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Statin intolerance

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https://www.readbyqxmd.com/read/29318532/management-of-statin-intolerance-in-2018-still-more-questions-than-answers
#1
REVIEW
Peter P Toth, Angelo Maria Patti, Rosaria Vincenza Giglio, Dragana Nikolic, Giuseppa Castellino, Manfredi Rizzo, Maciej Banach
Statin therapy is generally well tolerated and very effective in the prevention and treatment of cardiovascular disease, regardless of cholesterol levels; however, it can be associated with various adverse events (myalgia, myopathy, rhabdomyolysis, and diabetes mellitus, among others). Patients frequently discontinue statin therapy without medical advice because of perceived side effects and consequently increase their risk for cardiovascular events. In patients with statin intolerance, it may be advisable to change the dose, switch to a different statin, or try an alternate-day regimen...
January 9, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29313565/utilization-of-the-lipid-lowering-therapies-in-outpatient-settings-in-poland-epidemiological-survey-economedica-dyslipidemia-2015
#2
Filip M Szymański, Anna E Płatek, Anna Ryś, Karolina Semczuk-Kaczmarek, Bartosz Krzowski, Katarzyna Wróbel, Krzysztof J Filipiak
BACKGROUND: Dyslipidemia, especially elevated low-density lipoprotein (LDL) cholesterol is one of the most important cardiovascular risk factors. Treatment of dyslipidemia and prevention of cardiovascular disease with lipid-lowering drugs is one of the key issues in reducing cardiovascular mortality. Nevertheless, underutilization of statins and lipid-lowering drugs is still a problem globally. AIM: The present study aimed to describe the utilization of lipid-lowering drugs in groups of patients with indications for statin treatment and elevated LDL cholesterol...
January 9, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29276211/treatment-patterns-statin-intolerance-and-subsequent-cardiovascular-events-among-japanese-patients-with-high-cardiovascular-risk-initiating-statin-therapy
#3
Saurabh P Nagar, Pratik P Rane, Kathleen M Fox, Juliana Meyers, Keith Davis, Anne Beaubrun, Hyoe Inomata, Yi Qian, Kouji Kajinami
BACKGROUND: This study examined treatment patterns, possible statin intolerance, and incidence of cardiovascular events (CVEs) in 2 cohorts of patients with high cardiovascular risk (i.e., patients with atherosclerotic cardiovascular disease [ASCVD] and patients with diabetes mellitus).Methods and Results:A retrospective cohort study examined adults initiating either a statin or ezetimibe from 1 January 2006 to 31 May 2014 in the Japan Medical Data Center database. The first observed statin or ezetimibe prescription defined the index date...
December 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29260404/new-treatment-options-for-lipid-lowering-therapy-in-subjects-with-type-2-diabetes
#4
Roberto Scicali, Antonino Di Pino, Viviana Ferrara, Francesca Urbano, Salvatore Piro, Agata Maria Rabuazzo, Francesco Purrello
Dyslipidemias represent a variety of quantitative and/or qualitative lipoprotein abnormalities. According to etiology, we distinguish primary dyslipidemias with strictly genetic background and secondary ones with their origin in other disease or pathological states. Diabetic dyslipidemia is a type of secondary dyslipidemia and plays an important role in determining the cardiovascular risk of subjects with type 2 diabetes. In these patients, insulin resistance is responsible for overproduction and secretion of atherogenic very low density lipoprotein...
December 19, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/29242847/simvastatin-intolerance-genetic-determinants-some-features-in-ethnic-uzbek-patients-with-coronary-artery-disease
#5
Aleksandr B Shek, Ravshanbek D Kurbanov, Guzal J Abdullaeva, Aleksandr V Nagay, Shavkat U Hoshimov, Ulugbek I Nizamov, Adolat V Ziyaeva, Rano B Alieva
Introduction: The objective is to study the influence of CYP3A5 (6986A>G), CYP2C9 (430C>T), CYP2C9 (1075A>C), SLCO1B1 (521T>C) and BCRP (ABCG2, 421C>A) gene polymorphisms on the development of simvastatin intolerance in ethnic Uzbek patients with coronary artery disease (CAD). Material and methods: The case group contained 50 patients with clinical simvastatin-induced intolerance symptoms; the control group contained 50 patients without side-effects...
