Temat: lipid-lowering therapy

Skocz do pozycji: 1.

Tytuł:: Assessment of application of the new 2019 European Society of Cardiology/European Atherosclerosis Society Guidelines for the Management of Dyslipidaemias in daily clinical practice — one center study
Autorzy:: Cecha, Patrycja
Chromik, Anna
Piotrowska, Ilona
Zabojszcz, Michał
Dolecka-Ślusarczyk, Magdalena
Siudak, Zbigniew
Tematy:: cardiovascular risk
ESC/EAS guidelines
lipid-lowering therapy
PCSK9 inhibitors
statins; Pokaż więcej
Wydawca:: Polska Akademia Nauk. Czasopisma i Monografie PAN
Powiązania:: https://bibliotekanauki.pl/articles/56985284.pdf Link otwiera się w nowym oknie
Opis:: Background: Cardiovascular diseases are the first cause of death globally. Hypercholesterolemia is the most important factor responsible for atherosclerotic plaque formation and increasing cardiovascular risk. Reduction of LDL-C level is the most relevant goal for reduction of cardiovascular risk. Aims: Real life adherence to guidelines concerning statin therapy in one center study population. Methods: We analyzed data collected in the Department of Internal Diseases from September 2019 to February 2020, obtained from 238 patients hospitalized in this time period. We assessed application of the new 2019 ESC/EAS Guidelines for the Management of Dyslipidaemias in daily clinical practice and compared effectiveness of LLT according to 2016 and 2019 guidelines. Results: Only 1 in 5 patients with dyslipideamia achieve the 2019 ESC/EAS guideline-recommended levels of LDL-C with relation to their TCVR. We noticed that 20 of patients who did not achieve proper 2019 LDL level, meet the therapy targets established in year 2016. We observed that higher patient TCVR resulted in better compliance with guidelines and ordination of proper LLT. Most patients were on monotherapy with statins. Conclusions: It could be beneficial to start treatment with double or even triple therapy especially in group with the highest LDL-C levels.
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 2.

Autorzy:: Jankowski, Piotr
Shiba, Mariko H.
Almahmeed, Wael
Wood, David
Lloyd-Jones, Donald
Puri, Raman
Alonso, Rodrigo
Perel, Pablo
Ray, Kausik K.
Pinto, Fausto
Zhao, Dong
Olmo, Rosa Fernandez
Ference, Brian A.
Ezhov, Marat
Mehta, Roopa
Nicholls, Stephen J.
Blom, Dirk
Daccord, Magdalena
Lanas, Fernando
Virani, Salim S.
Santos, Raul D.
Gidding, Samuel S.
Severin, Tania
Wong, Nathan D.
Opis:: Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipoproteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome. Methods: Through a review of published guidelines and research papers since 2017, and consultation with a committee composed of experts in clinical management of dyslipidaemias and health systems research in low-and-middle income countries (LMICs), this Roadmap identifies (1) key principles to effective ASCVD prevention (2) gaps in implementation of these interventions (knowledge-practice gaps); (3) health system roadblocks to treatment of elevated cholesterol in LMICs; and (4) potential strategies for overcoming these. Results: Reducing the future burden of ASCVD will require diverse approaches throughout the life-course. These include: a greater focus on primordial prevention; availability of affordable cholesterol testing; availability of universal cholesterol screening for inherited dyslipidaemias; risk stratification moving beyond 10-year risk to look at lifetime risk with adequate risk estimators; wider availability of affordable cholesterol-lowering therapies which should include statins as essential medications globally; use of adequate doses of potent statin regimens; and combination therapies with ezetimibe or other therapies in order to attain and maintain robust reductions in LDL-C in those at highest risk. Continuing efforts are needed on health literacy for both the public and healthcare providers, utilising multi-disciplinary teams in healthcare and applications that quantify both ASCVD risk and benefits of treatment as well as increased adherence to therapies. Conclusions: The adverse effects of LDL-cholesterol and apo B containing lipoprotein exposure are cumulative and result in ASCVD. These are preventable by implementation of different strategies, aimed at efficiently tackling atherosclerosis at different stages throughout the human life-course. Preventive strategies should therefore be updated to implement health policy, lifestyle changes and when needed pharmacotherapies earlier with investment in, and a shift in focus towards, early preventive strategies that preserve cardiovascular health rather than treat the consequences of ASCVD.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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Skocz do pozycji: 3.

