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statin and (clinical practice)

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https://www.readbyqxmd.com/read/28938795/lipid-lowering-nutraceuticals-in-clinical-practice-position-paper-from-an-international-lipid-expert-panel
#1
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/28935032/effect-of-definition-on-incidence-and-prognosis-of-type-2-myocardial-infarction
#2
Thomas Nestelberger, Jasper Boeddinghaus, Patrick Badertscher, Raphael Twerenbold, Karin Wildi, Dominik Breitenbücher, Zaid Sabti, Christian Puelacher, Maria Rubini Giménez, Nikola Kozhuharov, Ivo Strebel, Lorraine Sazgary, Deborah Schneider, Janina Jann, Jeanne du Fay de Lavallaz, Òscar Miró, F Javier Martin-Sanchez, Beata Morawiec, Damian Kawecki, Piotr Muzyk, Dagmar I Keller, Nicolas Geigy, Stefan Osswald, Tobias Reichlin, Christian Mueller
BACKGROUND: Uncertainties regarding the most appropriate definition and treatment of type 2 myocardial infarction (T2MI) due to supply-demand mismatch have contributed to inconsistent adoption in clinical practice. OBJECTIVES: This study sought a better understanding of the effect of the definition of T2MI on its incidence, treatment, and event-related mortality, thereby addressing an important unmet clinical need. METHODS: The final diagnosis was adjudicated in patients presenting with symptoms suggestive of myocardial infarction by 2 independent cardiologists by 2 methods: 1 method required the presence of coronary artery disease, a common interpretation of the 2007 universal definition (T2MI2007); and 1 method did not require coronary artery disease, the 2012 universal definition (T2MI2012)...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28923179/drugs-and-hyperglycemia-a-practical-guide
#3
REVIEW
Vandana Jain, Ronak Kumar Patel, Zaureen Kapadia, Sneha Galiveeti, Maryann Banerji, Lisel Hope
Drug-induced diabetes is one of the factors contributing to the increasing incidence of diabetes worldwide. This review considers the frequency, pathogenesis and treatment of drug-induced diabetes. Drugs that induce diabetes include hormonal therapy, especially glucocorticoids and androgen blockers, cardiovascular drugs, especially statins, beta-blockers and diuretics, antipsychotics, especially clozapine, olanzapine and quetiapine, antiretrovirals (protease inhibitors and non-reverse transcriptase inhibitors - NRTIs) and other drugs (mechanistic target of rapamycin inhibitors -mTORs, post organ transplantation drugs, tyrosine kinase inhibitors and interferon-alpha)...
October 2017: Maturitas
https://www.readbyqxmd.com/read/28915960/pleiotropic-effects-of-metformin-to-rescue-statin-induced-muscle-injury-and-insulin-resistance-a-proposed-mechanism-and-potential-clinical-implications
#4
Nicholas W Carris, Srinivas M Tipparaju, David J Magness, Kalyan C Chapalamadugu, Ronald R Magness
The 2013 American Heart Association Blood Cholesterol Guidelines increased the number of patients recommended for statin therapy in the United States to 56million. Two common statin side effects are muscle pain, referred to as "statin-associated muscle symptoms", and increased risk for new onset type-2-diabetes mellitus. Up to 25% of statin users report muscle symptoms resulting in many patients being switched to lower dose or lower potency statins, or refusing statins altogether. The most likely signaling mechanisms for statin-associated muscle symptoms overlaps with the proposed mechanism of statin-induced insulin resistance...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28902717/new-approaches-to-address-dyslipidemia
#5
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/28887350/institutional-care-paths-development-implementation-and-evaluation
#6
Mandy C Leonard, Seth R Bauer, Christine Ahrens, Anita Reddy, Irene Katzan
PURPOSE: The Cleveland Clinic experience with care paths, including their creation and implementation, challenges overcome during development and testing, and outcomes of selected care path evaluations, is described. SUMMARY: Care paths are tools to assist healthcare professionals in practicing evidence-based medicine. The Cleveland Clinic health system has implemented or is developing approximately 100 care paths, including care paths designed to optimize management of sepsis and septic shock and to promote timely use of i...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28879791/incorporation-of-pcsk9-inhibitors-into-prevention-of-atherosclerotic-cardiovascular-disease
#7
Cezary Wójcik
Primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) has become recently more complex than ever, leaving the clinicians perplexed with outdated guidelines and emerging evidence about new LDL-C lowering therapies. 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines have focused on high intensity statin therapy for specific groups of patients, while abandoning long established LDL-C goals, a strategy which no longer seems valid. PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors have emerged as the add-on therapy on top of statins and/or ezetimibe for the treatment of hypercholesterolemia and ASCVD prevention...
