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statin and (clinical practice)

Michał Holecki, Gabriela Handzlik-Orlik, Agnieszka Almgren-Rachtan, Jan Duława, Jerzy Chudek
BACKGROUND: Statins are used to reduce a cardiovascular risk. However, the effectiveness of the therapy in many cases remains unsatisfactory. Therefore, the aim of this study was to evaluate the influence of obesity and diabetes on the achievement of therapeutic goal in lipid-lowering therapy in patients with a various cardiovascular risk in the daily clinical practice. METHODS: This study was conducted on the basis of questionnaires obtained from 7018 patients (41...
September 13, 2016: Pharmacological Reports: PR
Xiongjing Jiang
Abdominal aortic aneurysm (AAA) is an important cause of mortality in older adults. Most AAAs are asymptomatic and screening programs have been introduced to identify AAAs. There is currently some recommendations for medical optimisation of patients with AAA, such as anti-hypertension, statin, Anti-platelet therapy, B-blockade, et al. Some medical treatments to limit progression of small AAAs, which have examined the potential of targeting inflammation, proteolysis, the renin-angiotensin system, the coagulation system and sex hormones as approaches to limiting AAA pathogenesis are investigated as well as...
September 2016: Journal of Hypertension
Nasreen Al Sayed, Khalid Al Waili, Fatheya Alawadi, Saeed Al-Ghamdi, Wael Al Mahmeed, Fahad Al-Nouri, Mona Al Rukhaimi, Khalid Al-Rasadi, Zuhier Awan, Mohamed Farghaly, Mohamed Hassanein, Hani Sabbour, Mohammad Zubaid, Philip Barter
BACKGROUND: Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions. METHODS: A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East...
September 28, 2016: International Journal of Cardiology
Jesús Millán, Juan Pedro-Botet, Elisenda Climent, Joaquín Millán, Joan Rius
BACKGROUND AND OBJECTIVE: Muscle symptoms, with or without elevation of creatin kinase are one of the main adverse effects of statin therapy, a fact that sometimes limits their use. The aim of this study was to evaluate the clinical characteristics of patients treated with statins who have complained muscle symptoms and to identify possible predictive factors. PATIENTS AND METHODS: A cross-sectional one-visit, non-interventional, national multicenter study including patients of both sexes over 18 years of age referred for past or present muscle symptoms associated with statin therapy was conducted...
October 4, 2016: Clínica e Investigación en Arteriosclerosis
Mohamed Zaiou, Hamid El Amri
Cardiovascular disease (CVD) is the leading cause of death worldwide. The basic causes of CVD are not fully understood yet. Substantial evidence suggests that genetic predisposition plays a vital role in the physiopathology of this complex disease. Hence, identification of genetic contributors to CVD will likely add diagnostic accuracy and better prediction of an individual's risk. With high-throughput genetics and genomics technology and newer genome-wide study approaches, a number of genetic variations across the human genome were uncovered...
October 6, 2016: Clinical Genetics
Todd J Anderson, Jean Grégoire, Glen J Pearson, Arden R Barry, Patrick Couture, Martin Dawes, Gordon A Francis, Jacques Genest, Steven Grover, Milan Gupta, Robert A Hegele, David C Lau, Lawrence A Leiter, Eva Lonn, G B John Mancini, Ruth McPherson, Daniel Ngui, Paul Poirier, John L Sievenpiper, James A Stone, George Thanassoulis, Richard Ward
Since the publication of the 2012 guidelines new literature has emerged to inform decision-making. The 2016 guidelines primary panel selected a number of clinically relevant questions and has produced updated recommendations, on the basis of important new findings. In subjects with clinical atherosclerosis, abdominal aortic aneurysm, most subjects with diabetes or chronic kidney disease, and those with low-density lipoprotein cholesterol ≥ 5 mmol/L, statin therapy is recommended. For all others, there is an emphasis on risk assessment linked to lipid determination to optimize decision-making...
