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Cardiovascular Secondary prevention

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https://www.readbyqxmd.com/read/27922588/does-the-addition-of-ezetimibe-to-statins-reduce-cardiovascular-risk
#1
Francisca I Araya, Bruno Grassi
Statins are the mainstay of lipid-lowering therapy nowadays, since they reduce cardiovascular risk when used as primary or secondary prevention. However, only one third of the patients reach the goals established in several guidelines, and even if they do, they keep a risk higher than healthy controls. One of the new lipid-lowering agents is ezetimibe. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified nine systematic reviews comprising 67 trials overall...
December 5, 2016: Medwave
https://www.readbyqxmd.com/read/27921360/mortality-in-patients-who-discontinue-low-dose-acetylsalicylic-acid-therapy-after-upper-gastrointestinal-bleeding
#2
Antonio González-Pérez, María Eugenia Sáez, Saga Johansson, Péter Nagy, Luis A García Rodríguez
PURPOSE: Discontinuing low-dose acetylsalicylic acid (ASA) therapy after upper gastrointestinal bleeding (UGIB) may increase the risk of cardiovascular-related death. Our aim was to compare mortality in UK primary care patients who discontinue ASA after UGIB with that in patients who continue therapy. METHODS: ASA users at the time of UGIB and who were alive 30 days after were selected using The Health Improvement Network. Predictors of survival were assessed using adjusted Cox proportional hazards regression models...
December 6, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27920074/a-critical-appraisal-of-aspirin-in-secondary-prevention-is-less-more
#3
Giuseppe Gargiulo, Stephan Windecker, Pascal Vranckx, Charles Michael Gibson, Roxana Mehran, Marco Valgimigli
Aspirin represents the sine qua non for antiplatelet pharmacotherapy in patients with cardiovascular diseases because of its well-established role in secondary prevention and its widespread availability and affordability. Historical studies, conducted in an era that bears little resemblance to contemporary clinical practice, demonstrated large reductions in thrombotic risk when aspirin was compared with placebo, thus forming the evidence base promulgated in practice guidelines and recommendations. P2Y12 inhibitors have mostly been studied in addition to aspirin; dual-antiplatelet therapy proved superiority compared with aspirin monotherapy for the prevention of ischemic events, despite increased bleeding risks...
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27917712/the-role-of-antiplatelet-therapy-in-primary-prevention-a-review
#4
Lauge Østergaard, Emil L Fosbøl, Matthew T Roe
The efficacy of antiplatelet therapy for the secondary prevention of cardiovascular disease after an ischemic event is well established. However, the role for antiplatelet therapy for the primary prevention of cardiovascular disease is more complex because of the interplay of efficacy vs safety in individuals without established cardiovascular disease who have a relatively low, but linear trajectory of cardiovascular risk. Several large randomized trials have investigated the efficacy and safety of antiplatelet therapy (primarily aspirin) for patients without established cardiovascular disease...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27917124/the-benefit-and-safety-of-aspirin-for-primary-prevention-of-ischemic-stroke-a-meta-analysis-of-randomized-trials
#5
REVIEW
Hong Lei, Qian Gao, Shan-Rong Liu, Jian Xu
Background: Although aspirin is effective in the secondary prevention of stroke among men and women, its use in primary prevention remains controversial. We conducted a meta-analysis of randomized trials to evaluate the benefit and safety of aspirin for the primary prevention of ischemic stroke. Methods: We searched three electronic databases (Medline, the Cochrane Central Register of Controlled Trials, and Embase) for articles published before August 1st, 2016. Randomized trials reporting the effect of aspirin on the primary prevention of ischemic stroke and its side effects (hemorrhagic stroke and severe gastrointestinal bleeding) were included...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27915991/control-of-inflammatory-bowel-disease-and-colorectal-cancer-by-synthetic-vitamin-d-receptor-ligands
#6
Ichiro Takada, Makoto Makishima
Vitamin D deficiency and insufficiency are associated with an increased risk of cancer, autoimmune disease, inflammation, infection, cardiovascular disease and metabolic disease, as well as bone and mineral disorders. The vitamin D receptor (VDR), a member of the nuclear receptor superfamily, is a receptor for the active form of vitamin D, 1α,25-dihydroxyvitamin D3 [1,25(OH)2D3], and mediates vitamin D regulation of specific target gene expression. The secondary bile acid lithocholic acid, which is produced by intestinal bacteria, is another natural VDR ligand...
