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Statin intolerance

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https://www.readbyqxmd.com/read/29771156/achievement-of-low-density-lipoprotein-cholesterol-goals-in-18-countries-outside-western-europe-the-international-cholesterol-management-practice-study-iclps
#1
Nicolas Danchin, Wael Almahmeed, Khalid Al-Rasadi, Joseph Azuri, Abdelkrim Berrah, Carlos Alberto Cuneo, Yuri Karpov, Upendra Kaul, Meral Kayıkçıoğlu, Olena Mitchenko, Alvaro J Ruiz, Carlos A Aguilar Salinas, Raul D Santos, Florence Mercier, Dirk Blom
Background Little is known about the achievement of low density lipoprotein cholesterol (LDL-C) targets in patients at cardiovascular risk receiving stable lipid-lowering therapy (LLT) in countries outside Western Europe. Methods This cross-sectional observational study was conducted in 452 centres (August 2015-August 2016) in 18 countries in Eastern Europe, Asia, Africa, the Middle East and Latin America. Patients ( n = 9049) treated for ≥3 months with any LLT and in whom an LDL-C measurement on stable LLT was available within the previous 12 months were included...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#2
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762264/achieving-guideline-driven-high-intensity-statin-dose-in-cardiac-rehabilitation-patients-with-coronary-artery-disease
#3
Jonathan Lin, Alexandra Banathy, Carla Winters, Lars Andersen, Cindy Hudson, Heidi Testa, Joy Reardon, Peter Alagona
PURPOSE: The 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults recommends high-intensity statin therapy in patients aged ≤75 y with clinical coronary artery disease (CAD). The effectiveness of cardiac rehabilitation (CR) in lipid management and guideline adherence is unknown. The purpose of this study is to determine whether CR participation affects guideline-driven achievement for statin use...
May 12, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29758414/role-of-pcsk9-in-lipid-metabolism-and-atherosclerosis
#4
REVIEW
Xiao-Long Lin, Le-Le Xiao, Zhi-Han Tang, Zhi-Sheng Jiang, Mi-Hua Liu
Elevated plasma low-density lipoprotein cholesterol (LDL-C) is an important risk factor for cardiovascular diseases. Statins are the most widely used therapy for patients with hyperlipidemia. However, a significant residual cardiovascular risk remains in some patients even after maximally tolerated statin therapy. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new pharmacologically therapeutic target for decreasing LDL-C. PCSK9 reduces LDL intake from circulation by enhancing LDLR degradation and preventing LDLR recirculation to the cell surface...
May 11, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29735297/utilization-patterns-of-lipid-lowering-therapies-in-patients-with-atherosclerotic-cardiovascular-disease-or-diabetes-a-population-based-study-in-south-korea
#5
Siin Kim, Hyungtae Kim, Eunju Kim, Sola Han, Pratik P Rane, Kathleen M Fox, Zhongyun Zhao, Yi Qian, Hae Sun Suh
PURPOSE: We aimed to study the utilization patterns of lipid-lowering treatment (LLT), including treatment modification, adherence, and possible statin intolerance, in patients with atherosclerotic cardiovascular disease (ASCVD) or diabetes using national claims data in South Korea. METHODS: A retrospective cohort study was conducted using data from the Korean Health Insurance Review & Assessment Service claims database. Patients aged ≥18 years with >1 outpatient pharmacy claim for a statin and/or ezetimibe dated January 1, 2012, to December 31, 2014, were identified and categorized into the following cohorts: patients with ASCVD, and patients with diabetes mellitus without ASCVD...
May 4, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29726857/clinical-inquiries-does-niacin-decrease-cardiovascular-morbidity-and-mortality-in-cvd-patients
#6
Peter Lazzopina, Anne Mounsey, Lara Handler
No. Niacin doesn't reduce cardiovascular disease (CVD) morbidity or mortality in patients with established disease (strength of recommendation [SOR]: A, meta-analyses of randomized controlled trials [RCTs] and subsequent large RCTs). Niacin may be considered as monotherapy for patients intolerant of statins (SOR: B, one well-done RCT).
May 2018: Journal of Family Practice
https://www.readbyqxmd.com/read/29706390/does-googling-lead-to-statin-intolerance
#7
Sarah Khan, Anne Holbrook, Baiju R Shah
BACKGROUND: The nocebo effect, where patients with expectations of adverse effects are more likely to experience them, may contribute to the high rate of statin intolerance found in observational studies. Information that patients read on the internet may be a precipitant of this effect. The objective of the study was to establish whether the number of websites about statin side effects found using Google is associated with the prevalence of statin intolerance. METHODS: The prevalence of statin intolerance in 13 countries across 5 continents was established in a recent study via a web-based survey of primary care physicians and specialists...
