Lipid-lowering treatment in hypercholesterolaemic patients: the CEPHEUS Pan-Asian survey

2011 ◽  
Vol 19 (4) ◽  
pp. 781-794 ◽  
Author(s):  
Jeong Euy Park ◽  
Chern-En Chiang ◽  
Muhammad Munawar ◽  
Gia Khai Pham ◽  
Apichard Sukonthasarn ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Large Scale ◽  
Goal Attainment ◽  
Density Lipoprotein ◽  
Final Analysis ◽  
Relevant Information ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lipid Lowering Drugs

Background: Treatment of hypercholesterolaemia in Asia is rarely evaluated on a large scale, and data on treatment outcome are scarce. The Pan-Asian CEPHEUS study aimed to assess low-density lipoprotein cholesterol (LDL-C) goal attainment among patients on lipid-lowering therapy. Methods: This survey was conducted in eight Asian countries. Hypercholesterolaemic patients aged ≥18 years who had been on lipid-lowering treatment for ≥3 months (stable medication for ≥6 weeks) were recruited, and lipid concentrations were measured. Demographic and other clinically relevant information were collected, and the cardiovascular risk of each patient was determined. Definitions and criteria set by the updated 2004 National Cholesterol Education Program guidelines were applied. Results: In this survey, 501 physicians enrolled 8064 patients, of whom 7281 were included in the final analysis. The mean age was 61.0 years, 44.4% were female, and 85.1% were on statin monotherapy. LDL-C goal attainment was reported in 49.1% of patients overall, including 51.2% of primary and 48.7% of secondary prevention patients, and 36.6% of patients with familial hypercholesterolaemia. The LDL-C goal was attained in 75.4% of moderate risk, 55.4% of high risk, and only 34.9% of very high-risk patients. Goal attainment was directly related to age and inversely related to cardiovascular risk and baseline LDL-C. Conclusion: A large proportion of Asian hypercholesterolaemic patients on lipid-lowering drugs are not at recommended LDL-C levels and remain at risk for cardiovascular disease. Given the proven efficacy of lipid-lowering drugs in the reduction of LDL-C, there is room for further optimization of treatments to maximize benefits and improve outcomes.

scholarly journals Lipoprotein Particle Predictors of Arterial Stiffness after 17 Years of Follow Up: The Malmö Diet and Cancer Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Jacob Hartz ◽  
Ronald M. Krauss ◽  
Mikael Göttsater ◽  
Olle Melander ◽  
Peter Nilsson ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Arterial Stiffness ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Cancer Study ◽  
Lipoprotein Particle ◽  
Ldl Particles ◽  
Diet And Cancer

Background. Central arterial stiffness is a surrogate of cardiovascular risk and predicts cardiovascular mortality. Apolipoprotein B lipoproteins are also established cardiovascular risk factors. It is not known whether specific lipoprotein subclasses measured in the Malmö Diet and Cancer Study and previously shown to be associated with coronary heart disease also predict arterial stiffening after a mean period of 17 years. Methods. Lipoprotein particle analysis was performed on 2,505 men and women from Malmö, Sweden, from 1991 to 1994, and arterial stiffness was assessed by carotid-femoral pulse wave velocity (c-fPWV) on this same cohort from 2007 to 2012. Associations between c-fPWV and lipoprotein particles were determined with multiple linear regression, controlling for sex, presence of diabetes, waist-to-hip circumference, and smoking status at baseline, as well as heart rate (measured at the carotid artery), mean arterial pressure, antihypertensive and lipid-lowering medications, C-reactive protein (CRP), and age at the time of c-fPWV measurement. Results. The results confirm that triglycerides (TG) and high-density lipoprotein cholesterol (HDL-c) but not low-density lipoprotein cholesterol (LDL-c) predict c-fPWV. We identify a positive predictive association for very small, small, and medium (high risk), but not large LDL particles. There was a negative association for large HDL particles. The relationships between c-fPWV and high-risk LDL particles were unaffected by adjusting for LDL-c or CRP and were only mildly attenuated by adjusting for the homeostatic model for insulin resistance (HOMA-IR). Due to the collinearity of very small, small, and medium LDL particles and dyslipidemia (elevated TG and decreased HDL-c), the observed relationship between c-fPWV and high-risk LDL particles became insignificant after controlling for the concentration of HDL-c, large cholesterol-rich HDL particles, and TG. Conclusions. The development of central arterial stiffness previously associated with combined dyslipidemia may be mediated in part by LDL particles, particularly the very small-, small-, and medium-sized LDL particles.

