scholarly journals ATHEROSCLEROTIC PLAQUE MORPHOLOGY IN RESPONSE TO HIGH INTENSITY LIPID LOWERING THERAPY BY MULTIMODALITY IMAGING AMONG WOMEN AND MEN: A YELLOW-II SUB-STUDY

2017 ◽  
Vol 69 (11) ◽  
pp. 1056
Author(s):  
Samit Bhatheja ◽  
Kipp Johnson ◽  
Yuliya Vengrenyuk ◽  
Shameer Khader ◽  
Takahiro Yoshimura ◽  
...  
Keyword(s):  
Atherosclerotic Plaque ◽  
High Intensity ◽  
Multimodality Imaging ◽  
Lipid Lowering ◽  
Plaque Morphology ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy

scholarly journals Application of the 2019 ESC/EAS dyslipidaemia guidelines to nationwide data of patients with a recent myocardial infarction: a simulation study

2020 ◽  
Vol 41 (40) ◽  
pp. 3900-3909 ◽  
Author(s):  
Ali Allahyari ◽  
Tomas Jernberg ◽  
Emil Hagström ◽  
Margrét Leosdottir ◽  
Pia Lundman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Intensity ◽  
Low Density Lipoprotein ◽  
Monte Carlo Model ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Pcsk9 Inhibitors ◽  
Recent Myocardial Infarction ◽  
Lowering Therapy

Abstract Aims To estimate the proportion of patients with a recent myocardial infarction (MI) who would be eligible for additional lipid-lowering therapy according to the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines for the management of dyslipidaemias, and to simulate the effects of expanded lipid-lowering therapy on attainment of the low-density lipoprotein cholesterol (LDL-C) target as recommended by the guidelines. Methods and results Using the nationwide SWEDEHEART register, we included 25 466 patients who had attended a follow-up visit 6–10 weeks after an MI event, 2013–17. While most patients (86.6%) were receiving high-intensity statins, 82.9% of the patients would be eligible for expanded lipid-lowering therapy, as they had not attained the target of an LDL-C level of <1.4 mmol and a ≥50% LDL-C level reduction. When maximized use of high-intensity statins followed by add-on therapy with ezetimibe was simulated using a Monte Carlo model, the LDL-C target was reached in 19.9% using high-intensity statin monotherapy and in another 28.5% with high-intensity statins and ezetimibe, while 50.7% would still be eligible for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. When use of alirocumab or evolocumab was simulated in those who were eligible for PCSK9 inhibitors, around 90% of all patients attained the LDL-C target. Conclusion  Our study suggests that, even with maximized use of high-intensity statins and ezetimibe, around half of patients with MI would be eligible for treatment with PCSK9 inhibitors according to the 2019 ESC/EAS guidelines. Considering the current cost of PCSK9 inhibitors, the financial implications of the new guidelines may be substantial.

scholarly journals The Use of Plaque Score Measurements to Assess Changes in Atherosclerotic Plaque Burden Induced by Lipid-Lowering Therapy Over Time: The METEOR Study

2011 ◽  
Vol 18 (9) ◽  
pp. 784-795 ◽  
Author(s):  
Sanne A.E. Peters ◽  
Soner Dogan ◽  
Rudy Meijer ◽  
Mike K. Palmer ◽  
Diederick E. Grobbee ◽  
...  
Keyword(s):  
Atherosclerotic Plaque ◽  
Lipid Lowering ◽  
Plaque Burden ◽  
Lipid Lowering Therapy ◽  
Plaque Score ◽  
Lowering Therapy ◽  
Over Time

scholarly journals Raman Spectroscopic Evaluation of the Effects of Diet and Lipid-Lowering Therapy on Atherosclerotic Plaque Development in Mice

2001 ◽  
Vol 21 (10) ◽  
pp. 1630-1635 ◽  
Author(s):  
Sweder W.E. van de Poll ◽  
Tjeerd J. Römer ◽  
Oscar L. Volger ◽  
Dianne J.M. Delsing ◽  
Tom C. Bakker Schut ◽  
...  
Keyword(s):  
Atherosclerotic Plaque ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Raman Spectroscopic ◽  
Lowering Therapy ◽  
Plaque Development

scholarly journals The Goal of Achieving Atherosclerotic Plaque Regression with Lipid-Lowering Therapy: Insights from IVUS Trials

