Nonoptimal high-density lipoprotein cholesterol levels are highly prevalent in patients presenting with acute coronary syndromes and well-controlled low-density lipoprotein cholesterol levels

2010 ◽  
Vol 4 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Erika M. Felix-Getzik ◽  
Jeffrey T. Kuvin ◽  
Richard H. Karas
1996 ◽  
Vol 1 (3) ◽  
pp. 195-202 ◽  
Author(s):  
John M. Morgan ◽  
David M. Capuzzi ◽  
John R. Guyton ◽  
Robert M. Centor ◽  
Ronald Goldberg ◽  
...  

Background The present study was designed to determine the efficacy and safety of Niaspan (Kos Pharmaceuticals, Inc, Hollywood, FL), a new controlled-release formulation of niacin, in the treatment of primary hyperlipidemia, the occurrence and severity of flushing events, and potential adverse effects, particularly hepatotoxicity. Methods and Results The study was conducted as a multicenter, randomized, double-blind, placebo-controlled, parallel comparison of Niaspan in doses of 1000 mg/day and 2000 mg/day, administered once a day at bedtime. One hundred twenty-two patients with low-density lipoprotein cholesterol levels > 4.14 mM/L (160 mg/dL) with dietary intervention and high-density lipoprotein cholesterol ≤ 1.81 mM/L (70 mg/dL) were randomized to one of three treatment groups: placebo, and 1000 mg/day or 2000 mg/day of Niaspan. Safety and efficacy measures included 12-hour serum fasting lipid and lipoprotein concentrations, serum analyte levels for major organ function, flushing diaries, and adverse event records. The placebo group demonstrated no significant changes in serum lipoprotein concentrations over the treatment period of 12 weeks, except for a slight 4% increase in high-density lipoprotein cholesterol. Niaspan significantly lowered low-density lipoprotein cholesterol levels by 6% and 14% for the 1000 mg/day and 2000 mg/day doses, respectively. High-density lipoprotein cholesterol levels rose significantly, with a 17% increase occurring at the 1000 mg/day dose and a 23% increase occurring at the 2000 mg/day dose. Niaspan (2000 mg/day) produced significant decreases of 27% and 29%, respectively, for serum lipoprotein(a) and triglyceride concentration. Although the incidence of flushing was significant, these episodes were generally well tolerated. Conclusion Niaspan administered in doses of 1000 mg/day and 2000 mg/day at bedtime were well tolerated with few side effects and produced favorable effects on the major circulating lipoproteins of patients with primary dyslipidemias as specified by the enrollment criteria.


2018 ◽  
Vol 31 (2) ◽  
pp. 183-197 ◽  
Author(s):  
Larisse Monteles NASCIMENTO ◽  
Keila Rejane Oliveira GOMES ◽  
Marcio Denis Medeiros MASCARENHAS ◽  
Cassio Eduardo Soares MIRANDA ◽  
Telma Maria Evangelista de ARAÚJO ◽  
...  

ABSTRACT Objective This study aimed at validating the associations between the consumption of antioxidant nutrients as well as lipid alterations and cardiometabolic risks in adolescents. Methods This cross-sectional study included 327 adolescents aged 14-19 years. Sociodemographic and dietary information, anthropometric and blood pressure measurements, and biochemical data were obtained. Cardiometabolic risk was calculated by aggregating the risk factors, which were expressed as the sum of Z-scores. Poisson regression was performed to estimate the prevalence ratios. Results In boys, low intake of zinc was associated with elevated total cholesterol and triglyceride levels, whereas it was associated with low high-density lipoprotein cholesterol levels and high low-density lipoprotein cholesterol and total cholesterol levels in girls, thus indicating a cardiometabolic risk. Furthermore, low intake of copper was associated with high triglyceride levels and cardiometabolic risk in girls. The high prevalence ratios of high low-density lipoprotein cholesterol and total cholesterol levels and cardiometabolic risk were higher in those with low intake of vitamin A. Among girls, associations were also observed between lower intake of vitamin A and high triglyceride levels. Low intake of vitamin C among boys was associated with elevated high low-density lipoprotein cholesterol and triglyceride levels. Among girls, the intake of this vitamin was associated with lower low high-density lipoprotein cholesterol levels. In girls, low intake of vitamin E was associated with low low high-density lipoprotein cholesterol levels and high total cholesterol levels. Conclusion The associations between antioxidant micronutrients as well as lipid alterations and cardiometabolic risk emphasize the importance of encouraging the consumption of foods that are rich in these nutrients to modulate lipid alterations and cardiometabolic risk.