July 25, 2016: Canadian Journal of Cardiology
Rebecca J Brown, David Araujo-Vilar, Pik To Cheung, David Dunger, Abhimanyu Garg, Michelle Jack, Lucy Mungai, Elif A Oral, Nivedita Patni, Kristina Rother, Julia von Schnurbein, Ekaterina Sorkina, Takara Stanley, Corinne Vigouroux, Martin Wabitsch, Rachel Williams, Tohru Yorifuji
OBJECTIVE: Lipodystrophy syndromes are extremely rare disorders of deficient body fat associated with potentially serious metabolic complications, including diabetes, hypertriglyceridemia, and steatohepatitis. Due to their rarity, most clinicians are not familiar with their diagnosis and management. This practice guideline summarizes diagnosis and management of lipodystrophy syndromes not associated with HIV or injectable drugs. PARTICIPANTS: Seventeen participants were nominated by worldwide endocrine societies or selected by the committee as content experts...
October 6, 2016: Journal of Clinical Endocrinology and Metabolism
Aleix Cases Amenós, Juan Pedro-Botet Montoya, Vicente Pascual Fuster, Vivencio Barrios Alonso, Xavier Pintó Sala, Juan F Ascaso Gimilio, Jesús Millán Nuñez-Cortés, Adalberto Serrano Cumplido
BACKGROUND AND OBJECTIVES: This post hoc study analysed the perception of the relevance of chronic kidney disease (CKD) in dyslipidaemia screening and the choice of statin among primary care physicians (PCPs) and other specialists through a Delphi questionnaire. METHODS: The questionnaire included 4blocks of questions concerning dyslipidaemic patients with impaired carbohydrate metabolism. This study presents the results of the impact of CKD on screening and the choice of statin...
September 30, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Peter A Soden, Sara L Zettervall, Thomas Curran, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
OBJECTIVE: Prior studies on the cause and effect of surgical variation have been limited by utilization of administrative data. The Vascular Quality Initiative (VQI), a robust national clinical registry, provides anatomic and perioperative details allowing a more robust analysis of variation in surgical practice. METHODS: The VQI was used to identify all patients undergoing infrainguinal open bypass or endovascular intervention from 2009 to 2014. Asymptomatic patients were excluded...
September 27, 2016: Journal of Vascular Surgery
C Raina MacIntyre, Abela Mahimbo, Aye M Moa, Michelle Barnes
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Influenza is one of the leading infectious causes of morbidity and mortality globally, and evidence is accumulating that it can precipitate acute myocardial infarction (AMI). This is thought to be due to a range of factors including inflammatory release of cytokines, disruption of atherosclerotic plaques and thrombogenesis, which may acutely occlude a coronary artery. There is a large body of observational and clinical trial evidence that shows that influenza vaccine protects against AMI...
September 29, 2016: Heart: Official Journal of the British Cardiac Society
Paul Brassard, Jennifer W Wu, Pierre Ernst, Sophie Dell'Aniello, Brielan Smiechowski, Samy Suissa
PURPOSE: The effect of statins on cytokine-mediated inflammatory responses may impact on the prognosis of influenza. We assessed whether statin use decreases the incidence of adverse influenza-related outcomes. Additionally, we used a new-user study design to minimize healthy user bias. We further examined the possibility of non-causal associations by using unrelated outcomes. METHODS: We used the UK Clinical Practice Research Datalink to identify all patients aged 30 or older diagnosed with influenza-like illness during 1997-2010...
September 30, 2016: Pharmacoepidemiology and Drug Safety
Thomas Knickelbine, Matthew Lui, Ross Garberich, Michael D Miedema, Craig Strauss, Jeffrey J VanWormer
BACKGROUND: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease resulting in elevated serum low-density lipoprotein cholesterol (LDL-C) levels. Patients with FH have a very high lifetime risk of cardiovascular disease, but FH often goes unrecognized in clinical care. New treatments including PCSK9 inhibitors are now available for this population, and the use of the electronic record may be able to help identify potential patients for therapy. OBJECTIVES: The goal of this study was to determine the period prevalence of FH in a large ambulatory care population, including the homozygous form...
September 2016: Journal of Clinical Lipidology
Julia Spoendlin, J Bradley Layton, Mallika Mundkur, Christian Meier, Susan S Jick, Christoph R Meier
INTRODUCTION: Case reports and pharmacovigilance data reported cases of tendon ruptures in statin users, but evidence from observational studies is scarce and inconclusive. We aimed to assess the association between new statin use and tendon rupture. METHODS: We performed a propensity score (PS)-matched sequential cohort study, using data from the Clinical Practice Research Datalink. Patients aged ≥45 years with at least one new statin prescription between 1995 and 2014 were PS-matched within 2-year entry blocks to patients without a statin prescription during the block...
