scholarly journals Change in Carotid Intima-Media Thickness in a High-Risk Group of Patients by Intensive Lipid-Lowering Therapy With Rosuvastatin

2014 ◽  
Vol 55 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Hiroyoshi Yokoi ◽  
Ryuji Nohara ◽  
Hiroyuki Daida ◽  
Mitsumasa Hata ◽  
Kohei Kaku ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
High Risk Group ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Media Thickness ◽  
Lowering Therapy

scholarly journals Cardiovascular risk and response to lipid lowering therapy in patients with HIV infection according to different recommendations

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244675
Author(s):  
Agnieszka Pawlos ◽  
Marlena Broncel ◽  
Ewelina Wlazłowska ◽  
Elżbieta Jabłonowska ◽  
Paulina Gorzelak-Pabiś
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
High Cardiovascular Risk ◽  
Hiv Patients ◽  
Lowering Therapy ◽  
Very High

Background HIV patients are at increased cardiovascular risk while available European cardiovascular recommendations are ambiguous. Methods Retrospective analysis of 389 HIV-patients was conducted. Cardiovascular risk was determined by D:A:D, Framingham and SCORE scales. Patients were divided into risk groups as recommended by EACS 2019, PTN AIDS 2019 and ESC/EAS 2019 Guidelines and hypolipemic treatment was evaluated. Results In total, 389 HIV-positive patients took part in the study, most of whom were men (n = 312, 80.4%), mean age 41.69±10years. Mean lipid levels among all HIV patients: Tch:177.2±36mg/dl, HDL:48.9±18mg/dl, LDL:103.8±31mg/dl, TG:143.3±81mg/dl, AIP:0.45±0.3, non-HDL:129.2±36 mg/dl. Most of the participants (n = 360, 92.5%) were assigned to the high cardiovascular risk group according to ESC/EAS and PTN AIDS guidelines. The achievement of therapeutic LDLs according to ESC/EAS was 10.3% for those at very high cardiovascular risk (8.7% on lipid lowering treatment vs. 16.7% without hypolipemic drugs) and 12.0% (5.8% treated vs. 13.6% untreated) at high cardiovascular risk; according to PTN AIDS,17.2% achievement was noted by the very high-risk group (13% treated vs. 33.3% untreated), and 45.9% for the high-risk group (37.7% treated vs. 48.0% untreated); according to EACS Guidelines, 2.5% achievement in secondary prevention (3.8% treatedvs. 0% untreated) and 24.7% in primary prevention (22.2% treated vs. 26.1% untreated). Mean doses of statins were 8.75mg±6mg (Rosuvastatin) and 22.35±19mg (Atorvastatin). Conclusions The achievement of therapeutic LDLs by all recommendations is unsatisfactory, and generally worse in patients on lipid lowering therapy. Hypolipemic treatment of our HIV patients is based on low doses of statins, even in secondary prevention.

scholarly journals Effect of Long-Term Intensive Lipid-Lowering Therapy With Rosuvastatin on Progression of Carotid Intima-Media Thickness

2013 ◽  
Vol 77 (6) ◽  
pp. 1526-1533 ◽  
Author(s):  
Ryuji Nohara ◽  
Hiroyuki Daida ◽  
Mitsumasa Hata ◽  
Kohei Kaku ◽  
Ryuzo Kawamori ◽  
...  
Keyword(s):  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Media Thickness ◽  
Lowering Therapy

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.

P938Extensive formation of atherosclerotic cardiovascular disease in subjects with severe familial hypercholesterolemia defined by the international atherosclerosis society criteria

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Funabashi ◽  
Y Kataoka ◽  
M Harada-Shiba ◽  
M Hori ◽  
T Doi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Familial Hypercholesterolemia ◽  
Peripheral Artery Disease ◽  
Cardiac Death ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Peripheral Artery ◽  
Lowering Therapy ◽  
Artery Disease

Abstract Introduction The International Atherosclerosis Society (IAS) has proposed “severe familial hypercholesterolemia (FH)” as a FH phenotype with the highest cardiovascular risk. Coronary artery disease (CAD) represents a major atherosclerotic change in FH patients. Given their higher LDL-C level and atherogenic clinical features, more extensive formation of atherosclerosis cardiovascular disease including not only CAD but stroke/peripheral artery disease (PAD) may more frequently occur in severe FH. Methods 481 clinically-diagnosed heterozygous FH subjects were analyzed. Severe FH was defined as untreated LDL-C>10.3 mmol/l, LDL-C>8.0 mmol/l+ 1 high-risk feature, LDL-C>4.9 mmol/l + 2 high-risk features or presence of clinical ASCVD according to IAS proposed statement. Cardiac (cardiac death and ACS) and non-cardiac (stroke and peripheral artery disease) events were compared in severe and non-severe FH subjects. Results Severe FH was identified in 50.1% of study subjects. They exhibit increased levels of LDL-C and Lipoprotein (a) with a higher frequency of LDLR mutation. Furthermore, a proportion of %LDL-C reduction>50% was greater in severe FH under more lipid-lowering therapy (Table). However, during the observational period (median=6.3 years), severe FH was associated with a 5.9-fold (95% CI, 2.05–25.2; p=0.004) and 5.8-fold (95% CI, 2.02–24.7; p=0.004) greater likelihood of experiencing cardiac-death/ACS and stroke/PAD, respectively (picture). Multivariate analysis demonstrated severe FH as an independent predictor of both cardiac-death/ACS (hazard ratio=3.39, 95% CI=1.12–14.7, p=0.02) and stroke/PAD (hazard ratio=3.38, 95% CI=1.16–14.3, p=0.02) events. Clinical characteristics of severe FH Non-severe FH Severe FH P-value Baseline LDL-C (mmol/l) 5.3±1.5 6.6±2.0 <0.0001 Lp(a) (mg/dl) 15 [8–28] 21 [10–49] <0.0001 LDLR mutation (%) 49.6% 58.9% 0.00398 On-treatment LDL-C (mmol) 133 [106–165] 135 [103–169] 0.9856 %LDL-C reduction>50% 21.3% 49.8% <0.0001 High-intensity statin (%) 13.3% 42.3% <0.0001 PCSK9 inhibitor (%) 6.3% 21.2% <0.0001 Clinical outcome Conclusions Severe FH subjects exhibit substantial atherosclerotic risks for coronary, carotid and peripheral arteries despite lipid lowering therapy. Our finding underscore the screening of systemic arteries and the adoption of further stringent lipid management in severe FH patients.

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