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ASCVD risk

Brandon K Martinez, C Michael White
OBJECTIVE: To review the role of inflammatory suppression in patients with atherosclerotic cardiovascular disease (ASCVD) with a focus on the interleukin-1β blocker canakinumab. DATA SOURCES: An Ovid MEDLINE literature search (1946 to February 2018) was performed using search terms inflammation, ASCVD, atherosclerosis, C-reactive protein, canakinumab. Additional references were identified from a review of literature citations. STUDY SELECTION AND DATA EXTRACTION: English-language studies assessing the impact of pharmacological agents, including canakinumab, on inflammation as measured by high-sensitivity C-reactive protein (hsCRP) and the association with reducing ASCVD events were evaluated...
March 1, 2018: Annals of Pharmacotherapy
Jaideep Patel, Mahmoud Al Rifai, Maren T Scheuner, Steven Shea, Roger S Blumenthal, Khurram Nasir, Michael J Blaha, John W McEvoy
OBJECTIVE: To determine whether family history of coronary heart disease (FH) definitions differ in their association with atherosclerotic cardiovascular disease (ASCVD) events. PATIENTS AND METHODS: Participants who provided FH data from July 17, 2000, through February 24, 2004, were identified. Definitions of FH were any, premature, and Familial Risk Assessment (FRA). Outcomes included coronary heart disease (CHD), stroke, peripheral artery disease, angina, and congestive heart failure...
March 16, 2018: Mayo Clinic Proceedings
Simone L Verweij, Maurice W J de Ronde, Rutger Verbeek, S Matthijs Boekholdt, R Nils Planken, Erik S G Stroes, Sara-Joan Pinto-Sietsma
BACKGROUND: Elevated lipoprotein(a) (Lp(a)) levels are associated with increased risk for atherosclerotic cardiovascular disease (ASCVD). Individuals with a family history of premature ASCVD are at increased cardiovascular risk with concomitantly a higher burden of (subclinical) atherosclerosis. However, whether Lp(a) contributes to the increased atherosclerotic burden in these individuals remains to be established. OBJECTIVE: In this study, we evaluated the association between Lp(a) levels and coronary atherosclerotic burden, assessed by coronary arterty calcium (CAC) scores, in asymptomatic individuals with a family history of premature ASCVD...
February 16, 2018: Journal of Clinical Lipidology
Wilbert S Aronow, William H Frishman
The 2017 American College of Cardiology/American Heart Association hypertension guidelines diagnose hypertension if systolic blood pressure (SBP) is ≥ 130 mmHg or diastolic blood pressure (DBP) is ≥ 80 mmHg. Increased BP is SBP 120-129 mmHg with DBP < 80 mmHg. Lifestyle measures should be used to treat individuals with increased BP. Lifestyle measures plus BP-lowering drugs should be used for secondary prevention of recurrent cardiovascular events in individuals with clinical cardiovascular disease (coronary heart disease, congestive heart failure, or stroke) and an average SBP ≥ 130 mmHg or an average DBP ≥ 80 mmHg...
March 13, 2018: Drugs
Cristina Menni, Ivan Gudelj, Erin MacDonald-Dunlop, Massimo Mangino, Jonas Zierer, Erim Bešić, Peter Joshi, Irena Trbojević-Akmačić, Phil J Chowienczyk, Timothy D Spector, James F Wilson, Gordan Lauc, Ana M Valdes
<u>Rationale:</u> One measure of protein glycosylation (GlycA) has been reported to predict higher cardiovascular risk by reflecting inflammatory pathways <u>Objective:</u> To assess the role of a comprehensive panel of immunoglobulin (IgG) glycosylation traits on traditional risk factors for cardiovascular disease and on presence of subclinical atherosclerosis in addition to GlycA. <u>Methods and Results:</u> We measured 76 IgG glycosylation traits in 2970 women (age range 40-79 years) from the TwinsUK cohort and correlated it to their estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk score and their carotid and femoral plaque measured by ultrasound imaging...
March 13, 2018: Circulation Research
Martin Tibuakuu, Sina Kianoush, Andrew P DeFilippis, John W McEvoy, Di Zhao, Eliseo Guallar, Christie M Ballantyne, Ron C Hoogeveen, Michael J Blaha, Erin D Michos
Despite the causal role of cigarette smoking in atherosclerotic cardiovascular disease (ASCVD), the underlying mechanisms are not fully understood. We evaluated the joint relation between smoking and inflammatory markers with ASCVD risk. We tested cross-sectional associations of self-reported smoking status (never, former, current) and intensity (packs/day) with lipoprotein-associated phospholipase A2 (Lp-PLA2 ) activity and high-sensitivity C-reactive protein (hsCRP) in 10,506 Atherosclerosis Risk in Communities participants at Visit 4 (1996 to 1998)...