September 27, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Furio Colivicchi, Michele Massimo Gulizia, Laura Franzini, Giuseppe Imperoli, Lorenzo Castello, Alessandro Aiello, Claudio Ripellino, Nazarena Cataldo
INTRODUCTION: Switching from any statin to another non-equipotent lipid lowering treatment (LLT) may cause a low-density lipoprotein cholesterol increase and has been associated with a higher probability of negative cardiovascular outcomes. The aim of the study was to assess the impact of switching from rosuvastatin to any other LLT on clinical outcomes in primary care. METHODS: This was a retrospective analysis based on data from IMS Health Longitudinal Patient Database, which is a general practice database including information of more than 1...
September 26, 2016: Advances in Therapy
Anselm K Gitt, Dominik Lautsch, Jean Ferrieres, John Kastelein, Heinz Drexel, Martin Horack, Philippe Brudi, Brecht Vanneste, Peter Bramlage, Francois Chazelle, Vasilisa Sazonov, Baishali Ambegaonkar
BACKGROUND AND AIMS: There is an inconsistency between international guidelines on lipid-lowering treatment regarding whether to pursue LDL-C treatment targets or to focus on the intensity of treatment. While either approach is attractive, there is no recent global data on actual LDL-C values, treatment targets attained, and the intensity of treatment in statin-treated patients. We aimed to determine and compare the extent of treatment target attainment globally using standardized data collection...
September 9, 2016: Atherosclerosis
Adina Hayek, Rohina Joshi, Tim Usherwood, Ruth Webster, Baldeep Kaur, Bandana Saini, Carol Armour, Ines Krass, Tracey-Lea Laba, Christopher Reid, Louise Shiel, Charlotte Hespe, Fred Hersch, Stephen Jan, Serigne Lo, David Peiris, Anthony Rodgers, Anushka Patel
BACKGROUND: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification...
2016: Implementation Science: IS
Alon Eisen, Robert P Giugliano
PURPOSE OF REVIEW: Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors are promising therapies that inhibit the degradation of low-density lipoprotein (LDL) receptors in the hepatocyte and thus increase LDL cholesterol (LDL-C) uptake from the blood. This review summarizes main findings in the field of PCSK9 inhibitors, from basic mechanism to clinical studies, and aims to provide a contemporary and practical overview of the clinical implication and future directions with PCSK9 inhibitors...
November 2016: Current Opinion in Cardiology
Vicente Giner-Galvañ, María José Esteban-Giner, Vicente Pallarés-Carratalá
Modern medicine is characterized by a continuous genesis of evidence making it very difficult to translate the latest findings into a better clinical practice. Clinical practice guidelines (CPG) emerge to provide clinicians evidence-based recommendations for their daily clinical practice. However, the high number of existing CPG as well as the usual differences in the given recommendations usually increases the clinician's confusion and doubts. It has apparently been the case for the 2013 American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Treatment of Blood Cholesterol...
2016: Vascular Health and Risk Management
Alessandro Colletti, Giuseppe Derosa, Arrigo Fg Cicero
Hypercholesterolemia is one of the main risk factors for atherosclerosis and cardiovascular diseases. The treatment is based on the modification of the diet and lifestyle and if necessary on a pharmacological therapy. The most widely used drugs are the inhibitors of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (statins); nevertheless, many patients do not reach optimal levels of low-density lipoprotein-cholesterol (LDL-C) even with maximal dosage of statins (eventually associated to ezetimibe) or present side effects, which do not allow them to continue the treatment...
2016: Therapeutics and Clinical Risk Management
Z Yang, H Liu, D Li, X Xie, T Qin, J Ma, P Kang
OBJECTIVES: The primary purpose of this meta-analysis was to determine whether statin usage could reduce the risk of glucocorticoid-related osteonecrosis in animal models. METHODS: A systematic literature search up to May 2015 was carried out using the PubMed, Ovid, EBM reviews, ISI Web of Science, EBSCO, CBM, CNKI databases with the term and boolean operators: statins and osteonecrosis in all fields. Risk ratio (RR), as the risk estimate of specific outcome, was calculated along with 95% confidence intervals (CI)...
September 2016: Bone & Joint Research
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