Use and persistence of lipid-lowering therapy in patients with severe hypercholesterolemia: A prospective study

2021 ◽  
Author(s):  
María G. Matta ◽  
Benjamín Saenz ◽  
Laura Schreier ◽  
Agustina Corral ◽  
Agustina Sarobe ◽  
...  
Keyword(s):  
Prospective Study ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
A Prospective Study

scholarly journals 341 Observational multicentre study on effectiveness and tolerability of Alirocumab in real world, the OMERO study: interim data from the first 699 patients

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Alberico Luigi Catapano ◽  
Aldo Pietro Maggioni ◽  
Francesco Rossi ◽  
Giampaolo Tirone ◽  
Lucia Notarianni ◽  
...  
Keyword(s):  
Real Life ◽  
Lipid Lowering ◽  
Clinical Judgement ◽  
Lipid Lowering Therapy ◽  
Dosing Regimen ◽  
Statin Intolerance ◽  
Lowering Therapy ◽  
A Prospective Study ◽  
Level Reduction

Abstract Aims OMERO is a prospective study, aimed to assess the long-term effectiveness, tolerability, and safety of alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9-i), in the real life in Italy. The study is planned to include 800 patients, from 40 Italian sites, treated with alirocumab on top of standard lipid lowering therapy. Methods and results This analysis concerns 699 (out of 800) patients with all data available: 65.5% male; mean age 60.6 ± 11.09 years; 29.6% with HeFH in primary prevention; 70.4% in secondary prevention (with/without HeFH). Before ALI administration, 461 patients (66%) were treated with statins while 231 (33%) reported statin intolerance, that resulted in the statin discontinuation. Mean baseline LDL-C was 161.5 ± (53.07) mg/dl. Based on clinical judgement, ALI was initially prescribed at 75 mg Q2W dosing regimen in 60.80% of participants, whereas the remainder received 150 mg Q2W. At V1 57 patients (89.06%) switch from 75 mg Q2W to 150 mg Q2W and 7 patients (10.94%) from 150 mg Q2W to 75 mg Q2W. LDL-C level reduction from baseline (before ALI administration) to 6 months from the study enrolment (V1), was −45% (V1: mean LDL-C was 73.5 ± 45.70 mg/dl). LDL-C levels at V1 by participant category are shown in Figure 1. The rate of patients with at least one adverse event was 25.6% (of which SAE 7.4%); the rate of patients with at least one related adverse reaction to treatment was 3.8% none of them were serious. Conclusions OMERO confirmed in clinical practice the results observed in trials: a significant reduction of LDL-C was observed with ALI 75/150 mg Q2W in participants at high CV risk with or without HeFH. ALI was generally well tolerated.

scholarly journals Changes in the Diagnosis and Management of Diabetes in Mexico City Between 1998–2004 and 2015–2019

2021 ◽  
Author(s):  
Diego Aguilar-Ramirez ◽  
Jesus Alegre-Díaz ◽  
Louisa Gnatiuc ◽  
Raúl Ramirez-Reyes ◽  
Rachel Wade ◽  
...  
Keyword(s):  
Prospective Study ◽  
Mexico City ◽  
Diabetes Management ◽  
Medication Use ◽  
Diabetes Prevalence ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Glucose Lowering ◽  
Diagnosis And Management ◽  
Lowering Therapy

<i>Objective: </i>To investigate the trends in diabetes prevalence, diagnosis, and management among Mexican adults who were participants in a long-term prospective study. <p><i> </i></p> <p><i>Research design and methods:</i> In 1998-2004, 159,755 adults from Mexico City were recruited into a prospective study and in 2015-2019 10,144 survivors were resurveyed. Diabetes was defined as self-reported diagnosis, glucose-lowering medication use, or HbA<sub>1c</sub>≥6.5%. Controlled diabetes was defined as HbA<sub>1c</sub><7%. Prevalence estimates were uniformly standardised for age, sex and residential district. Cox models explored the relevance of controlled and inadequately controlled diabetes to cause-specific mortality. </p> <p><i> </i></p> <p><i>Results: </i>99,623 participants in 1998-2004 and 8986 participants in 2015-2019 were aged 45-84 years. Diabetes prevalence increased from 26% in 1998-2004 to 35% by 2015-2019. Of those with diabetes, the proportion previously-diagnosed increased from 76% to 89%, and glucose-lowering medication use among them increased from 80% to 94%. Median HbA<sub>1c</sub> among all with diabetes decreased from 8.2% to 7.3%, and the proportion of them with controlled diabetes increased from 16% to 37%. Use of blood pressure lowering medication among all with previously-diagnosed diabetes increased from 35% to 51% and their use of lipid-lowering therapy increased from 1% to 14%. The excess mortality risk associated with diabetes accounted for 34% of deaths at ages 35-74 years, of which 5% were attributable to controlled and 29% to inadequately controlled diabetes.</p> <p> </p> <i>Conclusions:</i> Inadequately controlled diabetes is a leading cause of premature adult death in Mexico. Improvements in diabetes management have increased diagnosis and control, but substantial opportunities remain to improve treatment, particularly with lipid-lowering therapy.

