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https://www.readbyqxmd.com/read/29148854/comparative-effectiveness-of-lipid-lowering-treatments-to-reduce-cardiovascular-disease
#1
Dong-Churl Suh, Scott K Griggs, Emmett R Henderson, Seung-Mi Lee, Taehwan Park
With the advent of a new drug class - the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, patients have another treatment option for lowering their high levels of low-density lipoprotein cholesterol (LDL-C) in recent years. The objective of this study was to systematically review the cost-effectiveness of lipid-lowering agents such as statins, ezetimibe, and PCSK9 inhibitors. Areas covered: Based on PubMed, Embase, and Cochrane Database of Systematic Reviews, we identified a total of 29 relevant articles...
November 17, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29096867/the-efficacy-of-anti-pcsk9-antibodies-results-from-recent-trials
#2
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
#3
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
#4
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
#5
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
#6
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-hope-3
#7
REVIEW
Travis M Howard, Aakash A Bavishi, Neil J Stone
Lifestyle medication is the cornerstone of preventing atherosclerotic cardiovascular disease (ASCVD). When this is not sufficient in reducing risk, statin therapy is first line. HOPE-3 was a randomized controlled trial of rosuvastatin vs 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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/29020356/a-common-missense-variant-of-lilrb5-is-associated-with-statin-intolerance-and-myalgia
#11
Moneeza K Siddiqui, Cyrielle Maroteau, Abirami Veluchamy, Aleksi Tornio, Roger Tavendale, Fiona Carr, Ngu-Uma Abelega, Dan Carr, Katyrzyna Bloch, Par Hallberg, Qun-Ying Yue, Ewan R Pearson, Helen M Colhoun, Andrew D Morris, Eleanor Dow, Jacob George, Munir Pirmohamed, Paul M Ridker, Alex S F Doney, Ana Alfirevic, Mia Wadelius, Anke-Hilse Maitland-van der Zee, Daniel I Chasman, Colin N A Palmer
Aims: A genetic variant in LILRB5 (leukocyte immunoglobulin-like receptor subfamily-B) (rs12975366: T > C: Asp247Gly) has been reported to be associated with lower creatine phosphokinase (CK) and lactate dehydrogenase (LDH) levels. Both biomarkers are released from injured muscle tissue, making this variant a potential candidate for susceptibility to muscle-related symptoms. We examined the association of this variant with statin intolerance ascertained from electronic medical records in the GoDARTS study...
August 29, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28994502/pro-protein-subtilisin-kexin-9-pcsk9-inhibition-in-practice-lipid-clinic-experience-in-2-contrasting-uk-centres
#12
Monika Kohli, Kinjal Patel, Zofia MacMahon, Radha Ramachandran, Martin A Crook, Timothy M Reynolds, Anthony S Wierzbicki
BACKGROUND: Prescribing criteria have been suggested for proprotein convertase subtilisin kexin-9 (PCSK-9) inhibitors but few studies exist of their real-world effectiveness. METHODS: This study audited PCSK-9 inhibitor therapy in 105 consecutive patients from two hospital centres-a university hospital (UH; n = 70) and a district general hospital (DGH; n = 35). Baseline characteristics including cardiovascular disease risk factors, NICE qualification criteria, efficacy and side effects were assessed...
October 10, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28978219/epidemiology-and-management-of-hyperlipidemia
#13
Samantha Karr
Cardiovascular disease (CVD) is the leading cause of death among adults in the United States, and people with hyperlipidemia are at roughly twice the risk of developing CVD as compared to those with normal total cholesterol levels.1 Patients with familial hypercholesterolemia (FH) have an even greater risk of developing CVD at an earlier age; therefore, early detection and treatment are imperative to reduce cardiovascular events and premature death. Statins are the mainstay treatment for hyperlipidemia; however, the limitations of statins include treatment resistance, intolerance due to adverse events, and a lack of adherence which contribute to poor outcomes...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28961179/anacetrapib-a-new-cetp-inhibitor-the-new-tool-for-the-management-of-dyslipidemias
#14
REVIEW
Theodosios D Filippatos, Anastazia Kei, Moses S Elisaf
Cholesteryl ester transfer protein (CETP) inhibitors significantly increase serum high-density lipoprotein cholesterol (HDL) cholesterol levels and decrease low-density lipoprotein cholesterol (LDL) cholesterol concentration. However, three drugs of this class failed to show a decrease of cardiovascular events in high-risk patients. A new CETP inhibitor, anacetrapib, substantially increases HDL cholesterol and apolipoprotein (Apo) AI levels with a profound increase of large HDL2 particles, but also pre-β HDL particles, decreases LDL cholesterol levels mainly due to increased catabolism of LDL particles through LDL receptors, decreases lipoprotein a (Lp(a)) levels owing to a decreased Apo (a) production and, finally, decreases modestly triglyceride (TRG) levels due to increased lipolysis and increased receptor-mediated catabolism of TRG-rich particles...
