Gender difference in lipid lowering treatment and lipid control in cardiometabolic diseases

Abstract BANKGROUND: Mortality from coronary artery disease continues to rise, and secondary prevention and treatment are particularly important. OBJECTIVE: The objective of this study is to evaluate low-density lipoprotein cholesterol (LDL-C) levels in patients after percutaneous coronary intervention (PCI), to describe how treatment outcomes for individual patients changed over time and to examine the potential impact of lipid control rates through population LDL-C levels changes.METHODS: This retrospective study was conducted in patients who underwent PCI between July 2017 and June 2019. The main results included LDL-C levels after PCI. To assess the outcome of prevention, three separate measures of LDL-C were considered: baseline, first follow-up, and final follow-up, and LDL-C control rates were analyzed according to different guidelines. we examine the impact of 0.1mmol/l decreases or increases in population LDL-C levels on LDL-C control.RESULTS: Data were analyzed for 423 patients (mean age, 62 ±10 years), and the baseline LDL-C level was 3.11 ± 0.99 mmol/l. 51.5% of the patients achieved the Chinese Lipids Guidelines treatment goal, 22% and 11.6% of the patients achieved the 2016 ESC Lipids Guidelines and 2019 ESC Lipids Guidelines treatment goal at the final follow-up period respectively. LDL-C levels fluctuated during the follow-up period, and the long-term maintenance results could not be guaranteed after PCI. Population LDL-C levels changes in lifestyle could have a very large impact on LDL-C control in China.CONCLUSION: LDL-C control with statins is not ideal in patients after PCI, which is far from the requirements of the latest guidelines. Although clinicians understand the lipid-lowering effect of statins, they should not give up active lifestyle changes, and should strengthen the comprehensive management of blood lipid control.

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Abstract P183: Lipid Control in Veterans Following Percutaneous Intervention

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_2.ap183 ◽

2011 ◽

Vol 4 (suppl_2) ◽

Author(s):

Sloane A McGraw ◽

Chris Healy ◽

Burhan Mohamedali ◽

Anupama Shivaraju ◽

Adhir Shroff

Keyword(s):

Total Cholesterol ◽

Therapeutic Option ◽

Coronary Intervention ◽

Lipid Lowering ◽

Lipid Management ◽

Beneficial Effects ◽

The Mean ◽

Lipid Control ◽

Statin Use

Background: Management of lipids is vital in patients with underlying coronary artery disease (CAD). According to the American College of Cardiology (ACC) guidelines, all patients with CAD should have low density lipoproteins (LDL) goals to be less than 100 mg/dl with the therapeutic option of treatment to less than 70 mg/dl. This can be achieved using multiple lipid lowering agents, however statin use is encouraged in CAD patients due to its multiple beneficial effects. Methods: We conducted a retrospective cohort study focusing on lipid management and statin use in 857 veterans undergoing percutaneous coronary intervention (PCI) between September 2004 and December 2009 at the Jesse Brown Veterans Hospital in Chicago, IL. Values were collected both pre-intervention as well as at six month follow up. Results: Both pre and post PCI, focus was maintained on the total cholesterol as well as the LDL levels. The mean total cholesterol prior to intervention was 166mg/dl and decreased to150mg/dl at six month follow up. The LDL mean pre-PCI was 98mg/dl and at six months the mean LDL decreased to 86mg/dl. With regards to ACC guidelines, the percent at goal for LDL less than 100mg/dl increased from 59% pre-PCI to 74% post-PCI Furthermore, treatment to less than 70mg/dl increased from 22 to 32% at six months. Lastly, the use of statins increased from 72 to 89%. Conclusions: There were in improvements in both total cholesterol and LDL values at six months post-PCI. There were also improvements in the percentage of patients who met the ACC recommended goal of LDL cholesterol less than 100mg/dl and the suggested goal of 70mg/dl. At six months, there was also an increase in usage of statin therapy.

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LIPID CONTROL AND USE OF LIPID-LOWERING DRUGS FOR SECONDARY PREVENTION OF CARDIOVASCULAR EVENTS IN TAIWAN: THE TAIWANESE SECONDARY PREVENTION FOR PATIENTS WITH ATHEROSCLEROTIC DISEASE (T-SPARCLE) REGISTRY

Heart ◽

10.1136/heartjnl-2012-302920a.23 ◽

2012 ◽

Vol 98 (Suppl 2) ◽

pp. E10.3-E11

Author(s):

Wei-Hsian Yin ◽

Wei-Hsian Yin

Keyword(s):

Secondary Prevention ◽

Cardiovascular Events ◽

Atherosclerotic Disease ◽

Lipid Lowering ◽

Lipid Lowering Drugs ◽

Lipid Control

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Modifiable factors for reducing the gender difference in lipid control

Clinical Lipidology ◽

10.2217/clp.12.48 ◽

2012 ◽

Vol 7 (4) ◽

pp. 379-387

Author(s):

Paramjit S Tappia ◽

Naranjan S Dhalla

Keyword(s):

Gender Difference ◽

Modifiable Factors ◽

Lipid Control

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Intensification of lipid-lowering therapy in patients with severe lipid metabolism disorders in specialized lipid control centers. Possibilities of using evolocumab

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-7-437-444 ◽

2020 ◽

Vol 4 (7) ◽

pp. 437-444

Author(s):

O.L. Barbarash ◽

◽

V.V. Kashtalap ◽

N.V. Fedorova ◽

D.Yu. Sedykh ◽

...