December 2, 2016: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/27912774/socioeconomic-inequalities-in-health-related-quality-of-life-between-men-and-women-5%C3%A2-years-after-a-coronary-angiography
#7
Anastase Tchicaya, Nathalie Lorentz
BACKGROUND: The aim of this study is to measure gender differences in health-related quality of life (HRQOL) among men and women patients with cardiovascular diseases (CVD), and to assess the impact of socioeconomic factors on HRQOL between men and women, 5 years after a coronary angiography. METHODS: The study included 1,289 out of 4,391 patients who had undergone an angiography in the National Institute for Cardiac Surgery and Interventional Cardiology, Luxembourg in 2008/2009...
December 3, 2016: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/27911918/statin-use-and-self-reported-hindering-muscle-complaints-in-older-persons-a-population-based-study
#8
Milly A van der Ploeg, Rosalinde K E Poortvliet, Sophie C E van Blijswijk, Wendy P J den Elzen, Petra G van Peet, Wouter de Ruijter, Jeanet W Blom, Jacobijn Gussekloo
PURPOSE: Statins are widely used by older persons in primary and secondary prevention of cardiovascular disease. Although serious adverse events are rare, many statin users report mild muscle pain and/or muscle weakness. It's unclear what impact statins exert on a patient's daily life. Research on statin related side effects in older persons is relatively scarce. We therefore investigated the relation between statin use and self-reported hindering muscle complaints in older persons in the general population...
2016: PloS One
https://www.readbyqxmd.com/read/27907962/critical-care-of-traumatic-cervical-spinal-cord-injuries-preventing-secondary-injury
#9
Gary Schwartzbauer, Deborah Stein
The incidence of traumatic spinal cord injury (SCI) has not changed much over the years due to an aging population suffering falls, yet advances have been made in quality of life and survival time. In addition to initial medical and surgical stabilization, modern intensive care unit (ICU) care throughout the critical early period following SCI is essential to avoid continued secondary injury to the spinal cord. Cervical SCI patients are particularly prone and sensitive to periods of cardiovascular instability and respiratory failure directly resulting from their injuries...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906998/explaining-the-decline-in-coronary-heart-disease-mortality-in-the-netherlands-between-1997-and-2007
#10
Carla Koopman, Ilonca Vaartjes, Ineke van Dis, W M Monique Verschuren, Peter Engelfriet, Edith M Heintjes, Anneke Blokstra, Dorly J H Deeg, Marjolein Visser, Michiel L Bots, Martin O'Flaherty, Simon Capewell
OBJECTIVE: We set out to determine what proportion of the mortality decline from 1997 to 2007 in coronary heart disease (CHD) in the Netherlands could be attributed to advances in medical treatment and to improvements in population-wide cardiovascular risk factors. METHODS: We used the IMPACT-SEC model. Nationwide information was obtained on changes between 1997 and 2007 in the use of 42 treatments and in cardiovascular risk factor levels in adults, aged 25 or over...
2016: PloS One
https://www.readbyqxmd.com/read/27903216/treatment-and-response-to-statins-gender-related-differences
#11
Raparelli Valeria, Pannitteri Gaetano, Todisco Tommaso, Toriello Filippo, Napoleone Laura, Manfredini Roberto, Basili Stefania
Response to drug administration is a primary determinant for treatment success. Sex and gender disparities play a role in determining the efficacy and safety of the most common used medications suggesting the need for a sex-tailored approach in prescription. Statins are a cost-effective strategy for cardiovascular disease (CVD) prevention. While statins are similarly effective in secondary CVD prevention, some concerns raised by conflicting data reported in primary CVD prevention clinical trials. The small representation of women in clinical trials and the fewer rates of events due to the lower female baseline CVD risk may have conditioned contradictory meta-analysis findings...