September 7, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28873416/cost-effectiveness-analysis-of-use-of-a-polypill-versus-usual-care-or-best-practice-for-primary-prevention-in-people-at-high-risk-of-cardiovascular-disease
#8
Sue Jowett, Pelham Barton, Andrea Roalfe, Kate Fletcher, F D Richard Hobbs, Richard J McManus, Jonathan Mant
BACKGROUND: Clinical trials suggest that use of fixed-dose combination therapy ('polypills') can improve adherence to medication and control of risk factors of people at high risk of cardiovascular disease (CVD) compared to usual care, but cost-effectiveness is unknown. OBJECTIVE: To determine whether a polypill is cost-effective compared to usual care and optimal guideline-recommended treatment for primary prevention in people already on statins and/or blood pressure lowering therapy...
2017: PloS One
https://www.readbyqxmd.com/read/28844070/the-increasing-impact-of-cerebral-amyloid-angiopathy-essential-new-insights-for-clinical-practice
#9
REVIEW
Gargi Banerjee, Roxana Carare, Charlotte Cordonnier, Steven M Greenberg, Julie A Schneider, Eric E Smith, Mark van Buchem, Jeroen van der Grond, Marcel M Verbeek, David J Werring
Cerebral amyloid angiopathy (CAA) has never been more relevant. The last 5 years have seen a rapid increase in publications and research in the field, with the development of new biomarkers for the disease, thanks to advances in MRI, amyloid positron emission tomography and cerebrospinal fluid biomarker analysis. The inadvertent development of CAA-like pathology in patients treated with amyloid-beta immunotherapy for Alzheimer's disease has highlighted the importance of establishing how and why CAA develops; without this information, the use of these treatments may be unnecessarily restricted...
August 26, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28840737/-clinical-study-fourier
#10
Ján Murín
A new group of hypolipidemic substances, i.e. PCSK9 protein inhibitors, is now coming into use in clinical practice, to what extent a high residual cardiovascular risk remains also in patients treated with statins. The FOURIER study (Further cardiovascular OUtcomes Research with PCSK9 Inhibition subjects with Elevated Risk) is the first "event" study which has shown that evolocumab (PCSK9 antibody) further significantly reduces serum LDL cholesterol and subsequently also cardiovascular morbidity and mortality: (a) composite primary goal (cardiovascular mortality, incidence of heart attacks, strokes, hospitalizations for unstable angina, coronary revascularization) by 15 % (p < 0...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28832867/cost-effectiveness-of-evolocumab-therapy-for-reducing-cardiovascular-events-in-patients-with-atherosclerotic-cardiovascular-disease
#11
Gregg C Fonarow, Anthony C Keech, Terje R Pedersen, Robert P Giugliano, Peter S Sever, Peter Lindgren, Ben van Hout, Guillermo Villa, Yi Qian, Ransi Somaratne, Marc S Sabatine
Importance: The proprotein convertase subtilisin/kexin type 9 inhibitor evolocumab has been demonstrated to reduce the composite of myocardial infarction, stroke, or cardiovascular death in patients with established atherosclerotic cardiovascular disease. To our knowledge, long-term cost-effectiveness of this therapy has not been evaluated using clinical trial efficacy data. Objective: To evaluate the cost-effectiveness of evolocumab in patients with atherosclerotic cardiovascular disease when added to standard background therapy...