Keyword(s):

Lipid Metabolism ◽

Current Data ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Pcsk9 Inhibitors ◽

Control Center ◽

Lowering Therapy ◽

Lipid Metabolism Disorders ◽

Target Values ◽

Lipid Control

The article presents current data on the prevalence of dyslipidemia worldwide and in the Russian Federation as the main cardiovascular risk factor of developing diseases associated with atherosclerosis. The article identifies the problems of low-level detection of dyslipidemia in the population and insufficient efficacy of lipid-lowering therapy to achieve the lipid profile target values depending on the established risk. It also presents the possibilities of modern lipid-lowering therapy with the use of innovative drugs — PCSK9 inhibitors and the use of evolocumab in accordance with evidence-based medicine. Adding that, the article shows the experience of two lipid control centers (in Kemerovo and Surgut) with the postulation of the need to expand the lipid control center chain to improve methods for providing medical care to patients with severe forms of dyslipidemia. The possibilities of intensifying lipid-lowering therapy in real clinical practice are outlined on the example of patients undergoing treatment in the lipid control center of Kemerovo. Evolocumab has been shown to be highly effective: reduction of atherogenic cholesterol fractions by 67% from the baseline and high safety of such therapy.KEYWORDS: lipid metabolism disorders, statins, lipid-lowering therapy, familial hypercholesterolemia, PCSK9 inhibitors, evolocumab.FOR CITATION: Barbarash O.L., Kashtalap V.V., Fedorova N.V. et al. Intensification of lipid-lowering therapy in patients with severe lipid metabolism disorders in specialized lipid control centers. Possibilities of using evolocumab. Russian Medical Inquiry. 2020;4(7):437–444. DOI: 10.32364/2587-6821-2020-4-7-437-444.

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Abstract P154: Blood Pressure and Lipid Control Variation in Faculty versus Trainee Clinics

Circulation ◽

10.1161/circ.137.suppl_1.p154 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Sarina Sachdev ◽

Bassam A Omar ◽

Christopher Malozzi ◽

G. Mustafa Awan

Keyword(s):

Blood Pressure ◽

Ldl Cholesterol ◽

Preventive Therapy ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Major Health Problem ◽

The Mean ◽

The Difference ◽

Student’S T ◽

Lipid Control

Background: Clinics run by trainees are often composed of indigent patients with challenging problems as to implementation of preventive measures. Methods: Charts were selected based on the inclusion of hypertension as a diagnosis; 100 visits were reviewed in each of two groups. The first group (clinic 1) included patients seen by a cardiologist faculty; all patients had insurance. The second group (clinic 2) included visits seen by cardiology fellows, and directly supervised by the same faculty physician; with the majority of these patients lacking insurance. The difference between the groups with regards to age, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and LDL cholesterol were analyzed using Student's t-Test. Results: The mean age of patients in clinic 1 was 62±14 years compared with 52±9 years in clinic 2 (P < 0.01). There was 100% documentation of weight, BP and HR on every visit. The mean weight in clinic 1 was insignificantly lower compared with clinic 2 (202±61 vs 218±60 lbs respectively; P = 0.06). SBP was similar in both clinics (132±18 vs 130±21 mmHg respectively; P = 0.38). HR was lower in clinic 1 compared with clinic 2 (67±10 vs 77±15 BPM respectively; P < 0.01). Lipid profiles, which required a separate visit to the lab and extra charge, were documented in 93% of patients in clinic 1 versus only 34% of patients in clinic 2. LDL cholesterol was lower in clinic 1 compared with clinic 2 (88±34 vs 106±35 mg/dL respectively; P=0.01). While HDL was similar in both clinics (48 ± 14 in clinic 1 versus 46 ± 15 mg/dL in clinic 2; P = NS), non-HDL was lower, at 115 ± 38 in clinic 1 versus 136 ± 40 mg/dL in clinic 2 (P < 0.01). Discussion: Hypertension and dyslipidemia are major health problem. Adequate control of blood pressure and LDL cholesterol correlate with better cardiovascular outcomes. Our data demonstrate that both faculty and fellow clinics achieved mean BP of < 140/90 mmHg, with 100% documentation. However, documentation and control of lipids appear to be more challenging in indigent patients due to the extra burden and cost of undergoing lab tests. Compliance with medications and the prescription of affordable generic, often less potent, lipid-lowering therapy to indigent patients in the fellow clinic may also play a role in the higher LDL levels compared with the faculty clinic. Efforts at improving the adherence of all patients to preventive therapy aimed at achieving guideline-based BP and lipid targets should be included in quality improvement projects during residency training.