2017: Archives of Medical Sciences. Atherosclerotic Diseases
https://www.readbyqxmd.com/read/29228784/efficacy-of-berberine-alone-and-in-combination-for-the-treatment-of-hyperlipidemia-a-systematic-review
#6
Laura M Koppen, Andrea Whitaker, Audrey Rosene, Robert D Beckett
The objective of this review is to identify, summarize, and evaluate clinical trials of berberine for the treatment of hyperlipidemia and other dyslipidemias. A literature search for randomized, controlled trials of berberine that assessed at least 2 lipid values as endpoints resulted in identification of 12 articles that met criteria. The majority of evaluated articles consistently suggest that berberine has a beneficial effect on low-density lipoprotein (reductions ranging from approximately 20 to 50 mg/dL) and triglycerides (reductions ranging from approximately 25 to 55 mg/dL)...
January 1, 2017: Journal of Evidence-based Complementary & Alternative Medicine
https://www.readbyqxmd.com/read/29210320/genetic-variation-in-statin-intolerance-and-a-possible-protective-role-for-ugt1a1
#7
Maria Alice V Willrich, Erin J Kaleta, Sandra C Bryant, Grant M Spears, Laura J Train, Sandra E Peterson, Vanda A Lennon, Stephen L Kopecky, Linnea M Baudhuin
The etiology of statin intolerance is hypothesized to be due to genetic variants that impact statin disposition and clearance. We sought to determine whether genetic variants were associated to statin intolerance. The studied cohort consisted of hyperlipidemic participants (n = 90) clinically diagnosed with statin intolerance by a cardiologist and matched controls without statin intolerance. Creatine kinase activity, lipid profiles and genetic analyses were performed on genes involved in statin metabolism and included UGT1A1 and UGT1A3 sequencing and targeted analyses of CYP3A4*22, CYP3A5*3, SLCO1B1*5 and *1b, ABCB1 c...
December 6, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/29171950/-evolocumab-repatha%C3%A2-a-human-monoclonal-antibody-against-pcsk9-protein-as-potent-cholesterol-lowering-therapy
#8
C Wallemacq
Evolocumab is a fully human monoclonal antibody (mAb) targeting ProProtein Convertase Subtilisin/Kexin 9 (PCSK9). PCSK9 is a circulating enzyme secreted by the liver and plays a key role in the LDL-Receptors (LDL-R) turnover. Binding of PCSK9 on the extracellular part of LDL-R is responsible for its degradation in the lysosome instead of its recycling to the cell surface, thereby producing a reduction in the number of LDL-R on the cell surface, a decreased LDL-C uptake and increased levels of LDL-C. Inhibiting PCSK9 is a new way to markedly reduce LDL-C...
November 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29153764/corrigendum-to-monascus-purpureus-for-statin-and-ezetimibe-intolerant-heterozygous-familial-hypercholesterolaemia-patients-a-clinical-study-atherosclerosis-supplements-30c-2017-86-91
#9
Claudia Stefanutti, Fabio Mazza, Dario Mesce, Claudia Morozzi, Serafina Di Giacomo, Marco Vitale, Mario Pergolini
No abstract text is available yet for this article.
November 16, 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29152896/trimetazidine-restores-the-positive-adaptation-to-exercise-training-by-mitigating-statin-induced-skeletal-muscle-injury
#10
Ming Song, Fang-Fang Chen, Yi-Hui Li, Lei Zhang, Feng Wang, Ran-Ran Qin, Zhi-Hao Wang, Ming Zhong, Meng-Xiong Tang, Wei Zhang, Lu Han
BACKGROUND: Exercise rehabilitation is demonstrated to improve the prognosis of patients with coronary heart disease (CHD). Statins, as the key medicine to lower cholesterol in CHD, result in skeletal muscle injury and impair exercise training adaptation. Energy metabolism dysfunction is identified as the potential mechanism underlying statin-induced skeletal muscle injury. In this study, we investigated the effects of the metabolic modulator trimetazidine on skeletal muscle energy metabolism and statin-associated exercise intolerance...