Tytuł:: Dyslipidemia treatment and attainment of LDL-cholesterol treatment goals in patients participating in the Managed Care for Acute Myocardial Infarction Survivors program
Autorzy:: Bujak, Kamil
Banach, Maciej
Mizia-Stec, Katarzyna
Wojakowski, Wojciech
Kulbat, Aleksandra
Witkowski, Adam
Gąsior, Mariusz
Nowowiejska-Wiewióra, Alicja
Kalarus, Zbigniew
Gąsior, Zbigniew
Legutko, Jacek
Trzeciak, Przemysław
Brzychczy, Piotr
Mędrala, Zofia
Wita, Krystian
Tomkiewicz-Pająk, Lidia
Opis:: Background: Patients after acute myocardial infarction (AMI) are at very high cardiovascular (CV) risk. Therefore, appropriate management of dyslipidemia with adequate lipid-lowering therapy is crucial for preventing subsequent CV events in these patients. Aims: Our analysis aimed to assess the treatment of dyslipidemia and attainment of low-density lipoprotein cholesterol (LDL-C) treatment goals in patients after AMI who participated in the Managed Care for Acute Myocardial Infarction Survivors (MACAMIS) program. Methods: This study is a retrospective analysis of consecutive patients with AMI who agreed to participate and completed the 12-month MACAMIS program at one of three tertiary referral cardiovascular centers in Poland between October 2017 and January 2021. Results: 1499 patients after AMI were enrolled in the study. High-intensity statin therapy was prescribed for 85.5% of analyzed patients on hospital discharge. Combined therapy with high-intensity statin and ezetimibe increased from 2.1% on hospital discharge to 18.2% after 12 months. In the whole study cohort, 20.4% of patients achieved the LDL-C target of < 55 mg/dl ( < 1.4 mmol/l), and 26.9% of patients achieved at least a 50% reduction in LDL-C level one year after AMI. Conclusions: Our analysis suggests that participation in the managed care program might be associated with improved quality of dyslipidemia management in AMI patients. Nonetheless, only one-fifth of patients who completed the program achieved the treatment goal for LDL-C. This highlights the constant need for optimizing lipid-lowering therapy to meet treatment targets and reduce CV risk in patients after AMI.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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Skocz do pozycji: 4.

Autorzy:: Mazur, Piotr
Natorska, Joanna
Ząbczyk, Michał
Undas, Anetta
Kopytek, Magdalena
Opis:: Calcific aortic stenosis (CAS) is the most common cause of acquired valvular heart disease in adults with no available pharmacological treatment to inhibit the disease progression to date. This review provides an up-to-date overview of current knowledge of molecular mechanisms underlying CAS pathobiology and the related treatment pathways. Particular attention is paid to current randomized trials investigating medical treatment of CAS, including strategies based on lipid-lowering and antihypertensive therapies, phosphate and calcium metabolism, and novel therapeutic targets such as valvular oxidative stress, coagulation proteins, matrix metalloproteinases, and accumulation of advanced glycation end products.
Dostawca treści:: Repozytorium Uniwersytetu Jagiellońskiego

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Skocz do pozycji: 5.