2019 ◽  
Vol 26 (7) ◽  
pp. 592-600 ◽  
Author(s):  
Hiroyuki Daida ◽  
Tomotaka Dohi ◽  
Yoshifumi Fukushima ◽  
Hirotoshi Ohmura ◽  
Katsumi Miyauchi
Keyword(s):  
Atherosclerotic Plaque ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Plaque Regression

Combined lipid-lowering therapy from standpoint of modern guidelines for management of dyslipidaemias

2021 ◽  
pp. 13-19
Author(s):  
O. D. Ostroumova ◽  
A. I. Kochetkov ◽  
A. I. Listratov
Keyword(s):  
Statin Therapy ◽  
Safety Profile ◽  
High Intensity ◽  
Residual Risk ◽  
Lipid Lowering ◽  
High Density Lipoproteins ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Increased Risk ◽  
Wide Range

Coronary artery disease (CAD) remains the leading cause of death, and its prevalence is projected to increase in the near future. Dyslipidemia is one of the most important risk factors for CAD, and special attention is currently being paid to improving approaches to its correction. In the new revision of the Russian Guidelines for the Management of Patients with dyslipidemia (2020), priorities are given to high-intensity statin therapy: new more strict target levels of low-density lipoprotein cholesterol (LDL–C) are introduced. Experts also emphasize the important role of the cholesterol fraction of non-high-density lipoproteins (non-HDL–C), primarily triglycerides, and introduce their target levels. The concept of residual risk, which remains despite effective statin therapy and achievement of the target level of LDL–C, is closely related to non-HDL–C. Here, hypertriglyceridemia is of crucial importance, contributing to an increased risk of coronary heart disease and cardiovascular mortality. Therefore, combined lipid-lowering therapy in the form of a combination of high-intensity statin and fenofibrate is an effective approach to significantly improve the prognosis and reduce the residual risk. According to research data, rosuvastatin provides a reduction in LDL–C by ≥ 50 %, has a wide range of pleiotropic effects in combination with an optimal safety profile. Fenofibrate allows you to effectively reduce the level of triglycerides and implements additional protective effects on the cardiovascular system. The logical continuation of the principle of combined lipid-lowering therapy was the appearance of a fixed combination (FC) of rosuvastatin and fenofibrate, which already has its own evidence base of studies indicating a complex and complementary effect on the disturbed blood lipid spectrum, a good safety profile of therapy, and the form of ‘single-pill’ significantly increases patients adherence to treatment. It can be expected that the widespread use of rosuvastatin and fenofibrate in clinical practice will effectively reduce the residual cardiovascular risk and thus provide an improved prognosis for patients.

scholarly journals Early Effect of Lipid-Lowering Therapy With Pitavastatin on Regression of Coronary Atherosclerotic Plaque

2009 ◽  
Vol 73 (8) ◽  
pp. 1466-1472 ◽  
Author(s):  
Toru Toi ◽  
Isao Taguchi ◽  
Shuichi Yoneda ◽  
Michiya Kageyama ◽  
Akiko Kikuchi ◽  
...  
Keyword(s):  
Atherosclerotic Plaque ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Early Effect ◽  
Lowering Therapy ◽  
Coronary Atherosclerotic Plaque

P828Low-density lipoprotein cholesterol lowering therapy and target level attainment after a recent myocardial infarction - nationwide cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Allahyari ◽  
T Jernberg ◽  
D Lautsch ◽  
P Lundman ◽  
E Hagstrom ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Intensity ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Moderate Intensity ◽  
Lipid Lowering Therapy ◽  
Target Level ◽  
Lowering Therapy ◽  
Esc Guidelines

