with coronary plaques with high-risk characteristics in the absence of significant stenoses. Anecdotal observations have suggested that the presence of coronary high-risk plaque results in an increased risk of acute coronary syndrome over time. This case presentation represents an example of this subgroup of patients. Intuitively, it would seem that high-dose statin therapy would be the treatment of choice, with percutaneous intervention reserved for the development of flow-limiting lesions; however, a prospective trial to determine outcomes to our knowledge has not been performed...
September 5, 2016: Echocardiography
Alon Eisen, Christopher P Cannon, Michael A Blazing, Erin A Bohula, Jeong-Gun Park, Sabina A Murphy, Jennifer A White, Robert P Giugliano, Eugene Braunwald
AIMS: To examine the efficacy and safety of ezetimibe added to statin in patients with prior coronary artery bypass graft surgery (CABG) following hospitalization for an acute coronary syndrome (ACS). METHODS AND RESULTS: In the IMPROVE-IT trial, post-ACS patients with mean low density lipoprotein cholesterol (LDL-C) of 93.8 mg/dL at presentation were randomized to simvastatin/ezetimibe or simvastatin/placebo. The primary endpoint was cardiovascular death, major coronary event or stroke, and the median follow-up was 6 years...
August 28, 2016: European Heart Journal
John A Ambrose, Tushar Acharya, Micah J Roberts
Patients with coronary artery disease or its equivalent are an appropriate target for guideline-directed therapy. However, finding and treating the individuals at risk for myocardial infarction or sudden death in primary prevention has been problematic. Most initial cardiovascular events are acute syndromes, and only a minority of these occurs in those deemed high risk by contemporary algorithms. Even newer noninvasive modalities cannot detect a majority of those at risk. Furthermore, accurate and early detection of high risk/vulnerability does not guarantee event prevention...
August 24, 2016: American Journal of Medicine
Abdulhalim Jamal Kinsara, Jamilah Saad Alrahimi, Oyindamola B Yusuf
OBJECTIVES: To compare the clinical features, management, and in-hospital outcomes of patients with ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTEACS), in the Western Region of Saudi Arabia. METHODS: A total of 71 patients were enrolled in a longitudinal study at a tertiary hospital without cardiac catheterization facility. These data were collected from Saudi Project for Assessment of Coronary Events registry. RESULTS: Twenty-three patients with STEMI were compared to 48 patients with NSTEACS...
July 2016: Indian Heart Journal
Rohit M Oemrawsingh, Hector M Garcia-Garcia, Robert J M van Geuns, Mattie J Lenzen, Cihan Simsek, Sanneke P M de Boer, Nicolas M Van Mieghem, Evelyn Regar, Peter P T de Jaegere, K Martijn Akkerhuis, Jurgen M R Ligthart, Felix Zijlstra, Patrick W Serruys, Eric Boersma
AIMS: Statins are highly effective in reducing major adverse clinical events, but the direct effects on coronary plaque composition remain debatable. Our aim was to mechanistically evaluate the treatment effect of high-intensity statin therapy on compositional coronary plaque changes. METHODS AND RESULTS: The third Integrated Biomarker and Imaging Study (IBIS-3) was a prospective, investigator-initiated, single-centre study. Serial radiofrequency intravascular ultrasound (RF-IVUS) measurements of a predefined non-stenotic segment in a non-culprit coronary artery were performed to evaluate the effect of rosuvastatin (intended dose: 40 mg daily) on necrotic core (NC) volume in patients with stable angina or acute coronary syndrome...
August 20, 2016: EuroIntervention
Monica Verdoia, Patrizia Pergolini, Roberta Rolla, Chiara Sartori, Matteo Nardin, Alon Schaffer, Lucia Barbieri, Veronica Daffara, Paolo Marino, Giorgio Bellomo, Harry Suryapranata, Giuseppe De Luca
Suboptimal platelet inhibition still represents an important challenge, especially for patients undergoing percutaneous coronary interventions (PCIs). However, very few are known so far on the predictors of high-residual platelet reactivity (HRPR) despite antiplatelet strategies. Increasing attention has been paid in the last years to the role of vitamin D in atherothrombosis. Therefore, the aim of our study was to evaluate the impact of vitamin D levels on platelet function in patients treated with dual antiplatelet therapy (DAPT)...
September 2016: Platelets
Shigemitsu Tanaka, Yuji Ikari, Takeshi Ijichi, Gaku Nakazawa
A reduction of low-density lipoprotein cholesterol (LDL-C) is important for the secondary prevention of coronary artery disease. We performed secondary prevention in 632 consecutive patients, including 315 with acute coronary syndrome, who underwent percutaneous coronary intervention according to current treat-to-target lipid-lowering guidelines to achieve LDL-C <100 mg/dL. We retrospectively analyzed 2-year all-cause mortality. The average LDL-C level was reduced from 114 ± 36 mg/dL at baseline to 94 ± 25 mg/dL at follow-up; 61 % of patients achieved the guideline target...