November 19, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/29148854/comparative-effectiveness-of-lipid-lowering-treatments-to-reduce-cardiovascular-disease
#11
REVIEW
Dong-Churl Suh, Scott K Griggs, Emmett R Henderson, Seung-Mi Lee, Taehwan Park
The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor is a new treatment option for patients with hypercholesterolemia. The objective of this study was to systematically review the cost-effectiveness of lipid-lowering agents. Areas covered: Based on Pubmed, Embase, and Cochrane Database of Systematic Reviews, we identified 29 relevant articles. Studies found statins were cost-effective compared with placebo or no treatment in general. Atorvastatin was reported to be cost-effective against simvastatin...
February 2018: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29096867/the-efficacy-of-anti-pcsk9-antibodies-results-from-recent-trials
#12
Ioanna Gouni-Berthold
The serine protease proprotein convertase subtilisin/kexin type 9 (PCSK9) binds to the low-density lipoprotein (LDL) receptor (LDLR) and directs it to the lysosome for degradation. This results in decreased numbers of LDLR available on the cell surface to bind LDL particles and remove them from the circulation and a subsequent increase in circulating LDL-cholesterol (LDL-C) concentrations. Since the role PCSK9 plays in LDL-C metabolism has been discovered in 2003, there have been major efforts in finding efficient and safe methods to inhibit it...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096866/monascus-purpureus-for-statin-and-ezetimibe-intolerant-heterozygous-familial-hypercholesterolaemia-patients-a-clinical-study
#13
Claudia Stefanutti, Fabio Mazza, Dario Mesce, Claudia Morozzi, Serafina Di Giacomo, Marco Vitale, Mario Pergolini
BACKGROUND: Hypercholesterolaemia is a major risk factor for cardiovascular disease and requires effective therapy in affected patients. Statins, the mainstay of lipid-lowering therapy, can cause side effects, including myalgia, in some patients. Ezetimibe, is frequently used as an add-on therapy for statins, and is also used as a monotherapy in statin-intolerant patients, however elevations in liver transaminases can occur. We examined the lipid-lowering efficacy of the natural fungal product Monascus purpureus (MP), which contains the natural statin monacolin K...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096858/management-of-patients-with-statin-intolerance
#14
Sabine Fischer, Ulrich Julius
In recent years statins have become an established option in lipid-lowering pharmacotherapy despite the fact that statin intolerance is fairly common. When muscle pains and/or an elevation of the creatine kinase appear, the dose must be lowered in patients with slight symptoms or stopped altogether if the symptoms are more severe. When the symptoms are alleviated and creatine kinase is normalized, re-exposition can be considered. If symptoms recur, treatment with another statin should be attempted - in these cases pravastatin or fluvastatin are recommended, although they are less effective in reducing LDL cholesterol...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29096827/pleiotropic-effects-of-regular-lipoprotein-apheresis
#15
Helmut Sinzinger, Sabine Steiner, Kurt Derfler
BACKGROUND: Lipoprotein(LP)-apheresis is the treatment of choice in patients suffering from severe familial hypercholesterolemia. A wide range of mechanisms has been claimed to be responsible for the known clinical benefit. METHODS: Patients suffering from heterozygous familial hypercholesterolemia undergoing LP-apheresis either with direct adsorption of lipoproteins (DALI) or dextran sulfate (DS) were examined. A total volume of 10 l blood was exchanged. Non-lipid effects, mainly concerning endothelial function (circulating endothelial cells, circulating endothelial progenitor cells, flow-mediated vasodilation, microalbuminuria) as well as left ventricular ejection fraction and homocysteine were assessed...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29080546/health-disparities-among-adult-patients-with-a-phenotypic-diagnosis-of-familial-hypercholesterolemia-in-the-cascade-fh%C3%A2-patient-registry
#16
Stephen M Amrock, P Barton Duell, Thomas Knickelbine, Seth S Martin, Emily C O'Brien, Karol E Watson, Joanna Mitri, Iris Kindt, Peter Shrader, Seth J Baum, Linda C Hemphill, Catherine D Ahmed, Rolf L Andersen, Iftikhar J Kullo, Dervilla McCann, John A Larry, Michael F Murray, Robert Fishberg, John R Guyton, Katherine Wilemon, Matthew T Roe, Daniel J Rader, Christie M Ballantyne, James A Underberg, Paul Thompson, Dannielle Duffy, MacRae F Linton, Michael D Shapiro, Patrick M Moriarty, Joshua W Knowles, Zahid S Ahmad
BACKGROUND AND AIMS: Most familial hypercholesterolemia (FH) patients remain undertreated, and it is unclear what role health disparities may play for FH patients in the US. We sought to describe sex and racial/ethnic disparities in a national registry of US FH patients. METHODS: We analyzed data from 3167 adults enrolled in the CAscade SCreening for Awareness and DEtection of Familial Hypercholesterolemia (CASCADE-FH) registry. Logistic regression was used to evaluate for disparities in LDL-C goals and statin use, with adjustments for covariates including age, cardiovascular risk factors, and statin intolerance...
