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Cardiovascular Secondary prevention

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https://www.readbyqxmd.com/read/28304291/insulin-resistance-and-future-cognitive-performance-and-cognitive-decline-in%C3%A2-elderly-patients-with-cardiovascular-disease
#1
Miri Lutski, Galit Weinstein, Uri Goldbourt, David Tanne
BACKGROUND: The role of insulin resistance (IR) in the pathogenesis of cognitive performance is not yet clear. OBJECTIVE: To examine the associations between IR and cognitive performance and change in cognitive functions two decades later in individuals with cardiovascular disease with and without diabetes. METHODS: A subset of 489 surviving patients (mean age at baseline 58±6.6 y) with coronary heart disease who previously participated in the secondary prevention Bezafibrate Infarction Prevention (BIP trial; 1990-1997), were included in the current neurocognitive study...
March 10, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28304224/evolocumab-and-clinical-outcomes-in-patients-with-cardiovascular-disease
#2
Marc S Sabatine, Robert P Giugliano, Anthony C Keech, Narimon Honarpour, Stephen D Wiviott, Sabina A Murphy, Julia F Kuder, Huei Wang, Thomas Liu, Scott M Wasserman, Peter S Sever, Terje R Pedersen
Background Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. Methods We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy...
March 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28303466/do-statins-have-antidepressant-effects
#3
Ole Köhler-Forsberg, Christiane Gasse, Michael Berk, Søren Dinesen Østergaard
Statins are used widely in primary and secondary prevention of cardiovascular disease; a treatment effect that has long been thought to be due to their cholesterol-lowering properties. However, statins also have a wide range of anti-inflammatory effects independent of their lipid-lowering mechanisms. In depression, low-grade inflammation is a replicated finding, and several studies have shown antidepressant properties of diverse anti-inflammatory drugs. Large observational studies have suggested reduced risks of depression amongst those taking statins, an effect that is thought to be explained by the anti-inflammatory properties of this class of drugs...
March 16, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28302739/changing-landscape-of-congenital-heart-disease
#4
Berto J Bouma, Barbara J M Mulder
Congenital heart disease is the most frequently occurring congenital disorder affecting ≈0.8% of live births. Thanks to great efforts and technical improvements, including the development of cardiopulmonary bypass in the 1950s, large-scale repair in these patients became possible, with subsequent dramatic reduction in morbidity and mortality. The ongoing search for progress and the growing understanding of the cardiovascular system and its pathophysiology refined all aspects of care for these patients. As a consequence, survival further increased over the past decades, and a new group of patients, those who survived congenital heart disease into adulthood, emerged...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28300864/whole-exome-sequencing-in-the-framingham-heart-study-identifies-rare-variation-in-hyal2-that-influences-platelet-aggregation
#5
John D Eicher, Ming-Huei Chen, Achilleas N Pitsillides, Honghuang Lin, Narayanan Veeraraghavan, Jennifer A Brody, Ginger A Metcalf, Donna M Muzny, Richard A Gibbs, Diane M Becker, Lewis C Becker, Nauder Faraday, Rasika A Mathias, Lisa R Yanek, Eric Boerwinkle, L Adrienne Cupples, Andrew D Johnson
Inhibition of platelet reactivity is a common therapeutic strategy in secondary prevention of cardiovascular disease. Genetic and environmental factors influence inter-individual variation in platelet reactivity. Identifying genes that contribute to platelet reactivity can reveal new biological mechanisms and possible therapeutic targets. Here, we examined rare coding variation to identify genes associated with platelet reactivity in a population-based cohort. To do so, we performed whole exome sequencing in the Framingham Heart Study and conducted single variant and gene-based association tests against platelet reactivity to collagen, adenosine diphosphate (ADP), and epinephrine agonists in up to 1,211 individuals...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28295777/can-ldl-cholesterol-be-too-low-possible-risks-of-extremely-low-levels
#6
Anders G Olsson, Bo Angelin, Gerd Assmann, Christoph J Binder, Ingemar Björkhem, Angel Cedazo-Minguez, Jonathan Cohen, Arnold von Eckardstein, Eduardo Farinaro, Dirk Müller-Wieland, Klaus G Parhofer, Paolo Parini, Robert S Rosenson, Jakob Starup-Linde, Matti J Tikkanen, Laurent Yvan-Charvet
Following the continuous accumulation of evidence supporting the beneficial role of reducing low-density lipoprotein cholesterol (LDL-C) levels in the treatment and prevention of atherosclerotic cardiovascular disease and its complications, therapeutic possibilities now exist to lower LDL-C to very low levels, similar to or even lower than those seen in newborns and nonhuman species. In addition to the important task of evaluating potential side-effects of such treatments, the question arises whether extremely low LDL-C levels per se may provoke adverse effects in humans...
