Quality Of Life Improvement In High And Very High Cardiovascular Risk Patients Treated With Pcsk9 Inhibitors

2019 ◽  
Vol 287 ◽  
pp. e199
Author(s):  
A. Cesaro ◽  
F. Gragnano ◽  
F. Fimiani ◽  
E. Moscarella ◽  
I. Pariggiano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Risk ◽  
High Cardiovascular Risk ◽  
Pcsk9 Inhibitors ◽  
Risk Patients ◽  
Life Improvement ◽  
Very High

Impact of PCSK9 inhibitors on the quality of life of patients at high cardiovascular risk

2019 ◽  
Vol 27 (5) ◽  
pp. 556-558 ◽  
Author(s):  
Arturo Cesaro ◽  
Felice Gragnano ◽  
Fabio Fimiani ◽  
Elisabetta Moscarella ◽  
Vincenzo Diana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Risk ◽  
High Cardiovascular Risk ◽  
Pcsk9 Inhibitors

scholarly journals Clinical profiles and quality of care of subjects with type 2 diabetes according to their cardiovascular risk: an observational, retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Basilio Pintaudi ◽  
Alessia Scatena ◽  
Gabriella Piscitelli ◽  
Vera Frison ◽  
Salvatore Corrao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Risk Factors ◽  
High Cardiovascular Risk ◽  
Very High

Abstract Background The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. Methods The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. Results Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased. Conclusions A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.

scholarly journals Indications of PCSK9 Inhibitors for Patients at High and Very High Cardiovascular Risk

2018 ◽  
Author(s):  
Paulo Eduardo Ballvé Behr ◽  
Emilio Hideyuki Moriguchi ◽  
Iran Castro ◽  
Luiz Carlos Bodanese ◽  
Oscar Pereira Dutra ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Cardiovascular Risk ◽  
Pcsk9 Inhibitors ◽  
Very High

scholarly journals Patterns of care of subjects with type 1 and type 2 diabetes according to their cardiovascular risk

2021 ◽  
Vol 24 (1) ◽  
pp. 30
Author(s):  
Pintaudi, B.
Keyword(s):  
Risk Factors ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Quality Indicators ◽  
High Cardiovascular Risk ◽  
Very High

AIM OF THE STUDY To explore the distribution by cardiovascular risk groups according to the classification promoted by the ESC (European Society of Cardiology) of subjects with type 1 (T1D) and type 2 (T2D) diabetes cared for by Italian diabetologists and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. DESIGN AND METHODS The study is based on data extracted from electronic medical records of patients treated at the 258 diabetes centers participating in the Annals AMD initiative and active in the year 2018. Patients with T1D or T2D were stratified by cardiovascular risk, in accordance with the recent ESC guidelines. General descriptive indicators and measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. RESULTS Overall, 29,368 adults with T1D and 473,740 subjects with T2D were evaluated. Among subjects with T1D: 64.7% were at very high cardiovascular risk, 28.5% at high risk and the remaining 6.8% at moderate risk. Among subjects with T1D at very high-risk: 54.7% had retinopathy, 29.0% had albuminuria, 7.3% had a history of major cardiovascular event, 47.3% had organ damage, 48.9% had three or more risk factors, and 70.6% had a diabetes duration of over 20 years. Among subjects with T2D: 78.5% were at very high cardiovascular risk, 20.9% at high risk and the remaining 0.6% at moderate risk. Among those with T2D at very high risk: 39.0% had organ damage, 89.1% had three or more risk factors, 18.7% had a previous major cardiovascular event, 26,4% had retinopathy, 39.5% had albuminuria. With regard to the glucose-lowering drugs: the use of DPPIV-i increased markedly as cardiovascular risk increased; the use of secretagogues also increased and, although within low percentages, also the use of GLP1-RA tended to increase. The use of SGLT2-i is also still limited, and only slightly higher in subjects with very high cardiovascular risk. In both types of diabetes, the overall quality of care, as summarized by the Q score values, tended to be lower as the level of cardiovascular riskincreased. CONCLUSIONS The analysis of a large population such as that of the AMD Annals database allowed to highlight the characteristics and quality indicators of care of subjects with T1D and T2D in relation to cardiovascular risk classes. A large proportion of subjects appear to be at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to the potential advantages in terms of reduction of cardiovascular risk of some drug categories (GLP1-RA and SGLT2-i) and, conversely, with respect to the potential risks related to the use of other pharmacological classes (sulfonylureas). Several actions are necessary to optimize care and improve the quality of care for both subjects with T1D and T2D. KEY WORDS type 1 diabetes; type 2 diabetes; cardiovascular risk; quality indicators of care.

scholarly journals Temporal trends of lipid control in very high cardiovascular risk patients

