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Statin in elderly

E Ginter, I Kajaba
No abstract text is available yet for this article.
2016: Bratislavské Lekárske Listy
Glen A Huynh, Audrey J Lee
A 91-year-old male was admitted to the hospital for worsening muscle weakness, muscle pain, and unexplained soreness for the past 10 days. Four months prior to his admission, the patient had experienced a myocardial infarction and was initiated on atorvastatin 80 mg daily. Although the provider had instructed the patient to decrease the atorvastatin dose to 40 mg daily 3 months prior to admission, the patient did not adhere to the lower dose regimen until 10 days prior to hospitalization. Upon admission, the patient presented with muscle weakness and pain, a serum creatinine phosphokinase of 18 723 U/L, and a serum creatinine of 1...
October 26, 2016: Journal of Pharmacy Practice
Patrice Tremblay, Susan Gold
INTRODUCTION: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications...
September 2016: Canadian Geriatrics Journal: CGJ
Paweł Nadrowski, Jerzy Chudek, Michał Skrzypek, Monika Puzianowska-Kuźnicka, Małgorzata Mossakowska, Andrzej Więcek, Tomasz Zdrojewski, Tomasz Grodzicki, Krystyna Kozakiewicz
BACKGROUND: Age-related diseases, including cardiovascular diseases (CVD) may be stimulated by microinflammation, marked by increased level of IL-6 and high-sensitivity CRP (hsCRP). We aimed to investigate whether aging "per se" independently contributesto themicroinflammation,inadditionto traditional and novel CVD risk factors. METHODS/RESULTS: The research sample included 4979 participants from PolSenior Study, aged over 65years. The study consisted of threevisitsandincludedquestionnairesurvey,geriatricassessmentandblood/urinesamplingin4101 participants (83...
October 8, 2016: Experimental Gerontology
Johannes M Just, Klaus Weckbecker, Katja S Just
BACKGROUND: Nocturnal leg cramps are painful, involuntary muscle contractions commonly seen in elderly. While mostly harmless, they can severely impair quality of life and often disrupt sleep. Adverse drug effects may be responsible for a fraction of nocturnal leg cramps but often go unrecognized, resulting in additional prescribing intended to deal with adverse effects that might be better addressed by reduction, substitution, or discontinuation of the offending agent. CASE PRESENTATION: An 87 year old female presented as outpatient in family medicine with nocturnal leg cramps which had been present for five years and increasingly burdened her quality of life...
October 1, 2016: BMC Geriatrics
Shintaro Sukegawa, Takahiro Kanno, Kengo Kanai, Toshiko Mandai, Akane Shibata, Yuka Takahashi, Yuji Hirata, Yoshihiko Furuki
Carotid artery stenosis is a significant risk factor for stroke. In elderly patients with carotid atherosclerosis and stenosis, it is not unusual for oral, head and neck cancer surgery to be performed. The present study describes a case of stroke that occurred during a neck dissection for the treatment of cervical lymph node metastasis of a left maxillary gingival carcinoma. The patient was an 84-year-old female who was considered to be at high risk of a stroke based on pre-operative head and neck computed tomography scans, which detected severe carotid atherosclerosis and stenosis...
October 2016: Oncology Letters
Inés Cruz-Esteve, Josep Ramón Marsal-Mora, Gisela Galindo-Ortego, Leonardo Galván-Santiago, Marcos Serrano-Godoy, Esther Ribes-Murillo, Jordi Real-Gatius
OBJECTIVE: Rational prescribing in older people is a priority for health care organizations. The STOPP/START screening tool has been developed to identify potentially inappropriate prescribing (PIP) in individuals. In a primary care setting, STOPP/START can estimate PIP prevalence and related factors at population level. The aim of this study is to measure the prevalence rates of PPI in elderly population using clinical and prescription claim databases. DESIGN: Cross-sectional population study...
September 29, 2016: Atencion Primaria
YaShu Kuang, Xiaolin Li, Xiaoli Chen, Huimin Sun, Brian Tomlinson, Paul Chan, Liang Zheng, Jinjiang Pi, Sheng Peng, Hong Wu, Xugang Ding, Dingguang Qian, Yixin Shen, Zuoren Yu, Lieying Fan, Ming Chen, Huimin Fan, Zhongmin Liu, Yuzhen Zhang
Lipid levels are increasing in all age groups in the Chinese population, but the use of statin treatment in the elderly is not well documented. We examined serum lipids, statin usage and achievement of lipid goals in 3950 subjects aged ≥65 years. Established CVD was present in 7.77% of participants and increased CVD risk was common. Elevated LDL-C according to CVD risk level was present in 46.70% of all subjects and was more frequent (p < 0.01) than elevated non-HDL-C at 32.58%. With increasing age, LDL-C was unchanged but triglycerides and non-HDL-C decreased and HDL-C increased...
