Targeting High-Risk Young Patients for Statin Therapy

JAMA ◽  
2004 ◽  
Vol 292 (3) ◽  
pp. 377 ◽  
Author(s):  
Antonio M. Gotto, Jr
Keyword(s):  
High Risk ◽  
Statin Therapy ◽  
Young Patients

Role of genetic factors in the development of hypertension in young patients with metabolic syndrome

2020 ◽  
pp. 23-32
Author(s):  
Elena Korneeva ◽  
Mikhail Voevoda ◽  
Sergey Semaev ◽  
Vladimir Maksimov
Keyword(s):  
Metabolic Syndrome ◽  
High Risk ◽  
Arterial Hypertension ◽  
Genetic Factors ◽  
Young Patients ◽  
Integrin Αiibβ3 ◽  
Ace Gene ◽  
The Metabolic Syndrome

Results of the study related to polymorphism of ACE gene (rs1799752)‎, integrin αIIbβ3, and CSK gene (rs1378942) influencing development of arterial hypertension in young patients with metabolic syndrome are presented. Hypertension as a component of the metabolic syndrome was detected in 15.0% of young patients. Prevalence of mutant alleles of the studied genes among the examined patients was quite high, so homozygous DD genotype was found in 21.6%, and mutant D allele of the ACE gene in 47.4%. A high risk of hypertension in patients with MS was detected in carriers of the T allele of the CSK (rs1378942) gene – 54.8%, which was most often observed in a combination of polymorphic ACE and CSK gene loci (p = 0.0053).

scholarly journals Increased Circulating Malondialdehyde-Modified Low-Density Lipoprotein Level Is Associated with High-Risk Plaque in Coronary Computed Tomography Angiography in Patients Receiving Statin Therapy

2021 ◽  
Vol 10 (7) ◽  
pp. 1480
Author(s):  
Keishi Ichikawa ◽  
Toru Miyoshi ◽  
Kazuhiro Osawa ◽  
Takashi Miki ◽  
Hiroshi Ito
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Statin Therapy ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Coronary Cta ◽  
Coronary Computed Tomography

Objective: To evaluate the association of serum malondialdehyde low-density lipoprotein (MDA-LDL), an oxidatively modified LDL, with the prevalence of high-risk plaques (HRP) determined with coronary computed tomography angiography (CTA) in statin-treated patients. Methods: This study was a single-center retrospective cohort comprising 268 patients (mean age 67 years, 58% men) with statin therapy and who underwent coronary CTA for suspected stable coronary artery disease. Patients were classified into two groups according to median MDA-LDL level or median LDL-C level. Coronary CTA-verified HRP was defined when two or more characteristics, including positive remodeling, low-density plaques, and spotty calcification, were present. Results: Patients with HRP had higher MDA-LDL (p = 0.011), but not LDL-C (p = 0.867) than those without HRP. High MDA-LDL was independently associated with HRP (odds ratio 1.883, 95% confidential interval 1.082–3.279) after adjustment for traditional risk factors. Regarding incremental value of MDA-LDL for predicting CTA-verified HRP, addition of serum MDA-LDL levels to the baseline model significantly increased global chi-square score from 26.1 to 32.8 (p = 0.010). Conclusions: A high serum MDA-LDL level is an independent predictor of CTA-verified HRP, which can lead to cardiovascular events in statin-treated patients.

scholarly journals PCV39 COST-EFFECTIVENESS OF NIASPAN®VERSUS ZETIA® AS ADD-ON TREATMENTTO STATIN THERAPY IN HIGH-RISK PATIENTS

2008 ◽  
Vol 11 (6) ◽  
pp. A393
Author(s):  
SV Sorensen ◽  
SF Webb ◽  
RT Burge
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Statin Therapy ◽  
High Risk Patients ◽  
Risk Patients

Programma 2000: Celebrating 10 Years of Activity of an Italian Pilot Programme on Early Intervention in Psychosis

2008 ◽  
Vol 42 (12) ◽  
pp. 1003-1012 ◽  
Author(s):  
Angelo Cocchi ◽  
Anna Meneghelli ◽  
Antonio Preti
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Rating Scale ◽  
Young Patients ◽  
Skills Training ◽  
First Episode ◽  
Global Functioning ◽  
Adult Intelligence Scale ◽  
Cognitive Behavioural ◽  
Early Intervention In Psychosis

Objective: This paper describes the structure and the organization of the single Italian programme specifically targeted at the early detection of and interventions for subjects at onset of or at high risk of psychosis, Programma 2000. Methods: Programma 2000 is a comprehensive multi-modal protocol of early intervention in psychosis, set up in Milan in 1999. The service has been very active since its opening, and at the time of writing (spring (April) 2008), more than 300 young patients have been evaluated through a detailed protocol that embraces Health of the Nation Outcome Scale (HoNOS), Brief Psychiatric Rating Scale (BPRS), Cognitive Behavioural Assessment 2.0, Disability Assessment Schedule, Camberwell Family Interview, Wechsler Adult Intelligence Scale and the Early Recognition Inventory Retrospective Assessment of Symptoms. The treatment includes psychoeducation, cognitive behavioural therapy (CBT), both structured and unstructured psychosocial interventions and pharmacotherapy, when necessary. Results: The programme focuses on young people aged 17–30 years: to date, a total of 132 subjects with definite psychosis or within the high-risk category have been enrolled in treatment after assessment. Patients with first-episode psychosis were, on average and expectedly, more severe than those in the at-risk group, and were more likely to be prescribed antipsychotic drugs. A large majority of patients in both groups received tailored CBT; individual sessions of skills training were provided to two-thirds of patients. In both groups, improvement was found in both the BPRS and HoNOS, and in the level of global functioning as assessed on Global Assessment of Functioning at 6 month and 1 year follow up. Global functioning was more sensitive to change than symptom severity, reflecting the intensive and personalized efforts to improve social and role functioning in patients. Conclusions: Programma 2000 is still in development but it has already gained the support of therapists and other relevant people involved in the life of subjects at onset, or at high risk of psychosis.