Becoming more focused therapeutic lipid patterns: results from the Hungarian MULTI GAP 2010

2011 ◽  
Vol 152 (21) ◽  
pp. 822-827 ◽  
Author(s):  
István Reiber ◽  
György Paragh ◽  
László Márk ◽  
Gyula Pados
Keyword(s):  
High Risk ◽  
Goal Attainment ◽  
Treatment Strategies ◽  
Hdl Cholesterol ◽  
High Risk Group ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Frequent Use ◽  
Risk Patients

Previous studies have found that many high-risk patients are not achieving their LDL-cholesterol goals, and many patients, despite being treated with lipid-lowering therapy, also have elevated triglycerides and/or low levels of HDL-cholesterol. Aims: Authors analyzed the treatment strategies for dyslipidemic subjects following cardiovascular events similarly to their former survey from 2008 and 2009. Methods: In the MULTI GAP (MULTI Goal Attainment Problem) 2010 trial data from standard and structured questionnaires of 2332 patients were processed. Authors analyzed the proportion of the patients reaching target levels for total cholesterol, LDL-C, HDL-C, A-C (atherogen cholesterol) and triglyceride. Results: 15% (n = 355) of the patients did not receive any lipid lowering treatment. 44% of the patients treated by specialists reached the target LDL-C level of 2.5 mmol/l. In „high risk” group target levels for HDL-C were reached by 61% of the patients, and for triglyceride by 43% of the subjects. 43% of the patients with the best compliance (>90%) reached the target LDL-C level of 2.5 mmol/l. Conclusion: There is a need for more effective lipid lowering therapy with more frequent use of higher doses of statins or combinations of lipid lowering drugs. Orv. Hetil., 2011, 152, 822–827.

scholarly journals Lipid Goal Attainment and Prescription Behavior in Asian Patients with Acute Coronary Syndromes: Experience from a Tertiary Hospital

2013 ◽  
Vol 7 ◽  
pp. CMC.S11488 ◽  
Author(s):  
Calvin W Chin ◽  
F Gao ◽  
TT Le ◽  
RS Tan
Keyword(s):  
Goal Attainment ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Dose Titration ◽  
Lipid Lowering Therapy ◽  
Coronary Syndrome ◽  
Asian Patients ◽  
Statin Dose ◽  
Prescription Behavior

Lipid goal attainment studies in Asian patients with acute coronary syndrome (ACS) are limited. The objectives of this study were to determine low-density lipoprotein cholesterol (LDL-C) goal attainment rate at 4 months, and to examine prescription behavior influencing lipid goal attainment in Asian patients with ACS. A retrospective analysis of 267 patients with ACS was performed. The mean follow-up duration was 41.2 ± 10.7 months. LDL-C goal attainment rate was highest at 4 months (36.7%) but declined progressively throughout follow-up. More than 85% of patients were discharged with equipotent statin dose of 2 (equivalent to simvastatin 20 mg) or less. In patients who did not attain LDL-C goals, the statin dose remained low throughout follow-up because of a lack in responsive dose titration. Aggressive lipid-lowering therapy should be initiated early to improve goal attainment in these high-risk patients.

scholarly journals Blood Lipid Levels in Patients with Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hang Zhao ◽  
An Song ◽  
Yong Li ◽  
Licui Qi ◽  
Chong Zheng ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Relevant Information ◽  
Lipid Lowering ◽  
Cochrane Library ◽  
Lipid Levels ◽  
Lipid Lowering Drugs ◽  
Blood Lipid Levels

Abstract Background: Considering the controversial relationship between blood lipid levels and osteopenia and osteoporosis (OP), we performed this meta-analysis.Methods: Using specific keywords and related words, we searched PubMed, Embase, and Cochrane Library databases. The Newcastle-Ottawa Scale form was used to evaluate the quality of the literature. According to the inclusion and exclusion criteria, we systematically screened the literature to extract relevant information and data. Revman 5.3 and Stata 13.0 software were used for statistical analysis. Results were expressed as the mean difference and 95% confidence interval. The heterogeneity test was conducted according to I2 and Q tests. Egger’s test was used to quantitatively evaluate publication bias.Results: This analysis involved 12 studies and included 12,395 subjects. The quality of the literature was acceptable. Among subjects who were not taking lipid-lowering drugs, total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) in the osteopenia were not significantly increased/decreased. There were no significant differences in LDL-C in postmenopausal women in osteopenia. TG was unchanged in the OP group in subjects without taking lipid-lowering drugs. HDL-C was elevated in OP group but not in osteopenia group in all subjectsConclusions: HDL-C was elevated in patients with OP.