July 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29609755/bempedoic-acid-etc-1002-a-current-review
#8
REVIEW
Anum Saeed, Christie M Ballantyne
Although statins are first-line therapy for low-density lipoprotein cholesterol (LDL-C) reduction, many individuals on maximally tolerated statin therapy have elevated LDL-C. Bempedoic acid (ETC-1002) is a novel once-daily LDL-C-lowering agent in phase 3 clinical trials. In phase 1 and 2 studies, ETC-1002 was efficacious in lowering LDL-C when used as monotherapy and when added to statin and/or ezetimibe and was well tolerated in patients with statin intolerance. ETC-1002 also improved cardiometabolic risk factors...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29609752/statin-intolerance-some-practical-hints
#9
REVIEW
Maciej Banach, Dimitri P Mikhailidis
Statin intolerance is the inability to tolerate a dose of statin required to sufficiently reduce cardiovascular risk. With the five-step approach, more than 90% of these patients might be treated with statins. The principal approaches are to try not to discontinue statin therapy and to treat these patients as effectively as possible. New therapies with the proprotein convertase subtilisin-kexin type 9 inhibitors and bempedoic acid might be an effective response to these needs. In case of lack of achieved goal of the therapy nutraceuticals with confirmed low-density lipoprotein cholesterol reduction properties may be considered as a part of the lipid-lowering combination therapy...
May 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29601328/statin-loading-in-cardiovascular-surgery-never-too-early-to-treat
#10
Niki Katsiki, Filippos Triposkiadis, Athanasios D Giannoukas, Dimitri P Mikhailidis
PURPOSE OF REVIEW: The effects of statin loading before, during or after vascular interventions on cardiovascular and renal outcomes are discussed. Furthermore, the selection of optimal statin type and dose, according to current evidence or guidelines, is considered. The importance of treating statin intolerance and avoiding statin discontinuation is also discussed. RECENT FINDINGS: Statin loading has been shown to beneficially affect cardiovascular outcomes, total mortality and/or contrast-induced acute kidney injury, in patients undergoing vascular procedures such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), carotid endarterectomy (CEA), carotid artery stenting, endovascular aneurysm repair, open abdominal aortic aneurysms (AAA) repair and lower extremities vascular interventions...
March 29, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29582393/adverse-events-to-food-supplements-containing-red-yeast-rice-comparative-analysis-of-faers-and-caers-reporting-systems
#11
Emanuel Raschi, Anna Girardi, Elisabetta Poluzzi, Emanuele Forcesi, Francesca Menniti-Ippolito, Gabriela Mazzanti, Fabrizio De Ponti
INTRODUCTION: Food supplements containing red yeast rice (RYR) are proposed as an alternative in statin-intolerant patients, although they actually contain natural statin(s) and their safety in clinical practice is still incompletely characterized. We described and compared adverse events (AEs) associated with RYR products submitted to reporting systems maintained by the Food and Drug Administration (FDA), with a focus on liver and muscular events. METHODS: We extracted RYR-related AEs from the FDA Adverse Event Reporting System (FAERS) [first quarter (Q1)-2004 to Q2-2016], a drug-based archive, and the Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS) (Q1-2004 to Q1-2017)...
March 26, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29580855/statin-therapy-is-associated-with-higher-long-term-but-not-perioperative-survival-after-abdominal-aortic-aneurysm-repair
#12
Thomas F X O'Donnell, Sarah E Deery, Katie E Shean, Murray A Mittleman, Jeremy D Darling, Mohammad H Eslami, Randall R DeMartino, Marc L Schermerhorn
BACKGROUND: Although preoperative and perioperative statin therapy improves postoperative outcomes in several populations, few data examine its association with survival after abdominal aortic aneurysm (AAA) repair. In addition, no data exist regarding the benefits of starting statins in patients with AAA not currently taking them. METHODS: We performed a registry-based study of all patients undergoing repair of AAAs in the Vascular Quality Initiative between 2003 and 2017 without documented statin intolerance...
March 23, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29562587/lipid-target-in-very-high-risk-cardiovascular-patients-lesson-from-pcsk9-monoclonal-antibodies
#13
REVIEW
Giovanni Ciccarelli, Saverio D'Elia, Michele De Paulis, Paolo Golino, Giovanni Cimmino
The role of low-density lipoproteins (LDLs) as a major risk factor for cardiovascular disease has been demonstrated by several epidemiological studies. The molecular basis for LDLs in atherosclerotic plaque formation and progression is not completely unraveled yet. Pharmacological modulation of plasma LDL-C concentrations and randomized clinical trials addressing the impact of lipid-lowering interventions on cardiovascular outcome have clearly shown that reducing plasma LDL-C concentrations results in a significant decrease in major cardiovascular events...
March 17, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29544086/new-medications-targeting-triglyceride-rich-lipoproteins-can-inhibition-of-angptl3-or-apoc-iii-reduce-the-residual-cardiovascular-risk
#14
REVIEW
Vesa M Olkkonen, Juha Sinisalo, Matti Jauhiainen
Remarkably good results have been achieved in the treatment of atherosclerotic cardiovascular diseases (CVD) by using statin, ezetimibe, antihypertensive, antithrombotic, and PCSK9 inhibitor therapies and their proper combinations. However, despite this success, the remaining CVD risk is still high. To target this residual risk and to treat patients who are statin-intolerant or have an exceptionally high CVD risk for instance due to familial hypercholesterolemia (FH), new therapies are intensively sought. One pathway of drug development is targeting the circulating triglyceride-rich lipoproteins (TRL) and their lipolytic remnants, which, according to the current view, confer a major CVD risk...