March 14, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28294880/-results-of-monitoring-of-the-plan-of-measures-directed-to-reduction-of-ischemic-heart-disease-in-north-caucasus-republics-analysis-of-dynamics-of-cardio-vascular-mortality
#7
M N Mamedov
Comparative analysis of dynamics of cardiovascular mortality in Russia and foreign countries as well as main directions of development of cardiological service in Russia are presented in this review article. Plan of measures for reduction of mortality from ischemic heart disease (IHD) was created in 2015. This plan comprises 4 blocks of assessment of the following measures: directed at improvement of primary IHD prevention (1), directed at secondary prevention of complications of IHD (2); directed at improvement of efficacy of medical care of patients with IHD (3), and directed at monitoring of some demographic parameters (4)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28293429/influence-of-nonsteroidal-anti-inflammatory-drugs-on-aspirin-s-antiplatelet-effects-and-suggestion-of-the-most-suitable-time-for-administration-of-both-agents-without-resulting-in-interaction
#8
Kenta Shibata, Yuuki Akagi, Naofumi Nozawa, Hitoshi Shimomura, Takao Aoyama
BACKGROUND: Low-dose aspirin irreversibly inhibits platelet cyclooxygenase-1 (COX-1) and suppresses platelet aggregation. It is effective for secondary prevention of cardiovascular events. Because nonsteroidal anti-inflammatory drugs (NSAIDs) reversibly bind with COX-1, the antiplatelet effects of aspirin may be suppressed when NSAIDs are co-administered. This interaction could be avoided by avoiding simultaneous administration; however, the minimum interval that should separate the administration of aspirin and loxoprofen is not well known...
2017: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/28290995/uses-of-polypills-for-cardiovascular-disease-and-evidence-to-date
#9
REVIEW
Mark D Huffman, Denis Xavier, Pablo Perel
Polypills have been approved in more than 30 countries, but worldwide experience with and availability of polypills remain limited, unlike fixed-dose combinations in other diseases such as HIV, tuberculosis, and malaria. In this Series review, we aim to propose a guide for the use of polypills in future research and clinical activities and to synthesise contemporary evidence supporting the use of polypills for prevention of atherosclerosis. Polypill uses can be categorised by population and indication, both of which influence the balance between benefits and risks...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290160/risk-scoring-for-the-primary-prevention-of-cardiovascular-disease
#10
REVIEW
Kunal N Karmali, Stephen D Persell, Pablo Perel, Donald M Lloyd-Jones, Mark A Berendsen, Mark D Huffman
BACKGROUND: The current paradigm for cardiovascular disease (CVD) emphasises absolute risk assessment to guide treatment decisions in primary prevention. Although the derivation and validation of multivariable risk assessment tools, or CVD risk scores, have attracted considerable attention, their effect on clinical outcomes is uncertain. OBJECTIVES: To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes, risk factor levels, preventive medication prescribing, and health behaviours...
March 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28289069/omega-3-polyunsaturated-fatty-acid-fish-oil-supplementation-and-the-prevention-of-clinical-cardiovascular-disease-a-science-advisory-from-the-american-heart-association
#11
REVIEW
David S Siscovick, Thomas A Barringer, Amanda M Fretts, Jason H Y Wu, Alice H Lichtenstein, Rebecca B Costello, Penny M Kris-Etherton, Terry A Jacobson, Mary B Engler, Heather M Alger, Lawrence J Appel, Dariush Mozaffarian
Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease...
March 13, 2017: Circulation
https://www.readbyqxmd.com/read/28285796/cardiovascular-disease-in-women-with-hiv-1-infection
#12
Massimo Volpe, Alessia Uglietti, Antonella Castagna, Cristina Mussini, Giulia Marchetti, Rita Bellagamba, Teresa Bini, Daniela Mancusi, Roberta Termini
Cardiovascular disease is a leading cause of death in women, nevertheless it is often underestimated in female patients without overt risk factors. The chronic infection by Human Immunodeficiency Virus (HIV) is clearly associated, along with the use of certain antiretroviral drugs and traditional risk factors, with an increased risk of cardiovascular diseases. The aim of this manuscript is to review the epidemiology, risk factors, pathogenesis, diagnostic approach, primary and secondary prevention strategies of cardiovascular disease in HIV-negative and HIV-positive female subjects...
February 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28285379/evolocumab-for-treating-primary-hypercholesterolaemia-and-mixed-dyslipidaemia-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#13
Christopher Carroll, Paul Tappenden, Rachid Rafia, Jean Hamilton, Duncan Chambers, Mark Clowes, Paul Durrington, Nadeem Qureshi, Anthony S Wierzbicki
As part of its single technology appraisal (STA) process, the UK National Institute for Health and Care Excellence (NICE) invited the manufacturer of evolocumab (Amgen) to submit evidence on the clinical and cost effectiveness of evolocumab. The appraisal assessed evolocumab as monotherapy or in combination with a statin with or without ezetimibe, or in combination with ezetimibe (without statin therapy), in adult patients with primary hypercholesterolaemia (which includes mixed dyslipidaemia), for whom statins do not provide optimal control of their low-density lipoprotein cholesterol (LDL-C) levels and/or for whom statins are contraindicated or not tolerated...