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GENDER DIFFERENCE IN CHANGES OF PLAQUE CHARACTERISTICS IN RESPONSE TO INTENSIVE LIPID-LOWERING THERAPY: SERIAL OPTICAL COHERENCE TOMOGRAPHY AND INTRAVASCULAR ULTRASOUND ANALYSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(15)60210-8 ◽

2015 ◽

Vol 65 (10) ◽

pp. A210

Author(s):

Yoshiyasu Minami ◽

Jingbo Hou ◽

Haibo Jia ◽

Sining Hu ◽

Rocco Vergallo ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Gender Difference ◽

Intravascular Ultrasound ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Optical Coherence ◽

Lowering Therapy

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The frequency and profile of lipid lowering treatment in a contemporary Russian population

European Heart Journal ◽

10.1093/eurheartj/ehab724.2586 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A Ryabikov ◽

E Mazdorova ◽

M Shapkina ◽

E Avdeeva ◽

G Simonova ◽

...

Keyword(s):

Low Density Lipoprotein ◽

Population Sample ◽

Density Lipoprotein ◽

Basic Research ◽

Russian Population ◽

High Rate ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

The Status ◽

Lipid Control

Abstract Background Despite of guidelines for management of dyslipidemias (DLP) and the availability of effective and safe lipid lowering drugs (LLD), about one half of CVD patients do not reach the target lipid levels. The knowledge on DLP management in Russian population is limited. Objective To analyze the frequency and profile of LLD therapy in subjects with DLP and cardiometabolic diseases in a contemporary Russian population. Methods A random population sample of men and women 55–84 years old (n=3898) was examined in 2015–17 in the Russian arm of the HAPIEE project. A composite dysmetabolic group included DLP (total cholesterol, TC ≥5 mmo/l or low-density lipoprotein cholesterol, LDLC ≥3 mmol/l or triglycerides, TG ≥1.7 mmol/l) and/or coronary heart disease (CHD) and/or diabetes mellitus type 2 (DM2). Regular medication intake for 12 months was coded by ATC. Results In studied population sample 88% of subjects had dysmetabolic disorders (DLP - 83.1%, CHD - 14.9%, DM2- 20.8%); among them 32.8% subjects received LLD therapy (21.2% in men vs. 39.4% in women, p<0.001) and 17.1% did not report the status of LLD receiving. The frequency of LLD use in CHD group was 48,3%, in DM2 – 35,0%, in DLP – 29.4%. Among named LLD, statins were predominantly used (98%). Lipids control was achieved among subjects with CHD in 18.3% (37.9% among those receiving LLD); among DM2 - in 9.0% (25.6%); among DLP without CHD or DM2 – in 7.3% (24.8%). Conclusion In an urban population sample aged 55–84 examined in 2015–17, more than one half of subjects with dysmetabolic disorders (CHD, DM2, DLP) did not receive LLD. Among those receiving lipid-lowering therapy, the lipid control was achieved in about 40% of participants with CHD, and in every forth participant with DM2 or DLP. The lack of lipid control is likely to contribute high rate of atherosclerotic CVD in studied population. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Russian Foundation of Basic Research; Russian Academy of Sciences

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Cardiometabolic diseases and active aging - polypharmacy in control

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0324 ◽

2020 ◽

Vol 73 (2) ◽

Author(s):

Adriana Nancy Medeiros dos Santos ◽

Dulcineia Rebecca Cappelletti Nogueira ◽

Beatriz Aparecida Ozello Gutierrez ◽

Rosa Yuka Sato Chubaci ◽

Caroline Ribeiro de Borja Oliveira

Keyword(s):

Prescription Drugs ◽

Prevalence Ratio ◽

The Elderly ◽

Lipid Lowering ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Cardiometabolic Diseases ◽

Chi Square Test ◽

The University

ABSTRACT Objectives: To estimate the prevalence of cardiometabolic diseases and their association with polypharmacy in elderly people at the University of the Third Age (Portuguese acronym: UnATI). Methods: A cross-sectional, descriptive, analytical study with 121 elderly patients. The prevalence ratio, Pearson’s Chi-square test and Fisher’s exact test were used as measures of association. Results: At the mean age of 68.3, most elderly had at least one cardiometabolic disease (82.6%), of which hypertension was the most prevalent (71.1%), and consumed prescription drugs of continuous use (92.6%). Almost half of the elderly (48.2%) used combinations of drugs, which suggests a high cardiovascular risk. Polypharmacy due to prescription was observed in almost one-third (28.6%) of the sample, associated with the use of antihypertensives (p=0.004), antidiabetics (p=0.000) or lipid-lowering agents (p<0.000). Conclusions: Clinical guidelines recommend changes in lifestyle, but increased pharmacotherapy prevails in practice, which increases the risk of adverse events, especially in old age.

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