February 6, 2018: American Journal of Cardiology
Aleksander Siniarski, Maciej Haberka, Magdalena Mostowik, Renata Gołębiowska-Wiatrak, Małgorzata Poręba, Krzysztof Piotr Malinowski, Zbigniew Gąsior, Ewa Konduracka, Jadwiga Nessler, Grzegorz Gajos
BACKGROUND AND AIMS: Numerous recent studies conducted in different clinical settings have focused on the benefits of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention of cardiovascular diseases. There is limited evidence that patients with type 2 diabetes (T2D) and very high cardiovascular risk can also benefit from a high dose of n-3PUFAs, especially those on optimal medical therapy as recommended by the guidelines. The aim of the present study was to assess the impact of high-dose n-3 PUFA treatment on endothelial function in patients with T2D and established atherosclerotic cardiovascular disease (ASCVD)...
March 2, 2018: Atherosclerosis
Cori Russell, Samip Sheth, Douglas Jacoby
PURPOSE OF REVIEW: We provide an overview of our current understanding of combination lipid-lowering therapies intended for dyslipidemia treatment and cardiovascular disease prevention. First, we analyze recent statin and non-statin combination therapy guidelines and clinical studies since the publication of 2013 American College of Cardiology Cholesterol Guidelines. Second, we examine the clinical utility of non-statin agents alone and in combination in terms of LDL-C lowering and ASCVD risk reduction...
March 7, 2018: Current Atherosclerosis Reports
Chee Hae Kim, Shuang Wang, Jun-Bean Park, Keun-Hwa Jung, Yeonyee E Yoon, Seung-Pyo Lee, Hyung-Kwan Kim, Yong-Jin Kim, Goo-Yeong Cho, Dae-Won Sohn
AIM: Speckle-tracking imaging has been introduced for the precise assessment of vessel mechanics. However, there are no data on the role of this imaging tool in assessing the changes in vasculature with statin therapy, which is known to enhance vascular elasticity. METHODS: This study was a prospective study including 48 statin-naïve patients (age, 58.2±8.4 years; 29.2% male) with hypercholesterolemia. Circumferential carotid artery strain (CAS) and stiffness index (β2 ) were measured using speckle-tracking imaging before and after 3 months of high-dose pitavastatin treatment (4 mg daily)...
March 7, 2018: Journal of Atherosclerosis and Thrombosis
Mohammed K Ali, Kai McKeever Bullard, Sharon Saydah, Giuseppina Imperatore, Edward W Gregg
BACKGROUND: There is controversy over the usefulness of prediabetes as a diagnostic label. Using data from US National Health and Nutrition Examination Surveys (NHANES) between 1988 and 2014, we examined the cardiovascular and renal burdens in adults with prediabetes over time and compared patterns with other glycaemic status groups. METHODS: We analysed cross-sectional survey data from non-pregnant adults aged 20 years and older from the NHANES survey periods 1988-94, 1999-2004, 2005-10, and 2011-14...
February 27, 2018: Lancet Diabetes & Endocrinology
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
Reto Daniel Kurmann, Rekha Mankad
Autoimmune rheumatologic conditions have increased cardiovascular morbidity and mortality compared to the general population. Many of these diseases occur more commonly in women, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis, and Sjogren's. Most of the literature that has identified the link between autoimmune diseases and atherosclerotic cardiovascular disease (ASCVD) has been regarding patients with RA and SLE. The reason for the increased ASCVD is related to both traditional risk factors for atherosclerosis and nontraditional risk factors such as the burden of inflammation...
February 26, 2018: Clinical Cardiology
Peter A McCullough, Christie M Ballantyne, Santosh K Sanganalmath, Gisle Langslet, Seth J Baum, Prediman K Shah, Andrew Koren, Jonas Mandel, Michael H Davidson
Patients with previous atherosclerotic cardiovascular disease (ASCVD) and/or heterozygous familial hypercholesterolemia (HeFH) are at high risk of future cardiovascular events. Despite maximally tolerated doses of statins, many patients still have elevated low-density lipoprotein cholesterol (LDL-C) levels. We evaluated the efficacy and safety of alirocumab in patients with ASCVD and/or HeFH on a maximally tolerated dose of statin (rosuvastatin 20 or 40 mg, atorvastatin 40 or 80 mg, or simvastatin 80 mg, or lower doses with an investigator-approved reason) ± other lipid-lowering therapies from 5 placebo-controlled phase 3 trials (52 to 78 weeks)...
February 2, 2018: American Journal of Cardiology
Faisal Rahman, Roger S Blumenthal, Steven R Jones, Seth S Martin, Tyler J Gluckman, Seamus P Whelton
PURPOSE OF REVIEW: Dyslipidemia is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD); however, lipid testing for risk assessment and treatment surveillance has been underutilized. Several factors likely account for this, including the common practice of measuring lipid levels in the fasting state, which often necessitates that patients return for an additional visit. In this review, we evaluate potential advantages and cautions associated with measuring lipids in the non-fasting state...