August 18, 2016: Cardiovascular Intervention and Therapeutics
Nicla A Varnier, Franzisca Pettit, David Rees, Steven Thou, Mark Brown, Amanda Henry
BACKGROUND: Cardiovascular disease affects 0.2-4% of pregnancies. Coupled with the physiological stress of pregnancy, cardiovascular disease may present significant management challenges including appropriate risk:benefit analysis of medical and surgical management options. CASE: A 33-year-old gravida 4 para 1 miscarriage 2 presented at 18 weeks' gestation to the high-risk pregnancy service with a history of coronary artery disease and homozygous familial hypercholesterolaemia...
September 2015: Obstetric Medicine
Gláucia de Souza Omori Maier, Eleine Aparecida Penha Martins
OBJECTIVE: to assess in-hospital care for patients with Acute Coronary Syndrome according to quality indicators. METHOD: a longitudinal quantitative study was performed between November 2012 and March 2013 with 94 patients, including interviews and medical records. RESULTS: a total of 39.4% of patients had unstable angina and 60.6% had myocardial infarction, of which 34% had ST segment elevation. Patients with TIMI and GRACE scores higher than four and 140 (p<0...
July 2016: Revista Brasileira de Enfermagem
Anthony S Gunnell, Joseph Hung, Matthew W Knuiman, Lee Nedkoff, Malcolm Gillies, Elizabeth Geelhoed, Michael St Hobbs, Judith M Katzenellenbogen, Jamie M Rankin, Michael Ortiz, Tom G Briffa, Frank M Sanfilippo
AIM: Describe the dispensing patterns for guideline-recommended medications during 2008 in people with acute coronary syndrome (ACS) and how dispensing varies by gender and time since last ACS hospitalisation. METHOD: A descriptive cohort spanning 20 years of people alive post ACS in 2008. We extracted all ACS hospitalisations and deaths in Western Australia (1989-2008), and all person-linked Pharmaceutical Benefits Scheme claims nationally for 2008. Participants were 23,642 men and women (36...
August 4, 2016: Cardiovascular Therapeutics
Amy L Gin, Rocco Vergallo, Yoshiyasu Minami, Daniel S Ong, Jingbo Hou, Haibo Jia, Tsunenari Soeda, Sining Hu, Shaosong Zhang, Hang Lee, Bo Yu, Ik-Kyung Jang
OBJECTIVES: The aim of this study was to examine coronary plaque morphology after initiation of statins and compare changes in plaque morphology in patients presenting with acute coronary syndrome (ACS) versus stable angina pectoris (SAP). BACKGROUND: ACS is associated with a pan-inflammatory state, and intraplaque features of inflammation correlate with coronary plaque progression. Statins have known anti-inflammatory properties that may contribute toward their beneficial cardiovascular effects...
July 27, 2016: Coronary Artery Disease
David Nanchen, Baris Gencer, Olivier Muller, Reto Auer, Soheila Aghlmandi, Dik Heg, Roland Klingenberg, Lorenz Räber, David Carballo, Sebastian Carballo, Christian M Matter, Thomas F Lüscher, Stephan Windecker, François Mach, Nicolas Rodondi
BACKGROUND: Patients with heterozygous familial hypercholesterolemia (FH) and coronary heart disease have high mortality rates. However, in an era of high-dose statin prescription after acute coronary syndrome (ACS), the risk of recurrent coronary and cardiovascular events associated with FH might be mitigated. We compared coronary event rates between patients with and without FH after ACS. METHODS: We studied 4534 patients with ACS enrolled in a multicenter, prospective cohort study in Switzerland between 2009 and 2013 who were individually screened for FH on the basis of clinical criteria according to 3 definitions: the American Heart Association definition, the Simon Broome definition, and the Dutch Lipid Clinic definition...
September 6, 2016: Circulation
Alberto J Lorenzatti, Brenda M Retzlaff
Atherosclerotic cardiovascular disease is the leading cause of death worldwide. Despite extraordinary advances in the understanding of the pathophysiology and the utilization of very effective medications such as statins, there still remains a significant residual risk. In fact, even after optimal interventional and medical therapy, the possibility of recurrent myocardial infarction remains at approximately one third for five years after acute coronary syndromes, thus emphasizing the urgent need for novel therapies to prevent the progress of atherosclerosis...
October 15, 2016: International Journal of Cardiology
Tamio Teramoto, Kiyoko Uno, Izuru Miyoshi, Irfan Khan, Katherine Gorcyca, Robert J Sanchez, Shigeto Yoshida, Kazuhiro Mawatari, Tomoya Masaki, Hidenori Arai, Shizuya Yamashita
BACKGROUND AND AIMS: Low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor in the development of cardiovascular (CV) disease. In 2012, the Japan Atherosclerosis Society (JAS) issued guidelines recommending statins as first-line pharmacotherapy for lowering LDL-C in patients at high risk for CV events. This study assessed achievement of recommended LDL-C goals and lipid-modifying therapy (LMT) use in a high CV risk population in Japan. METHODS: Patients from the Medical Data Vision (MDV) database, an electronic hospital-based claims database in Japan, who met the following inclusion criteria were included in this study: LDL-C measurement in 2013; ≥20 years of age; ≥2 years representation in the database; and a high CV risk condition (recent acute coronary syndrome (ACS), other coronary heart disease (CHD), ischemic stroke, peripheral arterial disease (PAD) or diabetes)...
August 2016: Atherosclerosis
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