August 23, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28832369/trial-designs-for-statin-muscle-intolerance
#12
Robert S Rosenson
PURPOSE OF REVIEW: This article aims to review the spectrum of statin-associated muscle symptoms (SAMS), the consequences of downtitration of statin therapy on cardiovascular events, the published trials of nonstatin therapy in patients who report SAMS, and to provide a framework for future trials in SAMS patients. RECENT FINDINGS: SAMS is reported in 10-25% of patients prescribed statin therapy; however, the few patients enrolled in randomized, double-blind, controlled clinical trials (RCTs) discontinue statin therapy due to adverse events...
August 21, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28831261/real-world-use-of-pcsk-9-inhibitors-by-early-adopters-cardiovascular-risk-factors-statin-co-treatment-and-short-term-adherence-in-routine-clinical-practice
#13
Kathleen A Fairman, Lindsay E Davis, David A Sclar
BACKGROUND: Inconsistency of real-world medication use with labeled indications may affect cost and clinical value of pharmacotherapy. PCSK-9 inhibitors are labeled in the US for use with statins to reduce low-density lipoprotein cholesterol in patients with atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH). OBJECTIVE: To assess consistency with labeled indications and treatment persistency for early (first 5 post-launch months) adopters of PCSK-9 inhibitor pharmacotherapy...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28826567/evaluating-the-atherogenic-burden-of-individuals-with-a-friedewald-estimated-low-density-lipoprotein-cholesterol-70%C3%A2-mg-dl-compared-with-a-novel-low-density-lipoprotein-estimation-method
#14
Seamus P Whelton, Jeffrey W Meeusen, Leslie J Donato, Allan S Jaffe, Amy Saenger, Lori J Sokoll, Roger S Blumenthal, Steven R Jones, Seth S Martin
BACKGROUND: A number of national and international guidelines recommend treatment to low-density lipoprotein cholesterol (LDL-C) <70 mg/dL. Comparing the performance of the Friedewald and a novel LDL-C estimate at these concentrations in a nationally representative and clinical cohorts can inform best practices. OBJECTIVES: The objectives of the study were to evaluate concordance between Friedewald-estimated LDL-C and novel-estimated LDL-C and compare with other atherogenic parameters when the estimated LDL-C is <70 mg/dL...
July 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28822512/implications-of-the-2013-acc-aha-cholesterol-guidelines-on-contemporary-clinical-practice-for-patients-with-atherosclerotic-coronary-and-peripheral-arterial-disease
#15
Prasad Gunasekaran, Vinodh Jeevanantham, Suresh Sharma, Rashmi Thapa, Kamal Gupta
BACKGROUND: Cholesterol management guidelines from the American College of Cardiology/American Heart Association (ACC/AHA-2013) recommend fixed statin dosing (dose depends on age ≤ or >75years) compared to the earlier adult treatment panel III (ATPIII) guidelines which recommended specific low-density lipoprotein-cholesterol (LDL-C) targets. Clinical implications of this recommendation are not known. METHODS: We retrospectively compared cholesterol levels and statin utilization across cohorts with coronary artery disease (CAD) (n=9563), peripheral arterial disease (PAD) (n=596) and CAD+PAD (n=975) by applying both guidelines...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28817709/assessment-of-physicians-awareness-and-knowledge-of-familial-hypercholesterolemia-in-saudi-arabia-is-there-a-gap
#16
Mohammed Ali Batais, Turky H Almigbal, Aref A Bin Abdulhak, Hani B Altaradi, Khalid F AlHabib
BACKGROUND: The scarcity of familial hypercholesterolemia (FH) cases reported in Saudi Arabia might be indicative of a lack of awareness of this common genetic disease among physicians. OBJECTIVE: To assess physicians' awareness, practice, and knowledge of FH in Saudi Arabia. METHODS: This is a cross-sectional study conducted among physicians at four tertiary hospitals in Riyadh, Saudi Arabia between March 2016 and May 2016 using a self-administered questionnaire...
