Can the ESC/EAS LDL-cholesterol target in patients with diabetes and high cardiovascular risk be achieved in clinical practice? Results from an ambulatory multidisciplinary diabetes center cohort

2019 ◽  
Vol 45 (6) ◽  
pp. 592-595
Author(s):  
T. Vidal-Trécan ◽  
M. Laloi-Michelin ◽  
C. Bouché ◽  
V. Juddoo ◽  
J.-G. Dillinger ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Risk ◽  
Ldl Cholesterol ◽  
High Cardiovascular Risk ◽  
Patients With Diabetes ◽  
Diabetes Center

scholarly journals Hyperuricemia, gout and high cardiovascular risk - how to manage them in clinical practice

2019 ◽  
Vol 91 (12) ◽  
pp. 75-83
Author(s):  
V V Fomin ◽  
T E Morosova ◽  
V V Tsurko
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Cardiovascular Risk ◽  
High Risk ◽  
High Cardiovascular Risk ◽  
Relationship Of ◽  
The Relationship

In recent years, the relationship of hyperuricemia and gout with a high risk of cardiovascular disease has been widely discussed. Therefore, it is important to systematically examine patients in order to diagnose comorbidities, among which cardiovascular disease and its complications occupy a leading place and consider mandatory treatment of patients with hyperuricemia and gout with high cardiovascular risk with lowering drugs, which fully reflects the provisions of the latest European recommendations for the management and treatment of patients with gout.

scholarly journals Features and main problems of treating patients with high and very high cardiovascular risk with statins in real clinical practice (according to the data of the “PRIORITET” research)

2018 ◽  
Vol 17 (6) ◽  
pp. 52-60 ◽  
Author(s):  
S. Yu. Martsevich ◽  
Yu. V. Lukina ◽  
N. P. Kutishenko ◽  
N. A. Dmitrieva ◽  
T. A. Gomova ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cardiovascular Risk ◽  
Statin Therapy ◽  
Working Group ◽  
Target Level ◽  
High Cardiovascular Risk ◽  
Lipid Pattern ◽  
Very High ◽  
Real Clinical Practice ◽  
Group 1

Aim. To determine the features and main problems of statin therapy, as well as assess the possibility of achieving the target level of lipid pattern in patients with high and very high cardiovascular risk (CVR) in real clinical practice.Material and methods. The design of the “PRIORITET” observational program is an open observational study. Patients with high and very high CVR were divided into 3 groups in accordance with the initial data: (1) not taking statins, (2) taking statins, but not reaching the target low-density lipoprotein cholesterol (LDL-C) level, (3) taking statins with the achievement of the target LDL-C level, which is justified in replacing the statin inside the class — adverse effects (AE), high price, etc. Within 12 weeks 3 visits of patients to hospitals were carried out: baseline visit (B0), visit 1 month after the study initiation (B1) and visit 3 months after the study initiation (B3). The choice of atorvastatin or rosuvastatin was assessed by the doctors.Results. Groups 1, 2 and 3 included 112, 170 and 16 people, respectively. At B0, 145 (48,7%) patients were prescribed atorvastatin, and 153 (51,3%) — rosuvastatin. Three people dropped out of the study to B3, 295 patients completed the program. Lipid pattern of 285 patients were analyzed: 121 (41%) people (101 with very high CVR and 20 with high CVR) achieved the target LDL-C level, the remaining 164 (59%) patients (CVR — 156 and 8, respectively) — no. The most pronounced dynamics of LDL=C level was revealed in group 1, the differences between group 1 and groups 2 and 3 are highly statistically significant (p<0,0001). There were no differences in the frequency of reaching the target LDL-C level between patients taking atorvastatin or rosuvastatin. The target level of LDL-C (p=0,003) in the treatment of rosuvastatin in patients with high CVR was reached significantly more often than in patients with very high CVR. Also 3 non-serious AEs were reported. On average, in 9% of cases, reaching the target level of LDL-С during visits B1 and B3 was wrong interpreted by the attending physicians.Conclusion. The main problems of statin therapy in real clinical practice are the wrong interpretation of reaching the target level of LDL-C, inertness of doctors in titrating of statins doses and achieving the target level of lipid pattern. It may be the cause of reduced efficiency and deterioration of lipid-lowering therapy results in patients with high and very high CVR. The results of the “PRIORITET” study demonstrated the possibility of improving the practice of statins use and its accordance with clinical guidelines.Skibitsky V. V. on behalf of the working group of the “PRIORITET” researchWorking Group of the “PRIORITET” study: Voronina V. P. (Moscow), Zelenova T. I. (Moscow), Sladkova T.A. (Moscow), Alekseeva A. I. (Tula), Barabanova T. Yu. (Tula), Zotova A. S. (Tula), Kolomeitseva T. M. (Tula), Prikhod’ko T. N. (Tula), Pazelt E. A. (Nizhny Novgorod), Khramushev N. Yu. (Nizhny Novgorod), Skibitsky A. V. (Krasnodar), Alekseeva V. V. (Saratov), Lazareva E. V. (Saratov).