March 8, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29531380/-nutraceuticals-a-useful-tool-for-cardiologists-to-improve-lipid-profile
#15
Elisa Covolo, Claudio Bilato
Hyperlipidemia is a major risk factor for cardiovascular morbidity and mortality. Treatment strategies include both lifestyle modification and pharmacological therapy. Statins are among the most effective agents to achieve optimal LDL-cholesterol levels, but, not infrequently, patients suffer from myalgia or other side effects. The proven or perceived intolerance to statins requires, therefore, alternative lipid-lowering strategies. In recent years, nutraceuticals have become extensively accepted, and a growing number of molecules with hypothetical cholesterol-lowering activity have been proposed, sometimes with no scientific evidence and/or no methodological accuracy, based only on the belief that these agents are "natural" and do not show side effects...
February 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29525445/alirocumab-in-high-risk-patients-observations-from-the-open-label-expanded-use-program
#16
Charles J Glueck, Alan Brown, Anne C Goldberg, James M McKenney, Louis Kantaros, John Stewart, Joseph Elassal, Andrew Koren
BACKGROUND: The alirocumab expanded use program provided open-label access to alirocumab before its commercial availability to patients with severe hypercholesterolemia not controlled with maximally tolerated doses of standard-of-care lipid-lowering therapy. OBJECTIVE: To describe the safety and lipid-lowering efficacy of alirocumab in high-risk patients who were likely to be early users of proprotein convertase subtilisin/kexin type 9 inhibitors after approval...
February 7, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29511875/evolocumab-considerations-for-the-management-of-hyperlipidemia
#17
REVIEW
Barbara S Wiggins, Jeffrey Senfield, Helina Kassahun, Armando Lira, Ransi Somaratne
PURPOSE OF REVIEW: To review the efficacy, safety, pharmacology, and pharmacokinetics of evolocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor. RECENT FINDINGS: PCSK9 inhibitors are a class of lipid-lowering agents that significantly reduce low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease and hyperlipidemia. Evolocumab is a monoclonal antibody that inhibits PCSK9 and has been evaluated in phase II and III studies as monotherapy, in combination with statins and other lipid-lowering therapies, in patients who are statin intolerant, and in patients with heterozygous and homozygous familial hypercholesterolemia...
March 6, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29503145/statin-dose-reduction-with-complementary-diet-therapy-a-pilot-study-of-personalized-medicine
#18
Bianca Scolaro, Marina S Nogueira, Aline Paiva, Adriana Bertolami, Lucia P Barroso, Tomas Vaisar, Sean P Heffron, Edward A Fisher, Inar A Castro
OBJECTIVE: Statin intolerance, whether real or perceived, is a growing issue in clinical practice. Our aim was to evaluate the effects of reduced-dose statin therapy complemented with nutraceuticals. METHODS: First phase: Initially, 53 type 2 diabetic statin-treated patients received a supplementation with fish oil (1.7 g EPA + DHA/day), chocolate containing plant sterols (2.2 g/day), and green tea (two sachets/day) for 6 weeks. Second phase: "Good responders" to supplementation were identified after multivariate analysis (n = 10), and recruited for a pilot protocol of statin dose reduction...
May 2018: Molecular Metabolism
https://www.readbyqxmd.com/read/29493648/-red-yeast-rice-monacolin-k-and-pleiotropic-effects
#19
Arrigo Francesco Giuseppe Cicero
The extracts of red yeast rice represent a nutraceutical with proven cholesterol lowering effect. Its efficacy is proportional to the concentration on monacolin K in the extract that could reach the amount of 10 mg per daily dose. The daily assumption of monacolin K could then reduce LDL-cholesterol plasma levels by 15-25% in 6-8 weeks. The LDL-cholesterol reduction is associated with a proportional reduction in total cholesterolemia, non-HDL cholesterolemia, plasma apolipoprotein B, high-sensitivity C-reactive protein, and matrix metalloproteinases 2 and 9...
February 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29489129/-current-update-on-pcks9-inhibitors
#20
Baris Gencer, David Nanchen, Tinh-Hai Collet, Nicolas Rodondi, François Mach
PCSK9 (proprotein convertase subtilisin kexin 9) monoclonal antibodies (mAb) are new therapeutic agents to lower efficiently LDL-cholesterol levels. New data from large clinical trials suggest that the addition of PCSK9 mAb to statins can reduce the incidence of major adverse cardiovascular events in very high risk patients. Alirocumab and evolocumab are two agents available in Switzerland with specific limitations for reimbursement. PCSK9 mAb should be considered in patients with clinical atherosclerotic cardiovascular disease (ASCVD), as well as in patients with familial hypercholesterolemia without ASCVD who have substantially high LDL-cholesterol levels despite the use of statin at maximally tolerated dose with or without ezetimibe, or intolerance to appropriate doses of several statins...
February 28, 2018: Revue Médicale Suisse
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