2017: PloS One
https://www.readbyqxmd.com/read/28797295/exploring-differences-in-the-use-of-the-statin-choice-decision-aid-and-diabetes-medication-choice-decision-aid-in-primary-care
#17
Aimee Yu Ballard, Maya Kessler, Marianne Scheitel, Victor M Montori, Rajeev Chaudhry
BACKGROUND: Shared decision making is essential to patient centered care, but can be difficult for busy clinicians to implement into practice. Tools have been developed to aid in shared decision making and embedded in electronic medical records (EMRs) to facilitate use. This study was undertaken to explore the patterns of use and barriers and facilitators to use of two decision aids, the Statin Choice Decision Aid (SCDA) and the Diabetes Medication Choice Decision Aid (DMCDA), in primary care practices where the decision aids are embedded in the EMR...
August 10, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28793863/cardiovascular-risk-and-dyslipidemia-among-persons-living-with-hiv-a-review
#18
REVIEW
Paolo Maggi, Antonio Di Biagio, Stefano Rusconi, Stefania Cicalini, Maurizio D'Abbraccio, Gabriella d'Ettorre, Canio Martinelli, Giuseppe Nunnari, Laura Sighinolfi, Vincenzo Spagnuolo, Nicola Squillace
BACKGROUND: Aim of this review is to focus the attention on people living with HIV infection at risk of developing a cardiovascular event. What is or what would be the most suitable antiretroviral therapy? Which statin or fibrate to reduce the risk? How to influence behavior and lifestyles? DISCUSSION: Prevention of cardiovascular disease (CVD) risk remains the first and essential step in a medical intervention on these patients. The lifestyle modification, including smoking cessation, increased physical activity, weight reduction, and the education on healthy dietary practices are the main instruments...
August 9, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28791683/the-variation-of-statin-use-among-nursing-home-residents-and-physicians-a-cross-sectional-analysis
#19
Michael A Campitelli, Colleen J Maxwell, Vasily Giannakeas, Chaim M Bell, Nick Daneman, Lianne Jeffs, Andrew M Morris, Peter C Austin, David B Hogan, Dennis T Ko, Kate L Lapane, Laura C Maclagan, Dallas P Seitz, Susan E Bronskill
OBJECTIVES: To examine the variability of statin use among nursing home residents and prescribing physicians, and to assess statin use by resident frailty. DESIGN: Population-based, cross-sectional analysis. SETTING: All nursing home facilities (N = 631) in Ontario, Canada between April 1, 2013 and March 31, 2014. PARTICIPANTS: All adults aged 66 years and older who received a full clinical assessment while residing in a nursing home facility and their assigned, most responsible, physician...
August 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28779871/meta-analysis-of-placebo-controlled-randomized-controlled-trials-on-the-prevalence-of-statin-intolerance
#20
REVIEW
Haris Riaz, Abdur Rahman Khan, Muhammad Shahzeb Khan, Karim Abdur Rehman, Shehab Ahmad Redha Alansari, Bashaer Gheyath, Sajjad Raza, Amr Barakat, Faraz Khan Luni, Haitham Ahmed, Richard A Krasuski
The prevalence of intolerance varies widely. Stopping statin therapy is associated with worse outcomes in patients with cardiovascular disease. Despite extensive studies, the benefits and risks of statins continue to be debated by clinicians and the lay public. We searched the PubMed, Medline, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for all randomized controlled trials of statins compared with placebo. Studies were included if they had ≥1,000 participants, had patients who were followed up for ≥1 year, and reported rates of drug discontinuation...
September 1, 2017: American Journal of Cardiology
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