November 17, 2016: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/27902693/the-long-term-benefits-of-increased-aspirin-use-by-at-risk-americans-aged-50-and-older
#12
David B Agus, Étienne Gaudette, Dana P Goldman, Andrew Messali
BACKGROUND: The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease...
2016: PloS One
https://www.readbyqxmd.com/read/27899849/statin-therapy-review-of-safety-and-potential-side-effects
#13
REVIEW
Satish Ramkumar, Ajay Raghunath, Sudhakshini Raghunath
BACKGROUND: Hydroxymethyl glutaryl coenzyme A reductase inhibitors, commonly called statins, are some of the most commonly prescribed medications worldwide. Evidence suggests that statin therapy has significant mortality and morbidity benefit for both primary and secondary prevention from cardiovascular disease. Nonetheless, concern has been expressed regarding the adverse effects of long term statin use. The purpose of this article was to review the current medical literature regarding the safety of statins...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27899103/time-to-event-versus-ten-year-absolute-risk-in-cardiovascular-risk-prevention-does-it-make-a-difference-results-from-the-optimizing-risk-communication-optrisk-randomized-controlled-trial
#14
Charles Christian Adarkwah, Nikita Jegan, Monika Heinzel-Gutenbrunner, Felicitas Kühne, Uwe Siebert, Uwe Popert, Norbert Donner-Banzhoff, Sarah Kürwitz
BACKGROUND: The concept of shared-decision-making is a well-established approach to increase the participation of patients in medical decisions. Using lifetime risk or time-to-event (TTE) formats has been increasingly suggested as they might have advantages, e.g. in younger patients, to better show consequences of unhealthy behaviour. In this study, the most-popular ten-year risk illustration in the decision-aid-software arriba(TM) (emoticons), is compared within a randomised trial to a new-developed TTE illustration, which is based on a Markov model...
November 29, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27897416/curcumin-an-effective-adjunct-in-patients-with-statin-associated-muscle-symptoms
#15
REVIEW
Amirhossein Sahebkar, Nikou Saboni, Matteo Pirro, Maciej Banach
In spite of the unequivocal efficacy of statins in reducing primary and secondary cardiovascular events, the use of these drugs in a considerable number of patients is limited because of statin intolerance, mainly statin-associated muscle symptoms (SAMS). SAMS encompass a broad spectrum of clinical presentations, including mild muscular aching and other types of myalgias, myopathy with the significant elevation of creatine kinase, and the rare but life-threatening rhabdomyolysis. Among several pathophysiologic mechanisms of SAMS, mitochondrial dysfunction is thought to be one of the main one...
September 22, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27895066/protocol-of-the-swiss-longitudinal-cohort-study-swicos-in-rural-switzerland
#16
Andreas W Schoenenberger, Franco Muggli, Gianfranco Parati, Augusto Gallino, Georg Ehret, Paolo M Suter, Renate Schoenenberger-Berzins, Therese J Resink, Paul Erne
INTRODUCTION: Increased longevity and consequent major changes in demographics and population lifestyles necessitate new approaches to reduce the burden of ageing-related diseases (including cardiovascular disease) and maintain an optimal quality of life. This study aims to examine and longitudinally follow health status and disease risk factors in a Swiss rural cohort, evaluating all health-related research and practice disciplines to assure development of new implementable and successful preventive strategies for healthy ageing...