Angiology ◽  
2008 ◽  
Vol 60 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Georgios S. Goumas

Aggressive therapy with statins to lower the low density lipoprotein cholesterol decreases cardiovascular events. Nevertheless, administration of the highest approved statin dose only offers limited additional benefit at the expense of an increased incidence of side effects. Therefore, novel compounds that further reduce the low-density lipoprotein cholesterol and at the same time have beneficial effects on other lipid parameters when added to statin therapy are under investigation. Nicotinic acid lowers the levels of the low-density lipoprotein cholesterol and triglycerides while raising the concentration of the protective high-density lipoprotein cholesterol. A significant inverse association exists between long-term intake of ω-3 fatty acids and cardiovascular mortality; these fish oils lower serum triglycerides levels. Fibrates substantially decrease triglycerides, increase high density lipoprotein cholesterol, and modestly decrease low-density lipoprotein cholesterol levels. Ezetimibe selectively inhibits cholesterol absorption in the gut. Combined therapy with ezetimibe and a statin provides an incremental reduction in the low-density lipoprotein cholesterol levels.


2005 ◽  
Vol 62 (11) ◽  
pp. 811-819
Author(s):  
Aleksandra Jovelic ◽  
Goran Radjen ◽  
Stojan Jovelic ◽  
Marica Markovic

Background/Aim. C-reactive protein is an independent predictor of the risk of cardiovascular events and diabetes mellitus in apparently healthy men. The relationship between C-reactive protein and the features of metabolic syndrome has not been fully elucidated. To assess the cross-sectional relationship between C-reactive protein and the features of metabolic syndrome in healthy people. Methods. We studied 161 military pilots (agee, 40?6 years) free of cardiovascular disease, diabetes mellitus and active inflammation on their regular annual medical control. Age, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides, fasting glucose, glycosylated hemoglobin, blood pressure, smoking habit, waist circumference and body mass index were evaluated. Plasma C-reactive protein was measured by the immunonephelometry (Dade Behring) method. Metabolic syndrome was defined according to the National Cholesterol Education Program Expert Panel. Results. The mean C-reactive protein concentrations in the subjects grouped according to the presence of 0, 1, 2 and 3 or more features of the metabolic syndrome were 1.11, 1.89, 1.72 and 2.22 mg/L, respectively (p = 0.023) with a statistically, significant difference between those with 3, and without metabolic syndrome (p = 0.01). In the simple regression analyses C-reactive protein did not correlate with the total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, body mass index and blood pressure (p > 0.05). In the multiple regression analysis, waist circumference (? = 0.411, p = 0.000), triglycerides to high density lipoprotein cholesterol ratio (? = 0.774, p = 0.000), smoking habit (? = 0.236, p = 0.003) and triglycerides (? = 0.471, p = 0.027) were independent predictors of C-reactive protein. Conclusions. Our results suggested a cross-sectional independent correlation between the examined cardiovascular risk factors as the predominant features of metabolic syndrome and C-reactive protein in the group of apparently healthy subjects. The lack of correlation of C-reactive protein with the total cholesterol and low density lipoprotein cholesterol in our study may suggest their different role in the process of atherosclerosis and the possibility to determine C-reactive protein in order to identify high-risk subjects not identified with cholesterol screening.


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