P651Prevalence of hypertriglyceridemia in statin treated high risk patients who might benefit from treatment with icosapent ethyl for secondary prevention in clinical practice - Results of DYSIS

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A K Gitt ◽  
M Horack ◽  
D Lautsch ◽  
J Ferrieres
Keyword(s):  
Clinical Practice ◽  
Ldl Cholesterol ◽  
Cardiovascular Death ◽  
Additional Treatment ◽  
High Cardiovascular Risk ◽  
Icosapent Ethyl ◽  
Mixed Dyslipidemia ◽  
Risk Patients ◽  
Ischemic Events ◽  
Very High

Abstract Background Patients with elevated triglyceride (TG) levels are at increased risk for ischemic events. In the recently published REDUCE-IT-Study among patients with elevated triglyceride levels who were receiving statin therapy, the risk of major ischemic events, including cardiovascular death, was significantly lower with 2 g of icosapent ethyl twice daily than with placebo. Little is known about how many patients in clinical practice might benefit from this additional treatment. Methods The cross sectional, observational Dyslipidemia International Study (DYSIS) examined lipid goal attainment among statin-treated very high cardiovascular risk patients (defined as per 2011 EAS/ESC guidelines, including patients suffering from coronary heart disease, diabetes, chronic kidney disease or peripheral atherosclerotic disease) in Canada, Europe, Middle East countries and China. Data were collected under real life conditions in physicians' offices and hospital outpatient wards between 2008–2012. We examined the prevalence of mixed dyslipidemia with TG >135 mg/dl in high statin treated high risk patients in clinical practice. Results Of a total of 44,593 patients on very high cardiovascular risk, all on chronic statin treatment, 21,312 (47.8%) had mixed dyslipidemia with TG values >135mg/dl. Patients with elevated TG also had higher levels of total and LDL-cholesterol. The overall use of additional fibrates on top of statins was low (4.0%), but more frequent in patients with TG >135 mg/dl. CVD patients with TG>135 mg/dl Pts with TG >135 mg/dl Pts with TG ≤135 mg/dl p-value OR (95% CI) n=21,312 (47.8%) n=23,281 (52.2%) Age (years) 65.4±10.1, 68.1±10.2 <0.0001 Females 42.2% 38.6% <0.0001 1.16 (1.12–1.21) Sedentary lifestyle 43.0% 37.6% <0.0001 1.25 (1.20–1.30) Risk factors/CV-disease   Hypertension 79.0% 74.9% <0.0001 1.26 (1.21–1.32)   Diabetes mellitus 56.3% 45.3% <0.0001 1.55 (1.50–1.61)   Ischemic heart disease 50.6% 54.4% <0.0001 0.86 (0.83–0.89)   Cerebrovascular disease 16.1% 17.7% <0.0001 0.90 (0.85–0.94)   Peripheral artery disease 8.1% 6.9% <0.0001 1.18 (1.10–1.27) Lipid lowering therapy   Rosuvastatin 11.3% 11.8% 0.13 0.95 (0.90–1.01)   Atorvastatin 38.2% 40.9% <0.0001 0.89 (0.86–0.93)   Simvastatin 41.9% 38.9% <0.0001 1.13 (1.09–1.18)   Other statins 8.6% 8.4% 0.12 0.96 (0.88–1.05)   Fibrates 5.5% 1.5% <0.0001 3.86 (3.40–4.37) Lipid Profile   Total Cholesterol (mg/dl) 185.6 159.0 <0.0001   LDL-Cholesterol (mg/dl) 102.1 88.9 <0.0001   Triglyderides (mg/dl) 189.5 95.7 <0.0001 Conclusion Almost half of consecutive patients with cardiovascular disease treated with statins for secondary prevention in clinical practice suffer from TG levels >135 mg/dl and might benefit from additional treatment with icosapent ethyl with further reduction in subsequent major ischemic events, including cardiovascular death. Acknowledgement/Funding MSD

scholarly journals Possibilities of combination lipid-lowering therapy in a patient with very high cardiovascular risk (сlinical case)

2021 ◽  
Vol 23 (1) ◽  
pp. 70-73
Author(s):  
Daria Yu. Sedykh ◽  
◽  
Natalia V. Fedorova ◽  
Vasily V. Kashtalap ◽  
◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Practice ◽  
Cardiovascular Risk ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
High Cardiovascular Risk ◽  
Coronary Syndrome ◽  
Lowering Therapy ◽  
Lipid Metabolism Disorders ◽  
Very High

The article demonstrates the possibility of prescribing an effective and safe lipid-lowering combination of the most tolerated doses of statins in combination with ezetimibe, using the example of a patient with severe lipid metabolism disorders in the post-infarction period. It has been shown that in real clinical practice, patients with acute coronary syndrome and persisting high LDL values are quite common, despite of the prescription of statins. These patients need closer follow-up and wider use of combined lipid-lowering therapy by adding ezetimibe to maximally tolerated doses of statins. Current clinical guidelines allow this to be done when patients fail to achieve target LDL values (>1.4 mmol/L) with statins monotherapy. This approach is effective and safe, which is illustrated by this hereditary clinical case. In routine clinical practice mandatory lipids control is required 4–6 weeks after patient’s discharge from the hospital for acute coronary syndrome. If the target lipids values were not achieved with the maximum dosage of statins, a mandatory using the combination therapy with ezetimibe is required. Keywords: myocardial infarction, dyslipidemia, improved prognosis, statins, ezetimibe For citation: Sedykh DYu, Fedorova NV, Kashtalap VV. Possibilities of combination lipid-lowering therapy in a patient with very high cardiovascular risk (сlinical case). Consilium Medicum. 2021; 23 (1): 70–73. DOI: 10.26442/20751753.2021.1.200604

scholarly journals Increased residual cardiovascular risk in patients with diabetes and high versus normal triglycerides despite statin-controlled LDL cholesterol

2018 ◽  
Vol 21 (2) ◽  
pp. 366-371 ◽  
Author(s):  
Gregory A. Nichols ◽  
Sephy Philip ◽  
Kristi Reynolds ◽  
Craig B. Granowitz ◽  
Sergio Fazio
Keyword(s):  
Cardiovascular Risk ◽  
Ldl Cholesterol ◽  
Residual Cardiovascular Risk ◽  
Patients With Diabetes
Sign in / Sign up

Export Citation Format

Share Document