A four-year naturalistic prospective study of cardiometabolic disease in antipsychotic-treated patients

2012 ◽  
Vol 27 (1) ◽  
pp. 50-55 ◽  
Author(s):  
P. Mackin ◽  
T. Waton ◽  
H.M. Watkinson ◽  
P. Gallagher
Keyword(s):  
Cardiovascular Risk ◽  
Prospective Study ◽  
Lipid Lowering ◽  
Antipsychotic Treatment ◽  
Oral Glucose ◽  
Lipid Lowering Therapy ◽  
Model Assessment ◽  
The Metabolic Syndrome ◽  
Lowering Therapy ◽  
Cardiovascular Morbidity And Mortality

AbstractThe relationship between antipsychotic use and cardiovascular morbidity and mortality is controversial. There is a lack of long-term prospective studies investigating changes in cardiometabolic risk in patients treated with antipsychotic drugs. We report data from a 4-year prospective study. Patients (89) underwent detailed metabolic and cardiovascular risk assessment at 4-years which included anthropometric assessment, blood pressure, lipid profile, and an oral glucose tolerance test. We used the homeostatic model assessment to determine insulin resistance, and calculated 10-year cardiovascular risk scores. Mean age of subjects was 44.7 (±11.5) years, and 52% were male. The prevalence of type 2 diabetes was 8%, and 38.4% fulfilled diagnostic criteria for the metabolic syndrome. With the exception of increased central adiposity over the 4-year follow-up period (p < 0.001), other cardiometabolic parameters were generally unchanged. There was a high prevalence of dyslipidaemia, but only 16.9% were prescribed lipid-lowering treatment. Commencing lipid-lowering therapy was associated with a reduction in cardiovascular risk score (OR 7.9, 95% CI = 1.3 to 48.7; p = 0.02). Patients established on longer-term antipsychotic treatment show less dramatic metabolic changes than those occurring in the early stages of treatment, but have a high burden of cardiovascular risk. Lipid-lowering therapy is associated with a significant reduction in cardiovascular risk.

scholarly journals Changes in the Diagnosis and Management of Diabetes in Mexico City Between 1998–2004 and 2015–2019

2021 ◽  
Author(s):  
Diego Aguilar-Ramirez ◽  
Jesus Alegre-Díaz ◽  
Louisa Gnatiuc ◽  
Raúl Ramirez-Reyes ◽  
Rachel Wade ◽  
...  
Keyword(s):  
Prospective Study ◽  
Mexico City ◽  
Diabetes Management ◽  
Medication Use ◽  
Diabetes Prevalence ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Glucose Lowering ◽  
Diagnosis And Management ◽  
Lowering Therapy

<i>Objective: </i>To investigate the trends in diabetes prevalence, diagnosis, and management among Mexican adults who were participants in a long-term prospective study. <p><i> </i></p> <p><i>Research design and methods:</i> In 1998-2004, 159,755 adults from Mexico City were recruited into a prospective study and in 2015-2019 10,144 survivors were resurveyed. Diabetes was defined as self-reported diagnosis, glucose-lowering medication use, or HbA<sub>1c</sub>≥6.5%. Controlled diabetes was defined as HbA<sub>1c</sub><7%. Prevalence estimates were uniformly standardised for age, sex and residential district. Cox models explored the relevance of controlled and inadequately controlled diabetes to cause-specific mortality. </p> <p><i> </i></p> <p><i>Results: </i>99,623 participants in 1998-2004 and 8986 participants in 2015-2019 were aged 45-84 years. Diabetes prevalence increased from 26% in 1998-2004 to 35% by 2015-2019. Of those with diabetes, the proportion previously-diagnosed increased from 76% to 89%, and glucose-lowering medication use among them increased from 80% to 94%. Median HbA<sub>1c</sub> among all with diabetes decreased from 8.2% to 7.3%, and the proportion of them with controlled diabetes increased from 16% to 37%. Use of blood pressure lowering medication among all with previously-diagnosed diabetes increased from 35% to 51% and their use of lipid-lowering therapy increased from 1% to 14%. The excess mortality risk associated with diabetes accounted for 34% of deaths at ages 35-74 years, of which 5% were attributable to controlled and 29% to inadequately controlled diabetes.</p> <p> </p> <i>Conclusions:</i> Inadequately controlled diabetes is a leading cause of premature adult death in Mexico. Improvements in diabetes management have increased diagnosis and control, but substantial opportunities remain to improve treatment, particularly with lipid-lowering therapy.

scholarly journals Cardiovascular risk factors and COVID-19 outcomes in hospitalised patients: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045482
Author(s):  
Didier Collard ◽  
Nick S Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F Reeskamp ◽  
Tom Dormans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Icu Admission ◽  
Lowering Therapy ◽  
Secondary Outcomes ◽  
Age And Sex

ObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.DesignWe analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).ConclusionsThe accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.

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