Are High-Risk Hypertensive Patients being Prescribed Concomitant Statin Therapy?

2009 ◽  
Vol 9 (5) ◽  
pp. 299-308 ◽  
Author(s):  
Richard H. Chapman ◽  
Allison A. Petrilla ◽  
Lance Berman ◽  
Joshua S. Benner ◽  
Simon S.K. Tang
Keyword(s):  
High Risk ◽  
Statin Therapy ◽  
Hypertensive Patients

scholarly journals The Role of Age, Neutrophil Infiltration and Antibiotics Timing in the Severity of Streptococcus pneumoniae Pneumonia. Insights from a Multi-Level Mathematical Model Approach

2020 ◽  
Vol 21 (22) ◽  
pp. 8428
Author(s):  
Guido Santos ◽  
Julio Vera
Keyword(s):  
Mathematical Model ◽  
Streptococcus Pneumoniae ◽  
High Risk ◽  
Young Patients ◽  
Alveolar Epithelium ◽  
Neutrophil Infiltration ◽  
Aged Patients ◽  
Effective Response ◽  
Multi Level

Bacterial pneumonia is one of the most prevalent infectious diseases and has high mortality in sensitive patients (children, elderly and immunocompromised). Although an infection, the disease alters the alveolar epithelium homeostasis and hinders normal breathing, often with fatal consequences. A special case is hospitalized aged patients, which present a high risk of infection and death because of the community acquired version of the Streptococcus pneumoniae pneumonia. There is evidence that early antibiotics treatment decreases the inflammatory response during pneumonia. Here, we investigate mechanistically this strategy using a multi-level mathematical model, which describes the 24 first hours after infection of a single alveolus from the key signaling networks behind activation of the epithelium to the dynamics of the local immune response. With the model, we simulated pneumonia in aged and young patients subjected to different antibiotics timing. The results show that providing antibiotics to elderly patients 8 h in advance compared to young patients restores in aged individuals the effective response seen in young ones. This result suggests the use of early, probably prophylactic, antibiotics treatment in aged hospitalized people with high risk of pneumonia.

scholarly journals Risk of reoperation in bioprosthetic valve patients with indication for long-term anticoagulation. Results from the observational retrospective multicentre PLECTRUM study

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000837
Author(s):  
Daniela Poli ◽  
Emilia Antonucci ◽  
Vittorio Pengo ◽  
Elisa Grifoni ◽  
Niccolò Maggini ◽  
...  
Keyword(s):  
High Risk ◽  
Point Of Care ◽  
Young Patients ◽  
Prosthetic Heart Valve ◽  
Mechanical Valve ◽  
Vitamin K Antagonist ◽  
Bioprosthetic Valve ◽  
Bleeding Events ◽  
Younger Patients

ObjectiveSeveral factors should be considered when a prosthetic heart valve, bioprosthetic valve (BV) or mechanical valve is to be implanted: thrombogenicity, life expectancy and the risk of reoperation.MethodsWe conducted an observational retrospective multicentre study among Italian Thrombosis Centers on patients with BV on long-term vitamin K antagonist (VKA) treatment to evaluate the risk of reoperation and the rate of bleeding and thrombotic events.ResultsWe analysed 612 patients (median age 71.8 years) with BV on long-term VKA treatment for the presence of atrial fibrillation (AF) (78.4%) or other indications (21.6%). Thirty-four major bleeding events (rate 1.1×100 patient-years) and 29 thromboembolic events (rate 0.9×100 patient-years) were recorded, and 46 patients (rate 1.5×100 patient-years) underwent reoperation. The rate of reoperation was higher among younger patients: 32.9% in patients <60 years and 3.9% in patients ≥60 years (relative risk (RR) 3.8, 95% CI 2.1 to 7.2; p=0.0001). When patients were analysed according to age <65 or ≥65 years and <75 or ≥70 years, younger patients still were at higher risk for reoperation (RR 3.1, 95% CI 1.7 to 6.0 and 3.7, 95% CI 1.7 to 8.6, respectively).ConclusionsOur findings suggest that the threshold of 65 years for implanting a BV should be carefully evaluated, considering the high risk for reoperation and the high risk of AF occurrence with persisting need for long-term anticoagulation. The high risk for reoperation of young patients implanted with BV and the availability of a safer and easier way to conduct VKA treatment, such as the use of point-of-care devices, should be considered when the type of valve must be chosen.

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