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statin and (clinical practice)

A J McFarland, A K Davey, C M McDermott, G D Grant, J Lewohl, S Anoopkumar-Dukie
3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) have been associated with conflicting effects within the central nervous system (CNS), with underlying mechanisms remaining unclear. Although differences between individual statins' CNS effects have been reported clinically, few studies to date have compared multiple statins' neuroprotective effects. This study aimed to compare six statins (atorvastatin, fluvastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin; 0-100 μM) using an in vitro model of lipopolysaccharide (LPS)-induced neuroinflammation and subsequent neurodegeneration...
March 6, 2018: Toxicology and Applied Pharmacology
Kyoung Im Cho, Ichiro Sakuma, Il Suk Sohn, Toshio Hayashi, Kazunori Shimada, Kwang Kon Koh
Statins are important for preventing adverse cardiovascular events in patients with both high and low risk of vascular disease, by reducing the levels of low-density lipoprotein cholesterol (LDL-C). However, statins dose-dependently increase adverse effects and increase the risk of type 2 diabetes. Previously, it was hypothesized this was caused by to off-target effects, but recent studies demonstrate it is caused by on-target effects. Nonetheless, the American guidelines recommend the use of high-intensity statin therapy, and extend its use to most people at risk of vascular diseases, particularly older people...
March 2, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
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...
February 20, 2018: Molecular Metabolism
Christophe Kosinski, Christel Tran, Thierry Kuntzer, Nicolas Rodondi, Tinh-Hai Collet
Statins are the first line treatment in hyperlipidemia, either in primary or secondary prevention of cardiovascular diseases. One of the most prescribed drug class worldwide, this drug class is often the focus of highly publicized drug controversies. Various adverse effects have been attributed to statins, in particular statin-associated muscle symptoms (SAMS). This condition varies in severity (from frequent isolated myalgia to rare severe myositis, even rhabdomyolysis) and often leads to treatment termination...
February 28, 2018: Revue Médicale Suisse
Hilda J I de Jong, Jan Willem Cohen Tervaert, Arief Lalmohamed, Frank de Vries, Rob J Vandebriel, Henk van Loveren, Olaf H Klungel, Tjeerd P van Staa
We examined the association between statin use and the risk of rheumatoid arthritis (RA), with special focus on describing the patterns of risks of RA during statin exposure in a large population-based cohort in the United Kingdom. In the Clinical Practice Research Datalink, patients aged ≥40 years with at least one prescription of statins (1995-2009) were selected, and matched by age (+/-5 years), sex, practice and date of first prescription of statins to non-users. The follow-up period of statin use was divided into periods of current, recent and past exposure, with patients moving between these three exposure categories over time...
2018: PloS One
Eddy Fan, Daniel Brodie, Arthur S Slutsky
Importance: Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure that affects approximately 200 000 patients each year in the United States, resulting in nearly 75 000 deaths annually. Globally, ARDS accounts for 10% of intensive care unit admissions, representing more than 3 million patients with ARDS annually. Objective: To review advances in diagnosis and treatment of ARDS over the last 5 years. Evidence Review: We searched MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 2012 to 2017 focusing on randomized clinical trials, meta-analyses, systematic reviews, and clinical practice guidelines...
February 20, 2018: JAMA: the Journal of the American Medical Association
Hyunah Kim, Hyeseon Lee, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae-Hyoung Cho, Hyunyong Lee, Hyeon Woo Yim, In Young Choi, Kun-Ho Yoon, Hun-Sung Kim
AIM: Prescription of statins to patients with chronic liver disease whose alanine transaminase (ALT) is over three times the upper normal limit (UNL) is not recommended. In this study, we attempted to evaluate patients with baseline ALT levels > 3 × UNL who were prescribed statins without ethical problems, using electronic medical records. METHODS: We enrolled subjects with ALT levels > 3 × UNL. The patients were divided into three groups consisting of those who had been taking agents affecting liver function (HEPA) and continued to do so after the statin prescription (HepCon), those who had not previously taken HEPA and began doing so after statin prescription (HepNew), and those who had never taken HEPA (HepNo)...