Tytuł:: Rhabdomyolysis induced by lipid-lowering therapy in patients with end-stage renal failure maintained on continuous ambulatory peritoneal dialysis – clinical implications
Rabdomioliza indukowana lekami hipolipemizującymi u chorych z terminalną niewydolnością nerek leczonych ciągłą ambulatoryjną dializą otrzewnową – wnioski kliniczne
Autorzy:: Żywiec, Joanna
Tomaszewski, Maciej
Żukowska-Szczechowska, Ewa
Grzeszczak, Władysław
Tematy:: rhabdomyolysis
lipid-lowering therapy
end-stage renal failure
continuous ambulatory peritoneal dialysis
side effects
rabdomioliza
terapia hipolipemizująca
objawy uboczne
terminalna niewydolność nerek
ciągła ambulatoryjna dializa otrzewnowa; Pokaż więcej
Wydawca:: Śląski Uniwersytet Medyczny w Katowicach
Powiązania:: https://bibliotekanauki.pl/articles/1038909.pdf Link otwiera się w nowym oknie
Opis:: The cases of rhabdomyolysis induced by lipid-lowering therapy in three patients with end-stage renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD) are presented. In most of the cases, the diagnosis of rhabdomyolysis was not problematic regarding their typical clinical symptoms and laboratory examinations. One patient, presumably due to diabetic neuropathy, did not experience typical muscle pain but only asthenia, abdominal pain and an enhanced serum kinase creatine level. Lipid-lowering drug cessation and intensification of the CAPD scheme were effective in all the cases. In certain cases LDL-apheresis was required. The high frequency of lipid disturbances and an enhanced cardio-vascular risk among CADO patients are reasons for the wide-spread use of lipid-lowering agents in this group of patients. Analysis of potential drug interactions, and diagnostic alertness (with watchful observation of atypical symptoms) are required because of the possibility of rhabdomyolysis occurrence as a side effect of this method. Interruption of lipid-lowering therapy with intensification of the peritoneal dialysis scheme are sufficiently effective treatment of iatrogenic rhabdomyolysis among CAPD patients. Persistent hyperlipidaemia with an individual’s predisposition to myolysis after different lipid-lowering agents remain a therapeutic problem.
Praca przedstawia przebieg rabdomiolizy wywołanej stosowaniem farmakoterapii hipolipemizującej u trzech chorych ze schyłkową niewydolnością nerek, leczonych nerkozastępczo metodą ciągłej ambulatoryjnej dializy otrzewnowej (CADO). Dwóch chorych prezentowało klasyczne objawy kliniczne rabdomiolizy, co w połączeniu z wynikami badań laboratoryjnych stanowiło oczywistą podstawę rozpoznania. W przypadku trzeciego chorego, prawdopodobnie w efekcie współistniejącej neuropatii cukrzycowej, nie występowały typowe bóle mięśniowe, a jedynie osłabienie mięśni, bóle brzucha i podwyższony poziom kinazy kreatynowej w surowicy. U wszystkich chorych uzyskano poprawę w wyniku odstawienia leku hipolipemizującego i intensyfi kacji schematu dializy otrzewnowej. W wybranych przypadkach w dalszej obserwacji konieczne było zastosowanie LDL-aferezy. Duża częstość występowania zaburzeń lipidowych oraz zwiększone ryzyko schorzeń sercowo-naczyniowych wśród chorych leczonych nerkozastępczo są powodem szerokiego stosowania leków hipolipemizujących w tej grupie osób. Możliwość wystąpienia rabdomiolizy jako powikłania takiego leczenia wymaga od lekarza analizy potencjalnych interakcji lekowych oraz czujności diagnostycznej, w tym bacznej obserwacji atypowej symptomatologii. Przerwanie leczenia hipolipemizującego oraz intensyfi kacja dializy otrzewnowej są wystarczająco efektywnym sposobem leczenia jatrogennej rabdomiolizy u chorych CADO. Problemem terapeutycznym nadal pozostaje utrzymująca się hiperlipidemia, przy równoczesnej osobniczej skłonności do występowania miolizy po różnych preparatach z grupy leków hipolipemizujących.
Dostawca treści:: Biblioteka Nauki

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