2021 ◽  
Vol 40 (9) ◽  
pp. 641-648
Author(s):  
Paulo Maia Araújo ◽  
Alzira Nunes ◽  
Sofia Torres ◽  
Carlos Xavier Resende ◽  
Sérgio Machado Leite ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Temporal Trends ◽  
High Cardiovascular Risk ◽  
Risk Patients ◽  
Lipid Control ◽  
Very High

scholarly journals Pathogenetic role of cell-free circulating mitochondrial DNA in blood in the development of arterial hypertension

2021 ◽  
pp. 50-57
Author(s):  
С.А. Лепехова ◽  
Е.А. Трофимова ◽  
С.В. Кирильчик ◽  
В.В. Киреева ◽  
Ю.К. Усольцев ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
High Cardiovascular Risk ◽  
Pathogenetic Role ◽  
Quantitative Indicator ◽  
Coronary Syndrome ◽  
Risk Patients ◽  
Very High

Изучение свободно циркулирующей митохондриальной ДНК (мтДНК) плазмы крови вызывает растущий интерес. Предполагается, что показатель мтДНК может быть перспективным клиническим биомаркёром оценки рисков течения заболеваний. Целью исследования явилась оценка взаимосвязи количественного показателя мтДНК со стадией заболевания и сердечно-сосудистым риском у пациентов с артериальной гипертензией (АГ). Методы. В исследовании участвовал 70 пациентов, которые были разделены на группу с АГ (n = 51) и контрольную группу практически здоровых пациентов (n = 19). Все пациенты подписали информированное согласие на обследование и обработку данных в рамках научного исследования. Проведена оценка демографических данных, длительности заболевания АГ, факторов риска, наследственности, уровня физической активности, антропометрических данных, лабораторное и инструментальное обследование. Оценка уровня мтДНК проведена методом количественной полимеразной цепной реакции. Использовали фрагмент мтДНК с праймерами FmtMinArc 5'-CTAAATAGCCCACACGTTCCC-3' и RmtMinArc 5'-AGAGCTCCCGTGAGTGGTTA-3'. Результаты. На основании проведенного исследования оценки взаимосвязи количественного показателя мтДНК в крови пациентов с АГ, выявлено, что независимо от стадии заболевания, достоверных различий в показателях уровня мтДНК не выявлено, однако отметим, что количество копий имело тенденцию к увеличению по сравнению с условно здоровыми пациентами. При анализе сердечно-сосудистого риска обнаружено, что количественный показатель мтДНК не зависит от стадии АГ. В то же время уровень мтДНК статистически значимо повышается у пациентов с АГ очень высокого сердечно-сосудистого риска по сравнению с условно здоровыми субъектами: Me (Q1; Q3) - 56731 (42531; 129375) копий/мл против 35156 (18325; 54956) копий/мл соответственно (p = 0,015). Заключение. Уровень мтДНК у пациентов с АГ может явиться маркёром сердечно-сосудистого риска. Учитывая ранее показанную патогенетическую роль уровня мтДНК при остром коронарном синдроме, следует продолжить анализ, чувствительность которого может быть повышена за счет включения количественных показателей содержания ядерной ДНК. Studying cell-free circulating mitochondrial DNA (mtDNA) in blood plasma induces growing interest. It is assumed that an indicator of mtDNA may appear a promising clinical biomarker for assessment of the risks in the course of diseases. The aim of this study was evaluating the relationship between the quantitative indicator of mtDNA in the blood of patients with arterial hypertension (AH) and the stage of the disease and the cardiovascular risk. Methods The study included 70 patients who were divided into a group with AH (n = 51) and a control group of apparently healthy patients (n = 19). All patients signed the informed consent for examination and the processing of personal data as a part of the study. Demographic data, duration of hypertension, risk factors, heredity, physical activity, anthropometric data, results of slaboratory and instrumental examinations were recorded. Concentration of mtDNA was measured by the quantitative polymerase chain reaction. A mtDNA fragment with primers FmtMinArc 5'-CTAAATAGCCCACACGTTCCC-3' and RmtMinArc 5'-AGAGCTCCCGTGAGTGGTTA-3' was used. Results. Studying the relationships between the quantitative indicator of mtDNA in the blood and AH showed that there were no significant differences in the indicators for the level of mtDNA regardless of the AH stage. However, we noted that the number of copies tended to increase in comparison with that in conventionally healthy patients. Analysis of the cardiovascular risk showed that the quantitative indicator of mtDNA did not depend on the stage of hypertension. At the same time, the level of mtDNA was significantly increased in very high cardiovascular risk patients with AH as compared to conventionally healthy subjects: Me (LQ; UQ), 56731.2 (42531.25; 129375.0) copies/ml vs. 35156.00 (18325.00; 54956.00) copies/ml, respectively (p = 0.015). Conclusion. The level of mtDNA in AH patients is a potential a marker for cardiovascular risk as shown by the increase in mtDNA in very high cardiovascular risk patients. Taking into account the previously demonstrated pathogenetic role of the level of mtDNA in acute coronary syndrome, the analysis should be continued. The analysis sensitivity can be increased by inclusion of quantitative indicators for the content of nuclear DNA.

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