February 21, 2018: Cardiovascular Therapeutics
Carla Carnovale, Emanuel Raschi, Luca Leonardi, Ugo Moretti, Fabrizio De Ponti, Marta Gentili, Marco Pozzi, Emilio Clementi, Elisabetta Poluzzi, Sonia Radice
BACKGROUND: An increasing number of reports indicates that vaccines against influenza may interact with specific drugs via drug metabolism. To date, actual impact of vaccine-drug interactions observed in the real world clinical practice has not been investigated. RESEARCH DESIGN AND METHODS: From VAERS and VigiBase, we collected Adverse Event Following Immunization (AEFI) reports for individuals receiving vaccines against influenza recorded as suspect and selected cases where predictable toxicity was recorded with oral anticoagulants, antiepileptics and statins (i...
February 16, 2018: Expert Review of Vaccines
Arritxu Etxeberria, Idoia Alcorta, Itziar Pérez, Jose Ignacio Emparanza, Elena Ruiz de Velasco, Maria Teresa Iglesias, Rafael Rotaeche
BACKGROUND: The implementation of evidence-based clinical practice guidelines (CPG) can improve patients care. To date, the impact of implementation strategies has not been evaluated in our context. This study is aimed to evaluate the effectiveness of a multifaceted tailored intervention targeting clinician education for the implementation of three cardiovascular risk-related CPGs (type 2 diabetes, hypertension and dyslipidemia) in primary care at the Basque Health Service compared with usual implementation...
February 8, 2018: BMC Health Services Research
Gregory S Pokrywka
Elevated low-density lipoprotein cholesterol (LDL-C) plays a major role in the development of atherosclerotic cardiovascular disease. Statins are the first-line treatment to lower LDL-C in patients with hypercholesterolemia; however, some high cardiovascular risk patients may have inadequate responses to statin therapy or are intolerant to statins, and may need additional and/or alternative non-statin therapies to further reduce their LDL-C levels. Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of circulating LDL-C levels, have received considerable attention as promising non-statin therapeutic options for the management of hypercholesterolemia...
February 7, 2018: Postgraduate Medicine
Krzysztof Chlebus, Barbara Cybulska, Marcin Gruchała, Anna Smaga, Katarzyna Wróbel, Bogdan Wojtyniak, Marcin Pajkowski, Piotr Jankowski, Tomasz Zdrojewski
BACKGROUND: Familial hypercholesterolaemia (FH) is the most common genetic disease leading to premature atherosclerosis. AIM: The aim of the study was to evaluate the prevalence, diagnosis, and treatment of FH in outpatient practice in Poland. METHODS: The study included a representative sample of 147 primary care physicians, cardiologists, and diabetologists caring for 2812 adult patients with hypercholesterolaemia and low-density lipoprotein cholesterol (LDL-C) level >1...
February 5, 2018: Kardiologia Polska
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trisha Greenhalgh
BACKGROUND: As a response to the criticisms evidence-based practice currently faces, groups of health care researchers and guideline makers have started to call for the appraisal and inclusion of different kinds of knowledge in guideline production (other than randomized controlled trials [RCTs]) to better link with the informal knowledge used in clinical practice. In an ethnographic study, Gabbay and Le May showed that clinicians in everyday practice situations do not explicitly or consciously use guidelines...
February 2, 2018: Journal of Medical Internet Research
David Osborn, Alexandra Burton, Rachael Hunter, Louise Marston, Lou Atkins, Thomas Barnes, Ruth Blackburn, Thomas Craig, Hazel Gilbert, Samira Heinkel, Richard Holt, Michael King, Susan Michie, Richard Morris, Steve Morris, Irwin Nazareth, Rumana Omar, Irene Petersen, Robert Peveler, Vanessa Pinfold, Kate Walters
BACKGROUND: People with severe mental illnesses, including psychosis, have an increased risk of cardiovascular disease. We aimed to evaluate the effects of a primary care intervention on decreasing total cholesterol concentrations and cardiovascular disease risk in people with severe mental illnesses. METHODS: We did this cluster randomised trial in general practices across England, with general practices as the cluster unit. We randomly assigned general practices (1:1) with 40 or more patients with severe mental illnesses using a computer-generated random sequence with a block size of four...