November 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27893331/multidisciplinary-approach-to-novel-therapies-in-cardio-oncology-research-manticore-101-breast-a-randomized-trial-for-the-prevention-of-trastuzumab-associated-cardiotoxicity
#17
Edith Pituskin, John R Mackey, Sheri Koshman, Davinder Jassal, Marshall Pitz, Mark J Haykowsky, Joseph J Pagano, Kelvin Chow, Richard B Thompson, Larissa J Vos, Sunita Ghosh, Gavin Y Oudit, Justin A Ezekowitz, D Ian Paterson
Purpose The primary toxicity of trastuzumab therapy for human epidermal growth factor receptor 2-overexpressing (HER2-positive) breast cancer is dose-independent cardiac dysfunction. Angiotensin-converting enzyme inhibitors and β-blockers are recommended first-line agents for heart failure. We hypothesized that angiotensin-converting enzyme inhibitors and β-blockers could prevent trastuzumab-related cardiotoxicity. Patients and Methods In this double-blinded, placebo-controlled trial, patients with HER2-positive early breast cancer were randomly assigned to receive treatment with perindopril, bisoprolol, or placebo (1:1:1) for the duration of trastuzumab adjuvant therapy...
November 28, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27892891/atorvastatin-for-high-risk-statin-na%C3%A3-ve-patients-undergoing-noncardiac-surgery-the-lowering-the-risk-of-operative-complications-using-atorvastatin-loading-dose-load-randomized-trial
#18
Otavio Berwanger, Pedro G M de Barros E Silva, Roberto Ramos Barbosa, Dalton Bertolim Precoma, Estêvão Lanna Figueiredo, Ludhmila Abrahão Hajjar, Cleber Dario Pinto Kruel, Carolina Alboim, Adail Paixão Almeida, Marianna Deway Andrade Dracoulakis, Hugo Vargas Filho, Maria José Carvalho Carmona, Lília Nigro Maia, João Bosco de Oliveira Filho, Jose Francisco Kerr Saraiva, Rafael M Soares, Lucas Damiani, Denise Paisani, Alessandra A Kodama, Beatriz Gonzales, Dimas T Ikeoka, Philip J Devereaux, Renato D Lopes
: Preliminary evidence suggests that statins may prevent major perioperative vascular complications. METHODS: We randomized 648 statin-naïve patients who were scheduled for noncardiac surgery and were at risk for a major vascular complication. Patients were randomized to a loading dose of atorvastatin or placebo (80 mg anytime within 18hours before surgery), followed by a maintenance dose of 40 mg (or placebo), started at least 12hours after the surgery, and then 40 mg/d (or placebo) for 7days...
November 9, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27889702/statins-and-the-cholesterol-mortality-paradox
#19
José Pedro L Nunes
Large-scale randomised controlled trials, carried out in the context of secondary cardiovascular prevention, have shown that statins are superior to placebo: these drugs were shown to decrease cardiovascular events and total mortality. A further set of clinical trials compared high intensity to low/standard intensity LDL cholesterol lowering in the same setting (using either statins or a statin/ezetimibe association). In this case, a decrease in LDL cholesterol and a concomitant significant reduction in cardiovascular events were seen with intensive therapy, however with no change in total mortality...
November 26, 2016: Scottish Medical Journal
https://www.readbyqxmd.com/read/27888904/-anti-pcsk9-antibodies-in-type-2-diabetes-and-secondary-prevention-of-cardiovascular-diseases
#20
José López-Miranda, Xavier Pintó
Patients with type 2 diabetes are considered to have the same cardiovascular risk as patients with ischemia. However, the degree of lipid control in diabetic and ischemic patients remains highly deficient. The availability of new agents, such as anti-PCSK9 monoclonal antibodies, could represent a notable advance in meeting this unmet need. Alirocumab and evolucumab, followed by bococizumab, are currently under the advanced phase of research. A growing database has demonstrated a relationship between glucose metabolism, body weight and PCSK9 function, but the clinical implications of this relationship have not been well defined...
May 2016: Clínica e Investigación en Arteriosclerosis
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