Importance of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in the treatment of dyslipidemia and atherosclerosis

2019 ◽  
pp. 40-52
Author(s):  
Maksim Maksimov ◽  
Anastasia Shikaleva ◽  
Aleksandra Kuchaeva
Keyword(s):  
Clinical Studies ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density ◽  
Pcsk9 Inhibitors ◽  
Lipid Lowering Drugs ◽  
Antibody Preparations

Representatives of different groups of lipid-lowering drugs may have some differences in the nature and severity of the effect on the blood lipid spectrum. A new class of drugs, PCSK9 inhibitors, whose activity is associated with a protein involved in the control of low density lipoprotein receptors, has recently appeared. In clinical practice, this group is represented by monoclonal antibody preparations evolocumab and alirocumab. PCSK9 inhibitors are promising drugs for use in combination lipid-lowering therapy, which so far, given the results of clinical studies, can be recommended in the third place after statins and ezetimibe. In clinical studies, it was shown that alirocoumab and evolocumab alone or in combination with statins and/or other lipid-lowering drugs significantly reduce cholesterol levels in low density lipoproteins – by an average of 60%, depending on the dose.

scholarly journals Statins in the primary prevention of cardiovascular disease. Rosuvastatin capabilities

2021 ◽  
Vol 12 (2) ◽  
pp. 110-118
Author(s):  
Marina G. Bubnova ◽  
Marianna Y. Ilchenko ◽  
Petr A. Lebedev
Keyword(s):  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Clinical Results ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Clinical Effects ◽  
Lowering Therapy ◽  
Novel Coronavirus

The article discusses the modern principles of lipid-lowering therapy and approaches to its administration in terms of levels of cardiovascular risk. The characteristics of groups of patients with different levels of cardiovascular risk (from low to high) in primary prevention are given. The article defines the target levels of low- density lipoprotein cholesterol, which should be achieved with the modern lipid-lowering therapy. The clinical effects of statins in primary prevention are presented. The clinical results of two large studies of rosuvastatin that have changed the approach to statin prescribing in primary prevention are discussed. The article presents the results of the analysis of long-term follow-up of patients in the primary prevention after the completion of randomized clinical studies. Approaches to the use of statins for novel coronavirus infection are considered.

scholarly journals Control of Low-Density Lipoprotein Cholesterol in Secondary Prevention of Coronary Artery Disease in Real-Life Practice: The DAUSSET Study in French Cardiologists

2021 ◽  
Vol 10 (24) ◽  
pp. 5938
Author(s):  
Jean Ferrières ◽  
François Roubille ◽  
Michel Farnier ◽  
Patrick Jourdain ◽  
Denis Angoulvant ◽  
...  
Keyword(s):  
High Risk ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Real Life ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Cholesterol Goal ◽  
Very High

Introduction: Patients with established coronary artery disease (CAD) are at very high risk for cardiovascular events. Methods: The DAUSSET study is a national, multicenter, non-interventional study that included very high-risk CAD patients followed by French cardiologists. It aimed to describe real-life clinical practices for low-density lipoprotein (LDL) cholesterol control in the secondary prevention of CAD. Results: A total of 912 patients (mean age, 65.4 years; men, 76.1%; myocardial infarction, 69.4%; first episode, 80.1%) were analyzed. The LDL cholesterol goal was 70 mg/dL in most cases (84.9%). The LDL cholesterol goal <70 mg/dL was achieved in 41.7% of patients. Of the 894 (98.0%) patients who received lipid-lowering therapy, 81.2% had been treated more intensively after the cardiac event, 27.0% had been treated less intensively and 13.1% had been maintained. Participating cardiologists were very satisfied or satisfied with treatment response in 72.6% of patients. Moderate satisfaction or dissatisfaction with lipid-lowering therapy was related to not achieving objectives (100%), treatment inefficacy (53.7%), treatment intolerance (23.4%) and poor adherence (12.3%). Conclusion: These real-world results show that lipid control in very high-risk patients remains insufficient. More than half of the patients did not achieve the LDL cholesterol goal. Prevention of cardiovascular events in these very high-risk patients could be further improved by better education and more intensive lipid-lowering therapy.

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