February 17, 2018: Current Atherosclerosis Reports
Adam Leigh, John W McEvoy, Parveen Garg, J Jeffrey Carr, Veit Sandfort, Elizabeth C Oelsner, Matthew Budoff, David Herrington, Joseph Yeboah
OBJECTIVES: This study assessed the utility of the pooled cohort equation (PCE) and/or coronary artery calcium (CAC) for atherosclerotic cardiovascular disease (ASCVD) risk assessment in smokers, especially those who were lung cancer screening eligible (LCSE). BACKGROUND: The U.S. Preventive Services Task Force recommended and the Centers for Medicare & Medicaid Services currently pays for annual screening for lung cancer with low-dose computed tomography scans in a specified group of cigarette smokers...
February 9, 2018: JACC. Cardiovascular Imaging
Chern-En Chiang, Shih-Yi Lin, Tsung-Hsien Lin, Tzung-Dau Wang, Hung-I Yeh, Jung-Fu Chen, Chia-Ti Tsai, Yi-Jen Hung, Yi-Heng Li, Ping-Yen Liu, Kuan-Cheng Chang, Kang-Ling Wang, Ting-Hsing Chao, Kou-Gi Shyu, Wei-Shiung Yang, Kwo-Chang Ueng, Pao-Hsien Chu, Wei-Hsian Yin, Yen-Wen Wu, Hao-Min Cheng, Shyi-Jang Shin, Chien-Ning Huang, Lee-Ming Chuang, Shing-Jong Lin, San-Jou Yeh, Wayne Huey-Herng Sheu, Jiunn-Lee Lin
The global incidence and prevalence of type 2 diabetes have been escalating in recent decades. Patients with type 2 diabetes have an increased risk of atherosclerotic cardiovascular disease (ASCVD). About two-thirds of death in type 2 diabetes are due to ASCVD, including 40% from coronary heart disease (CHD), 15% from heart failure (HF), and 10% from stroke. The association between hyperglycemia and elevated CV risk has been demonstrated in multiple cohort studies. However, clinical trials of intensive glucose reduction did not significantly reduce macrovascular outcomes...
February 13, 2018: Journal of the Chinese Medical Association: JCMA
Malgorzata Poreba, Pawel Rostoff, Aleksander Siniarski, Magdalena Mostowik, Renata Golebiowska-Wiatrak, Jadwiga Nessler, Anetta Undas, Grzegorz Gajos
BACKGROUND: There are inconsistent data about the role of serum phospholipid fatty acid composition in patients with type 2 diabetes (T2DM) and atherosclerotic cardiovascular disease (ASCVD). The aim of the study was to investigate the relationship between serum phospholipid fatty acid composition, systemic low-grade inflammation, and glycemic control in high-risk T2DM patients. METHODS: Seventy-four patients (26% women, mean age 65.6 ± 6.8 years) with T2DM (median diabetes duration 10 years) and documented ASCVD (74 with coronary artery disease, 26 with peripheral arterial disease) were enrolled in the study...
February 16, 2018: Cardiovascular Diabetology
Virginia A Triant, Jeremiah Perez, Susan Regan, Joseph M Massaro, James B Meigs, Steven K Grinspoon, Ralph B D'Agostino
Background -Cardiovascular disease (CVD) risk is elevated in HIV-infected individuals, with contributions from both traditional and non-traditional risk factors. The accuracy of established CVD risk prediction functions in HIV is uncertain. We sought to assess the performance of three established CVD risk prediction functions in a longitudinal cohort of HIV-infected men. Methods -Framingham Heart Study (Framingham) functions for hard coronary heart disease (Framingham CHD) and atherosclerotic CVD (Framingham ASCVD) and the American College of Cardiology/American Heart Association (ACC/AHA ASCVD) function were applied to the Partners HIV cohort...
February 14, 2018: Circulation
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
Khadija Irfan Khawaja, Saqib Ali Mian, Aziz Fatima, Ghulam Murtaza Tahir, Fehmida Farrukh Khan, Saira Burney, Ali Hasan, Faisal Masud
INTRODUCTION: Metabolic heterogeneity among obese individuals is thought to translate into variation in cardiovascular risk. Identifying obese people with an unfavourable metabolic profile may allow targeting preventive strategies towards those at greatest risk. This study aimed to identify clinical, biochemical and immunological differences between insulin sensitive and resistant obese subgroups, to understand the population-specific pathophysiological basis of the adverse cardiovascular risk profile in the latter group...
February 12, 2018: Singapore Medical Journal
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