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By Jamie Jarmul Md / PhD student at UNC - Chapel Hill, PhD in Health Policy and Management
Angela Pirillo, Alberico Luigi Catapano
Despite the efficacy of statins in reducing cardiovascular events in both primary and secondary prevention, the adherence to statin therapy is not optimal, mainly due to the occurrence of muscular adverse effects. Several risk factors may concur to the development of statin-induced myotoxicity, including patient-related factors (age, sex, and race), statin properties (dose, lipophilicity, and type of metabolism), and the concomitant administration of other drugs. Thus, the management of patients intolerant to statins, particularly those at high or very high cardiovascular risk, involves alternative therapies, including the switch to another statin or the use of intermittent dosage statin regimens, as well as nonstatin lipid lowering drugs (ezetimibe and fibrates) or new hypolipidemic drugs such as PCSK9 monoclonal antibodies, the antisense oligonucleotide against the coding region of human apolipoprotein B mRNA (mipomersen), and microsomal triglyceride transfer protein inhibitor lomitapide...
May 2015: Current Cardiology Reports
Jennifer G Robinson
PURPOSE OF REVIEW: In randomized trials and many observational studies, statins are associated with a modest excess of type 2 diabetes mellitus. High-intensity statins, such as atorvastatin 80 mg and rosuvastatin 20 mg, are associated with a higher excess risk of diabetes than moderate-intensity statins, such as atorvastatin 10 mg, simvastatin 20-40 mg, or pravastatin 40 mg. RECENT FINDINGS: Multiple mechanisms have been proposed for statin-associated diabetes risk, primarily related to increased insulin resistance or impaired insulin secretion...
June 2015: Current Opinion in Lipidology
Emily C O'Brien, DaJuanicia N Simon, Matthew T Roe, Tracy Y Wang, Eric D Peterson, Karen P Alexander
Elevated low-density lipoprotein cholesterol (LDL-C) is associated with increased risk of myocardial infarction and is a target for disease prevention. The association between initial LDL-C and statin treatment in patients with non-ST-segment elevation myocardial infarction (NSTEMI)/unstable angina pectoris (UAP) has not been well characterized. We explored detailed LDL-C levels and statin treatment in 22,938 patients with NSTEMI/UAP enrolled in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines Registry (2003 to 2006)...
June 15, 2015: American Journal of Cardiology
Brandy R Pauff, Michael R Jiroutek, Melissa A Holland, Beth S Sutton
PURPOSE: In 2008, the American Diabetes Association (ADA) recommended that patients aged >40 years with diabetes and cardiovascular disease or with ≥1 cardiovascular disease risk factor be prescribed a statin. This study assessed statin prescribing patterns in patients with diabetes, per the ADA guideline, using data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey-Outpatient Department for the years 2005 to 2010. This study also examined patients' demographic characteristics associated with statin prescribing, including sex, age, ethnicity, race, insurance type, body mass index, region, primary care provider, hypertension and hyperlipidemia...
June 1, 2015: Clinical Therapeutics
Alexander Turin, Jay Pandit, Neil J Stone
Statin nonadherence is a major challenge to optimal management. Patients nonadherent to statin therapy do not receive the expected benefit relative to the degree of low-density lipoprotein cholesterol (LDL-C) lowering obtained. This is important because new evidence guidelines recommend statins as the first-line therapy for those in high-risk groups (secondary prevention, patients with diabetes 40-75 years of age, and LDL-C ≥ 190 mg/dL) and in selected primary prevention patients. Statin assignment in the latter group occurs only in those with an estimated ≥7...
September 2015: Journal of Cardiovascular Pharmacology and Therapeutics
Michael E Johansen, Jennifer L Hefner, Randi E Foraker
Antiplatelets and statins are efficacious for preventing future cardiovascular events in patients with coronary heart disease. Disparity in cardiovascular outcomes exists by race/ethnicity and gender; however, few studies have explored potential disparities in long-term antiplatelet and statin use by race/ethnicity and gender. We conducted a repeated cross-sectional analysis using the nationally representative Medical Expenditure Panel Survey from 2003 to 2012. The sample consisted of 14,334 men and women >29 years with coronary heart disease...