Abstract Background Lowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of cardiovascular disease after a myocardial infarction (MI). The European Society of Cardiology (ESC) guidelines recommend lipid lowering therapy to reach LDL-C treatment targets after an MI. Purpose To assess LDL-C target level attainment according to the ESC guidelines among patients with a recent MI in Sweden. Methods We used data from nationwide registers in Sweden and included patients aged 18–74 years admitted to a hospital with MI (1 January 2013–1 October 2016). Among patients who were alive and had LDL-C data available, we assessed LDL-C target achievement at 6–10 weeks (n=21,505) and 12–14 months (n=17,957) after the MI by category of lipid lowering therapy (no statin; low/moderate-intensity statins; high-intensity statins; any statin plus ezetimibe). The target was defined as an LDL-C of <1.8 mmol/L and a ≥50% reduction from the baseline if LDL-C was 1.8–3.5 mmol/L and the patient was not already receiving statins. Results Most patients were treated with high-intensity statin monotherapy (84.2% and 72.0%) or any statin with ezetimibe (2.1% and 10.4%) at 6–10 weeks and 12–14 months after the MI, respectively. In total, 37.7% (6–10 weeks) and 38.3% (12–14 months) had attained their LDL-C target. The proportion of patients attaining their LDL-C target at 6–10 weeks was 12% (no statin), 30% (low/moderate-intensity statins), 39% (high-intensity statins), and 49% (any statin plus ezetimibe). The corresponding numbers at 12–14 months were 16% (no statin), 29% (low/moderate-intensity statins), 39% (high-intensity statins), and 58% (any statin plus ezetimibe). A total of 11.8% at 6–10 weeks and 12.3% at 12–14 months reached an LDL-C level of <1.8 mmol/L, but did not reach their LDL-C target level due to the ≥50% reduction criteria. (Figure 1) Figure 1 Conclusions In this large population-based study using nationwide data, more than half of patients with a recent MI did not achieve the ESC guidelines LDL-C target levels, despite a large proportion with high-intensity statin therapy. In patients treated with statins and ezetimibe, four out of ten did not reach the ESC LDL-C target level. Our findings indicate that there may be a need for additional LDL-C lowering therapy if the target level is to be attained in all patients. Acknowledgement/Funding This project was supported by funding from Merck Sharp & Dohme.

scholarly journals PCSK9 Inhibitors in Clinical Practice: Experience of a Specialized Lipid Center

2022 ◽  
Vol 17 (6) ◽  
pp. 808-815
Author(s):  
A. V. Blokhina ◽  
A. I. Ershova ◽  
A. S. Limonova ◽  
O. V. Kopylova ◽  
A. N. Meshkov ◽  
...  
Keyword(s):  
High Intensity ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Pcsk9 Inhibitors ◽  
Lipid Clinic ◽  
Lowering Therapy ◽  
Lipid Metabolism Disorders ◽  
Very High

Aim. To characterize patients receiving PCSK9 inhibitors, and assess the efficiency of their treatment in a specialized lipid center.Material and methods. A retrospective analysis of the medical records of patients who visited the Lipid clinic of the National Medical Research Center for Therapy and Preventive Medicine (Moscow, Russia), receiving PCSK9 inhibitor and having lipid profile in dynamics, was carried out (n=77). Cardiovascular risk (CVR) and low-density lipoprotein cholesterol (LDL-C) target levels were evaluated in accordance with the Russian guidelines for the diagnostics and correction of dyslipidemias 2020.Results. Of 77 patients taking PCSK9 inhibitors (44.2% males, the median of age 56 [47; 66] years), the majority (64.0%) had a probable or definite familial hypercholesterolemia (FH). The proportion of other lipid metabolism disorders, pure hypercholesterolemia and combined hyperlipidemia was 21% and 15%. More than half of the patients (68.8%) had a very high CVR, mainly due to the presence of coronary heart disease (84.9%). The proportion of patients receiving PCSK9 inhibitors as monotherapy was 7.8%, in combination with high-intensity statin therapy – 33.8%, as part of triple lipid-lowering therapy (high-intensity statin, ezetimibe, PCSK9 inhibitors) – 50.6%. Addition of PCSK9 inhibitors to combined lipid-lowering therapy enabled to reduce the LDL-C level to 1.02 [0.62; 1.39] mmol/l with its total decrease from the baseline by 87.3%. While taking PCSK9 inhibitors, LDL-C <1.8 mmol/l and <1.4 mmol/l achieved at 78.3% and 57.7% FH patients with high and very high CVR, respectively. Among patients with other hyperlipidemias, 74.1% of patients with very high CVR was achieved the target LDL-C level <1.4 mmol/l.Conclusion: In a specialized lipid center, PCSK9 inhibitors are prescribed to patients with high or very high CVR, most of whom are FH patients. The effectiveness of the use of PCSK9 inhibitors in real-world practice is comparable to the results of clinical trials.

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