October 6, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29074093/a-new-hope-lessons-from-heart-outcomes-prevention-evaluation-3
#17
REVIEW
Travis M Howard, Aakash A Bavishi, Neil J Stone
Lifestyle modification is the cornerstone of preventing atherosclerotic cardiovascular disease. When this is not sufficient in reducing risk, statin therapy is first line. Heart Outcomes Prevention Evaluation (HOPE-3) was a randomized controlled trial of rosuvastatin versus placebo, which demonstrated a significant net benefit in a lower-risk population without known atherosclerotic cardiovascular disease. There were many novel characteristics about this trial that should not be overlooked. It contained a diverse population and was the first trial to base inclusion solely on easily ascertainable metabolic risk factors...
October 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29067242/impact-of-vitamin-d-status-on-statin-induced-myopathy
#18
Krista D Riche, Justin Arnall, Kristin Rieser, Honey E East, Daniel M Riche
INTRODUCTION: There is a multitude of evidence supporting the benefit of statin use in cardiovascular disease; however, statin-induced myopathy is a major reason for statin discontinuation and non-adherence. Vitamin D deficiency has been independently associated with muscle weakness and severe myopathy, and may be a confounder for statin-induced myopathies. Since there is no consensus on a treatment course of action for statin-induced myopathy, investigation into potential confounders to elucidate the dynamics of statin-induced myopathy is warranted...
December 2016: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29056268/successful-treatment-of-a-patient-with-statin-induced-myopathy-and-myotonic-dystrophy-type-ii-with-proprotein-convertase-subtilisin-kexin-type-9-inhibitor-alirocumab-praluent
#19
Mohamed K M Shakir, Terry Shin, Thanh D Hoang, Vinh Q Mai
Presently there are limited treatment options for hypercholesterolemia in patients with statin intolerance and myotonic dystrophy. A 74 year-old male presented to endocrine clinic with hypercholesterolemia (serum LDL-C 210 mg/dL), hypogonadism, insulin-controlled type 2 diabetes mellitus, and minimally elevated serum creatine kinase (CK) levels (184 U/L, ref. range 38-174). Shortly after simvastatin treatment, patient developed severe myalgias in the proximal lower and upper extremities; and serum CK increased to 317 U/L...
September 4, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29040646/statins-affect-skeletal-muscle-performance-evidence-for-disturbances-in-energy-metabolism
#20
Neeltje A E Allard, Tom J J Schirris, Rebecca J Verheggen, Frans G M Russel, Richard J Rodenburg, Jan A M Smeitink, Paul D Thompson, Maria T E Hopman, Silvie Timmers
Context: Statin myopathy is linked to disturbances in mitochondrial function and exercise intolerance. Objectives: To determine whether differences exist in exercise performance, muscle function and mitochondrial oxidative capacity and content between symptomatic and asymptomatic statin users, and non-statin using controls. Design: Cross-sectional study. Setting: Department of Physiology of the Radboud University Medical Center...
October 9, 2017: Journal of Clinical Endocrinology and Metabolism
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