June 1, 2015: American Journal of Cardiology
Rishi Puri, Stephen J Nicholls, Mingyuan Shao, Yu Kataoka, Kiyoko Uno, Samir R Kapadia, E Murat Tuzcu, Steven E Nissen
BACKGROUND: Statins can regress coronary atheroma and lower clinical events. Although pre-clinical studies suggest procalcific effects of statins in vitro, it remains unclear if statins can modulate coronary atheroma calcification in vivo. OBJECTIVES: This study compared changes in coronary atheroma volume and calcium indices (CaI) in patients receiving high-intensity statin therapy (HIST), low-intensity statin therapy (LIST), and no-statin therapy. METHODS: In a post-hoc patient-level analysis of 8 prospective randomized trials using serial coronary intravascular ultrasound, serial changes in coronary percent atheroma volume (PAV) and CaI were measured across matched coronary segments in patients with coronary artery disease...
April 7, 2015: Journal of the American College of Cardiology
William M Vollmer, Ashil A Owen-Smith, Jeffrey O Tom, Reesa Laws, Diane G Ditmer, David H Smith, Amy C Waterbury, Jennifer L Schneider, Cyndee H Yonehara, Andrew Williams, Suma Vupputuri, Cynthia S Rand
OBJECTIVES: Evaluate the utility of 2 electronic medical record (EMR)-linked, automated phone reminder interventions for improving adherence to cardiovascular disease medications. STUDY DESIGN: A 1-year, parallel arm, pragmatic clinical trial in which 21,752 adults were randomized to receive either usual care (UC) or 1 of 2 interventions in the form of interactive voice recognition calls-regular (IVR) or enhanced (IVR+). The interventions used automated phone reminders to increase adherence to cardiovascular disease medications...
November 2014: American Journal of Managed Care
Ji-Hyun Park, Yong-Ho Lee, Su-Kyoung Ko, Bong-Soo Cha
OBJECTIVES: Single-pill combination therapy (amlodipine/atorvastatin) might be more effective than double-pill therapy (amlodipine+atorvastatin) in patients with diabetes and concomitant hypertension requiring statin therapy. We compared the cost-effectiveness of a single-pill with that of double-pill for control of low density lipoprotein cholesterol (LDL-C) levels, with the ultimate goal of cardiovascular disease prevention, in these patients using a cost-effectiveness analysis model that considered medication adherence...
2015: Epidemiology and Health
Femi Philip, Eugene Blackstone, Samir R Kapadia
BACKGROUND: We conducted a retrospective cohort study of patients after first-time isolated coronary artery bypass graft surgery (CABG) and assessed the impact of a discharge regimen including beta-blockers and statin therapy and their relationship to long-term all cause mortality and major adverse cardiovascular events (MACE). METHODS: We identified patients age >18 years, undergoing first time isolated CABG from 1993 to 2005. Patients were identified using the Cardiovascular Information Registry (CVIR)...
February 2015: Cardiovascular Diagnosis and Therapy
(no author information available yet)
BACKGROUND: In Thai National List of Essential Drugs in 2010, simvastatin is the only medication on the list for the statin group. Patients who previously prescribed other groups of statin were recommended to switch to simvastatin. OBJECTIVE: Comparison of lipid low-density lipoprotein cholesterol (LDL) levels before and after switching from rosuvastatin or atorvastatin to simvastatin. MATERIAL AND METHOD: The study was a retrospective observational study performed in patients older than 18 year-old who were enrolled as an outpatient at Siriraj Hospital during October 2009 and October 2010...