September 30, 2016: Scientific Reports
Jasvinder A Singh, Shaohua Yu
BACKGROUND: Previous studies of allopurinol and stroke risk have provided contradictory findings, ranging from a protective effect to an increased risk. Our objective was to assess whether allopurinol use is associated with the risk of stroke in the elderly. METHODS: We used the 5 % random sample of Medicare beneficiaries from 2006-2012 to study the association of new allopurinol initiation and incident stroke. We used multivariable-adjusted Cox regression models adjusted for age, gender, race, Charlson index, and cardio-protective medications (beta-blockers, ACE inhibitors, diuretics, statins) to calculate hazards ratio (HR) with 95 % confidence intervals (CI)...
September 7, 2016: BMC Neurology
Nadia Aissaoui, Etienne Puymirat, Yves Juilliere, Patrick Jourdain, Didier Blanchard, François Schiele, Pascal Guéret, Batric Popovic, Jean Ferrieres, Tabassome Simon, Nicolas Danchin
AIMS: Alhough cardiogenic shock (CS) after acute myocardial infarction (AMI) is more common in elderly patients, information on the epidemiology of these patients is scarce. This study aimed to assess the trends in prevalence, characteristics, management, and outcomes of elderly patients admitted with CS complicating AMI between 1995 and 2010, using data from the FAST-MI programme. METHODS AND RESULTS: We analysed the incidence and 1-year mortality of CS in four nationwide French surveys carried out 5 years apart from 1995 to 2010, including consecutive AMI patients over 1-month periods...
September 2016: European Journal of Heart Failure
Peter Bramlage, Stefanie Lanzinger, Wolfgang Rathmann, Anton Gillessen, Nikolaus Scheper, Sebastian M Schmid, Matthias Kaltheuner, Jochen Seufert, Thomas Danne, Reinhard W Holl
AIMS: Dyslipidaemia is common in patients with type 2 diabetes mellitus (T2DM). Characterised by high levels of triglyceride (TG)-rich and small dense low-density lipoprotein particles, as well as low levels of high-density lipoprotein cholesterol (HDL-C), diabetic dyslipidaemia differs from non-diabetic individuals. Data regarding lipid abnormalities in T2DM patients, and the effect of treatment, are lacking. MATERIALS AND METHODS: We combined data from the German DIVE (DIabetes Versorgungs-Evaluation) and the DPV (Diabetes-Patienten-Verlaufsdokumentation) database to produce a large cohort of patients with T2DM...
September 4, 2016: Diabetes, Obesity & Metabolism
Bruce C Stuart, Xian Shen, Charlene C Quinn, Nicole Brandt, Pamela Roberto, F Ellen Loh, Franklin Hendrick, Caroline Kim, Xingyue Huang, Swapnil Rajpathak
BACKGROUND: Noninsulin antihyperglycemic agents (NAAs) are the mainstay of treatment for type 2 diabetes, yet persistence in NAA use is suboptimal in many diabetes patients. Most of the research on NAA discontinuance has focused on sociodemographic characteristics and general health status, but such factors are inherently limited in explaining dynamic events such as discontinuance. OBJECTIVE: To assess the relative importance of static and proximal dynamic factors in explaining long-term NAA discontinuance among Medicare beneficiaries with diabetes...
September 2016: Journal of Managed Care & Specialty Pharmacy
Martin Bødtker Mortensen, Valentin Fuster, Pieter Muntendam, Roxana Mehran, Usman Baber, Samantha Sartori, Erling Falk
BACKGROUND: The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines recommend primary prevention with statins for individuals with ≥7.5% 10-year risk for atherosclerotic cardiovascular disease (ASCVD). Everyone living long enough will become eligible for risk-based statin therapy due to age alone. OBJECTIVES: This study sought to personalize ACC/AHA risk-based statin eligibility using noninvasive assessment of subclinical atherosclerosis...
August 30, 2016: Journal of the American College of Cardiology
Manon C Stam-Slob, Frank L J Visseren, J Wouter Jukema, Yolanda van der Graaf, Neil R Poulter, Ajay Gupta, Naveed Sattar, Peter W Macfarlane, Patricia M Kearney, Anton J M de Craen, Stella Trompet
OBJECTIVE: To estimate the absolute treatment effect of statin therapy on major adverse cardiovascular events (MACE; myocardial infarction, stroke and vascular death) for the individual patient aged ≥70 years. METHODS: Prediction models for MACE were derived in patients aged ≥70 years with (n = 2550) and without (n = 3253) vascular disease from the "PROspective Study of Pravastatin in Elderly at Risk" (PROSPER) trial and validated in the "Secondary Manifestations of ARTerial disease" (SMART) cohort study (n = 1442) and the "Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm" (ASCOT-LLA) trial (n = 1893), respectively, using competing risk analysis...