March 11, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28285267/angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-in-high-vascular-risk
#14
Louis Potier, Ronan Roussel, Yedid Elbez, Michel Marre, Uwe Zeymer, Christopher M Reid, Magnus Ohman, Kim A Eagle, Deepak L Bhatt, Philippe Gabriel Steg
OBJECTIVE: ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely prescribed in patients with high cardiovascular (CV) risk. However, whether both classes have equivalent effectiveness to prevent CV events remains unclear. The aim of this study was to compare the incidence of major CV events between ACEI and ARB users. METHODS: The Reduction of Atherothrombosis for Continued Health registry is an observational study who enrolled 69 055 individuals with high CV risk...
March 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28284844/investigating-methotrexate-toxicity-within-a-randomized-double-blinded-placebo-controlled-trial-rationale-and-design-of-the-cardiovascular-inflammation-reduction-trial-adverse-events-cirt-ae-study
#15
Jeffrey A Sparks, Medha Barbhaiya, Elizabeth W Karlson, Susan Y Ritter, Soumya Raychaudhuri, Cassandra C Corrigan, Fengxin Lu, Jacob Selhub, Daniel I Chasman, Nina P Paynter, Paul M Ridker, Daniel H Solomon
BACKGROUND: The role of low dose methotrexate (LDM) in potential serious toxicities remains unclear despite its common use. Prior observational studies investigating LDM toxicity compared LDM to other active drugs. Prior placebo-controlled clinical trials of LDM in inflammatory conditions were not large enough to investigate toxicity. The Cardiovascular Inflammation Reduction Trial (CIRT) is an ongoing NIH-funded, randomized, double-blind, placebo-controlled trial of LDM in the secondary prevention of cardiovascular disease...
February 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28279217/hypofibrinolysis-in-diabetes-a-therapeutic-target-for-the-reduction-of-cardiovascular-risk
#16
REVIEW
Katherine Kearney, Darren Tomlinson, Kerrie Smith, Ramzi Ajjan
An enhanced thrombotic environment and premature atherosclerosis are key factors for the increased cardiovascular risk in diabetes. The occlusive vascular thrombus, formed secondary to interactions between platelets and coagulation proteins, is composed of a skeleton of fibrin fibres with cellular elements embedded in this network. Diabetes is characterised by quantitative and qualitative changes in coagulation proteins, which collectively increase resistance to fibrinolysis, consequently augmenting thrombosis risk...
March 9, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28279072/aspirin-in-older-adults
#17
Mandi Sehgal, Sarah K Wood, Joseph G Ouslander, Charles H Hennekens
In the treatment or secondary prevention of cardiovascular disease (CVD), there is general consensus that the absolute benefits of aspirin far outweigh the absolute risks. Despite evidence from randomized trials and their meta-analyses, older adults, defined as aged 65 years or older, are less likely to be prescribed aspirin than their middle-aged counterparts. In primary prevention, the optimal utilization of aspirin is widely debated. There is insufficient randomized evidence among apparently healthy participants at moderate to high risk of a first CVD event, so general guidelines seem premature...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28277861/state-transition-model-vorapaxar-added-to-standard-antiplatelet-therapy-to-prevent-thrombosis-post-myocardial-infarction-or-peripheral-artery-disease
#18
Mark Du, Monica Chase, Mustafa Oguz, Glenn Davies
OBJECTIVE: To evaluate long-term health benefits and risks of adding vorapaxar (VOR) to the standard care antiplatelet therapy (SC) of aspirin and/or clopidogrel, among a population with a recent myocardial infarction (MI) and/or peripheral artery disease (PAD). RESEARCH DESIGN AND METHODS: In a state-transition model, patients transition between health states (event-free, recurrent MI, stroke, death), while at risk of experiencing non-transition-related revascularization and non-fatal bleeding events...
March 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28276790/new-onset-diabetes-mellitus-induced-by-statins-current-evidence
#19
Steven G Chrysant
The hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase inhibitors of statin action are very effective and safe drugs, and they are widely used for the treatment of hyperlipidemia and the prevention of primary and secondary cardiovascular diseases (CVDs). However, recent meta-analyses of previous studies done with statins have shown that these drugs could induce new onset diabetes mellitus (NODM), especially in subjects prone to diabetes: obese, females, older age, Asian descent, and those with pre-diabetes or the metabolic syndrome...
February 24, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28270639/new-insights-into-pathophysiology-diagnosis-and-treatment-of-renovascular-hypertension
#20
Fariba Samadian, Nooshin Dalili, Ali Jamalian
Renovascular disease includes renal artery stenosis, renovascular hypertension, and azotemic renovascular disease (ischemic nephropathy). Renovascular hypertension is defined as an elevated blood pressure caused by renal hypoperfusion, usually resulting from anatomic stenosis of the renal artery and activation of the renin-angiotensin system. It accounts for 1% to 2 % of all cases of hypertension in the general population and 5.8 % of secondary hypertension, but it plays a major role in treatable causes of hypertension in the young individuals...
March 2017: Iranian Journal of Kidney Diseases
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