January 15, 2018: Lancet Psychiatry
Sahin Iscan, Bortecin Eygi, Yuksel Besir, Ismail Yurekli, Habib Cakir, Levent Yilik, Orhan Gokalp, Ali Gurbuz
Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response...
January 31, 2018: Current Pharmaceutical Design
Enrique Esteve-Valverde, Raquel Ferrer-Oliveras, Natàlia Gil-Aliberas, Antònia Baraldès-Farré, Elisa Llurba, Jaume Alijotas-Reig
Importance: We have performed a systematic search to summarize the role of statins for preventing and treating severe preeclampsia. Objective: The aim of this study was to examine whether pravastatin is a useful and safe alternative for treating preeclampsia during pregnancy. Evidence Acquisition: A systematic MEDLINE (PubMed) search was performed (1979 to June 2017), which was restricted to articles published in English, using the relevant key words of "statins," "pregnancy," "preeclampsia," "obstetrical antiphospholipid syndrome," and "teratogenicity...
January 2018: Obstetrical & Gynecological Survey
Elisa Waldmann, Charlotte Bamberger, Klaus G Parhofer
No abstract text is available yet for this article.
August 2017: Atherosclerosis
Natalie C Ward, Jing Pang, Jacqueline D M Ryan, Gerald F Watts
There is considerable evidence for the role of low-density lipoprotein cholesterol (LDL-C) in the development of atherosclerotic cardiovascular disease. Although statin therapy remains the most frequency prescribed medication to reduce LDL-C and lower risk of cardiovascular disease, a considerable number of patients develop muscle-related side affects. This review summarizes recent literature supporting the role of nutraceuticals as LDL-C-lowering therapy in statin-intolerant patients, with evidence from our own clinical practices...
January 2018: Clinical Cardiology
Lucía Cea-Soriano, F Gerry R Fowkes, Saga Johansson, Alaster M Allum, Luis Alberto García Rodriguez
OBJECTIVES: To assess time trends in symptomatic peripheral artery disease (PAD) incidence and prevalence, and secondary preventive therapy. DESIGN: Cohort study using The Health Improvement Network. SETTING: UK primary care. PARTICIPANTS: Individuals aged 50-89 years identified annually between 2000 and 2014. Participants with symptomatic PAD were identified using Read codes. OUTCOME MEASURES: Incidence and prevalence of symptomatic PAD from 2000 to 2014, overall and by sex and age...
January 21, 2018: BMJ Open
Tamio Teramoto, Takahito Kai, Asuka Ozaki, Bruce Crawford, Hidenori Arai, Shizuya Yamashita
AIM: To evaluate the epidemiology and real-world treatment patterns associated with lipid-modifying therapies (LMTs) among groups of Japanese patients with familial hypercholesterolemia (FH). METHODS: A retrospective observational study was conducted using an electronic hospital-based administrative claims database and electronic medical records. Patients with existing diagnosis of FH (FH-D) and patients with suspected FH (FH-S) defined by low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dL were included, and medical records of hospitals across Japan were analyzed to assess the diagnostic status, management of LDL-C levels, and treatment patterns...
January 19, 2018: Journal of Atherosclerosis and Thrombosis
Evangelos Kaltsas, George Chalikias, Dimitrios Tziakas
Acute kidney injury (AKI) is one of the most common complications during hospitalization in various clinical settings. The goal of this review was to assess the incidence of AKI in acute myocardial infarction patients (AMI), how this incidence is affected by the diverse definitions, and if there is variability in the reported rates over recent years. Additionally, we sought to appraise the impact of AKI on short- and long-term prognosis of these patients. Finally, we report on the current preventive measures as they are suggested in the current guidelines of various societies, we comment on the evidence that support them, and we review the literature for other proposed therapeutic strategies, which either failed to prove their efficacy or they are not adequately confirmed yet...
January 19, 2018: Cardiovascular Drugs and Therapy
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