September 29, 2017: Diseases (Basel)
https://www.readbyqxmd.com/read/28951664/use-of-the-guidelines-directed-medical-therapy-after-coronary-artery-bypass-graft-surgery-in-saudi-arabia
#15
Khalid A Alburikan, Rakan I Nazer
Background: incidence of cardiovascular diseases in Saudi Arabia is growing and more patients are expected to have cardiac revascularization surgery. Optimal pharmacotherapy management with Guideline Directed Medical Therapy (GDMT) post coronary artery bypass grafting (CABG) plays an important role in the prevention of adverse cardiovascular outcomes. The objective of this study was to assess the utilization of GDMT for secondary prevention in CABG patients and determine whether specific patients' characteristics can influence GDMT utilization...
September 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28943224/the-effect-of-lipophilicity-and-dose-on-the-frequency-of-statin-associated-muscle-symptoms-a-systematic-review-and-meta-analysis
#16
REVIEW
Jordon C Irwin, Saman Khalesi, Andrew S Fenning, Rebecca K Vella
Addressing the factors which lead to the development of statin-associated muscle symptoms (SAMS) is vital for maintaining patient compliance with these pharmaceuticals, and thus improving patient outcomes. This study aimed to clarify the relationship between statin lipophilicity, or dose, and the frequency of adverse muscle symptoms using a systematic review of randomised controlled trials (RCTs). RCTs, including statin monotherapy and placebo groups, which reported data on muscle adverse events were identified through the PubMed and Scopus databases...
September 21, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28938795/lipid-lowering-nutraceuticals-in-clinical-practice-position-paper-from-an-international-lipid-expert-panel
#17
Arrigo F G Cicero, Alessandro Colletti, Gani Bajraktari, Olivier Descamps, Dragan M Djuric, Marat Ezhov, Zlatko Fras, Niki Katsiki, Michel Langlois, Gustavs Latkovskis, Demosthenes B Panagiotakos, Gyorgy Paragh, Dimitri P Mikhailidis, Olena Mitchenko, Bernhard Paulweber, Daniel Pella, Christos Pitsavos, Željko Reiner, Kausik K Ray, Manfredi Rizzo, Amirhossein Sahebkar, Maria-Corina Serban, Laurence S Sperling, Peter P Toth, Dragos Vinereanu, Michal Vrablík, Nathan D Wong, Maciej Banach
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity...
September 1, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28914630/strategies-for-the-use-of-nonstatin-therapies
#18
Angela Pirillo, Giuseppe D Norata, Alberico L Catapano
PURPOSE OF REVIEW: Dyslipidaemias are a major risk factor for cardiovascular disease (CVD); in particular, high levels of low-density lipoprotein cholesterol (LDL-C) have been associated to a higher cardiovascular risk. Reducing LDL-C levels decreases the risk of coronary heart disease (CHD), and the greater the LDL-C reduction, the greater the decrease in cardiovascular risk. Although statins represent the first line lipid-lowering therapy, many patients do not reach the recommended goals or exhibit adverse side effects leading to therapy discontinuation; in addition, a significant percentage of statin-treated patients continue to experience cardiovascular events even in the presence of well controlled LDL-C levels, because of alterations in other lipid/lipoprotein classes, including triglycerides and high-density lipoprotein cholesterol...
December 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28902717/new-approaches-to-address-dyslipidemia
#19
Klaus G Parhofer
PURPOSE OF REVIEW: Although lipid-lowering treatment with statins, ezetimibe, and PCSK9 inhibitors is a very successful strategy to prevent cardiovascular events, there is a need for further drug developments. Not all patients respond sufficiently to the available therapy (very high baseline values, intolerance). Furthermore, patients may be characterized by dyslipidemias not accessible to available drugs such as patients with homozygous familial hypercholesterolemia, chylomicronemia syndrome, or elevated lipoprotein(a)...
September 11, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28886926/2017-focused-update-of-the-2016%C3%A2-acc%C3%A2-expert-consensus-decision-pathway-on-the-role-of-non-statin-therapies-for-ldl-cholesterol-lowering-in%C3%A2-the-management-of-atherosclerotic-cardiovascular-disease-risk-a-report-of-the-american-college-of-cardiology-task-force
#20
Donald M Lloyd-Jones, Pamela B Morris, Christie M Ballantyne, Kim K Birtcher, David D Daly, Sondra M DePalma, Margo B Minissian, Carl E Orringer, Sidney C Smith
In 2016, the American College of Cardiology published the first expert consensus decision pathway (ECDP) on the role of non-statin therapies for low-density lipoprotein (LDL)-cholesterol lowering in the management of atherosclerotic cardiovascular disease (ASCVD) risk. Since the publication of that document, additional evidence and perspectives have emerged from randomized clinical trials and other sources, particularly considering the longer-term efficacy and safety of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors in secondary prevention of ASCVD...
October 3, 2017: Journal of the American College of Cardiology
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