January 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Anthony C Chyou, Anay Thodge, Dmitriy N Feldman, Rajesh V Swaminathan
Coronary angiography and percutaneous coronary interventions are common procedures that utilize iodinated contrast medium to visualize the coronary arterial tree and treat stable and unstable ischemic heart syndromes. Exposure to contrast agents can cause acute and persistent worsening of renal function leading to increased morbidity and mortality. Certain patient characteristics such as age, presence of diabetes, congestive heart failure, chronic kidney disease, hemodynamic instability on presentation, and type and volume of contrast used can increase the risk of developing contrast-induced nephropathy (CIN) and its subsequent complications...
April 2015: Current Treatment Options in Cardiovascular Medicine
Nobuhiro Akuzawa, Takashi Hatori, Kunihiko Imai, Yonosuke Kitahara, Masahiko Kurabayashi
BACKGROUND: Although statin therapy significantly reduces cardiovascular morbidity and mortality, atherosclerotic plaque progresses in some patients taking statins. This study investigated the factors associated with onset of acute coronary syndrome (ACS) early after the initiation of statin therapy. METHODS: Consecutive patients taking statins who presented with ACS (n = 64) were divided into < 1-year and > 1-year groups based on the duration of statin therapy...
May 2015: Journal of Clinical Medicine Research
Brian T Bateman, Sonia Hernandez-Diaz, Michael A Fischer, Ellen W Seely, Jeffrey L Ecker, Jessica M Franklin, Rishi J Desai, Cora Allen-Coleman, Helen Mogun, Jerry Avorn, Krista F Huybrechts
OBJECTIVE: To examine the teratogenic potential of statins. DESIGN: Cohort study. SETTING: United States. PARTICIPANTS: A cohort of 886,996 completed pregnancies linked to liveborn infants of women enrolled in Medicaid from 2000 to 2007. METHODS: We examined the risk of major congenital malformations and organ specific malformations in offspring associated with maternal use of a statin in the first trimester...
2015: BMJ: British Medical Journal
Françoise Haramburu, Amélie Daveluy, Ghada Miremont-Salamé
No abstract text is available yet for this article.
2015: BMJ: British Medical Journal
Sidney Wolfe
No abstract text is available yet for this article.
2015: BMJ: British Medical Journal
Aris P Agouridis, Devaki R Nair, Dimitri P Mikhailidis
This editorial discusses several options to overcome statin intolerance in clinical practice. For example, switching to a different statin, changing statin dosing, using lipid-lowering drugs other than statins (e.g., ezetimibe, bile acid sequestrants and fibrates, alone or in combination), or combining statins with other lipid-lowering drugs. The authors focus on the potential mechanisms involved in statin-related myopathy. New lipid-lowering drugs currently in development (e.g., cholesterol ester transfer protein inhibitors [anacetrapib] and proprotein convertase subtilisin/kexin 9 inhibitors) inhibitors may help in the management of statin intolerance while achieving low-density lipoprotein cholesterol targets as set out by the guidelines...
June 2015: Expert Opinion on Drug Metabolism & Toxicology
Aaron G Wernham, Shireen S Velangi
Background. Plantar warts are a common presenting skin complaint caused by the human papillomavirus. 1st line therapies include cryotherapy and topical salicylic acid. Where there is resistance to these treatments, consideration is made for 2nd line therapies, including intralesional bleomycin, imiquimod, 5-fluorouracil, and photodynamic therapy. We present a case of bilateral persistent plantar warts, resistant to treatment with repeated cryotherapy and topical salicylic acid over a 6-year period. Following a patient initiated decision to discontinue their statin medication, we observed rapid clearance of plantar warts without change to standard therapy or their environment...
2015: Case Reports in Dermatological Medicine
Neel R Sodha, Frank W Sellke
Statins are being used with increasing frequency for indications beyond lipid-lowering therapy. In the perioperative setting, the use of statins as anti-inflammatory agents has been an area of growing interest. Despite the early clinical adoption, the data are controversial. Herein we review the available clinical trials examining the effects of statin therapy on perioperative markers of inflammation in cardiac and thoracic surgery.
June 2015: Journal of Thoracic and Cardiovascular Surgery
Orli G Bahcall
No abstract text is available yet for this article.
April 2015: Nature Reviews. Genetics
2015-03-27 13:56:13
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