August 23, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Shaunak S Adkar, Ryan S Turley, Ehsan Benrashid, Sandhya Lagoo, Cynthia K Shortell, Leila Mureebe
OBJECTIVE: The initiation of bundled payment for care improvement (BPCI) by Centers for Medicare & Medicaid Services (CMS) has led to increased financial and performance accountability. As the majority of vascular surgery patients are elderly and reimbursed via CMS, improving their outcomes will be critical for durable financial stability. As a first step in forming a multi-disciplinary pathway for the elderly vascular patient, we sought to identify modifiable perioperative variables in geriatric patients undergoing lower extremity arterial bypass (LEB)...
August 12, 2016: Annals of Vascular Surgery
Gunnar Nilsson, Eva Samuelsson, Lars Söderström, Thomas Mooe
BACKGROUND: Cholesterol-lowering therapy with statins is recommended in established cardiovascular disease (CVD) and should be considered for patients at high cardiovascular risk. We surveyed statin treatment before first-time myocardial infarction in clinical practice compared to current guidelines, in patients with and without known CVD in primary care clinics with general practitioners (GPs) on short-term contracts vs. permanent staff GPs. METHODS: A total of 931 patients (345 women) in northern Sweden were enrolled in the study between November 2009 and December 2014 and stratified by prior CVD, comprising angina pectoris, revascularisation, ischaemic stroke or transitory ischaemic attack, or peripheral artery disease...
2016: BMC Family Practice
Roelof A J Smit, Stella Trompet, Behnam Sabayan, Saskia le Cessie, Jeroen van der Grond, Mark A van Buchem, Anton J M de Craen, J Wouter Jukema
BACKGROUND: Recently, it was shown that intraindividual variation in low-density lipoprotein cholesterol (LDL-C) predicts both cerebrovascular and cardiovascular events. We aimed to examine whether this extends to cognitive function and examined possible pathways using a magnetic resonance imaging substudy. METHODS: We investigated the association between LDL-C variability and 4 cognitive domains at month 30 in 4428 participants of PROSPER (PROspective Study of Pravastatin in the Elderly at Risk)...
July 19, 2016: Circulation
Lucian Câlmâc, Vlad Bătăilă, Beatrice Ricci, Zorana Vasiljevic, Sasko Kedev, Olivija Gustiene, Dijana Trininic, Božidarka Knežević, Davor Miličić, Mirza Dilic, Olivia Manfrini, Edina Cenko, Lina Badimon, Raffaele Bugiardini, Alexandru Scafa-Udriște, Oana Tăutu, Maria Dorobanțu
BACKGROUND: A substantial proportion of elderly with ST segment elevation myocardial infarction (STEMI) do not undergo percutaneous coronary intervention (PCI). We sought to investigate factors associated with the decision not to perform coronary angiography at admission in these patients. METHODS: We evaluated 1315 STEMI patients aged ≥75years old enrolled in the International Survey of Acute Coronary Syndromes in Transitional Countries (ISACS TC) registry between October 2010 and February 2015...
August 2016: International Journal of Cardiology
Giulia Maria Camerino, Michela De Bellis, Elena Conte, Antonella Liantonio, Kejla Musaraj, Maria Cannone, Adriano Fonzino, Arcangela Giustino, Annamaria De Luca, Rossella Romano, Claudia Camerino, Antonio Laghezza, Fulvio Loiodice, Jean-Francois Desaphy, Diana Conte Camerino, Sabata Pierno
Statin-induced skeletal muscle damage in rats is associated to the reduction of the resting sarcolemmal chloride conductance (gCl) and ClC-1 chloride channel expression. These drugs also affect the ClC-1 regulation by increasing protein kinase C (PKC) activity, which phosphorylate and close the channel. Also the intracellular resting calcium (restCa) level is increased. Similar alterations are observed in skeletal muscles of aged rats, suggesting a higher risk of statin myotoxicity. To verify this hypothesis, we performed a 4-5-weeks atorvastatin treatment of 24-months-old rats to evaluate the ClC-1 channel function by the two-intracellular microelectrodes technique as well as transcript and protein expression of different genes sensitive to statins by quantitative real-time-PCR and western blot analysis...
September 1, 2016: Toxicology and Applied Pharmacology
Marco Cannistrà, Raffaele Grande, Michele Ruggiero, Matteo Novello, Alessandra Zullo, Elisabetta Bonaiuto, Sebastiano Vaccarisi, Giuseppe Cavallari, Raffaele Serra, Bruno Nardo
INTRODUCTION: Progressive functional impairment with age has a significant impact on perioperative risk management. Chronic liver diseases induce a strong oxidative stress; in the elderly, in particular, impaired elimination of free radicals leads to insufficient DNA repair. The events associated with a weak response to growth factors after hepatectomy leads to a decline in liver regeneration. Hypercholesterolemia is highly prevalent in the elderly, which may alter the coenzyme Q10 (CoQ) levels and in turn the cellular energy balance...
September 2016: International Journal of Surgery
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