scholarly journals Tactics features for managing out-patients with cardiovascular comorbidity in Krasnoyarsk city

2020 ◽  
pp. 63-69
Author(s):  
M.A. Khramchenko ◽  
◽  
A.D. Karpenkova ◽  
M.M. Petrova ◽  
D.S. Kaskaeva ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Clinical Guidelines ◽  
Total Cholesterol Level ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Primary And Secondary Prevention ◽  
Cardiovascular Comorbidity ◽  
Cardiovascular Continuum

The aim of the research is to study the structure of cardiovascular continuum within comorbid pathology within outpatient clinic of Krasnoyarsk; to evaluate the quality of out-patients management in accordance with modern clinical guidelines. Material and methods. To conduct a single retrospective analysis, 1928 medical records of Krasnoyarsk cardiovascular out-patients were taken. All the patients consulted local therapists in 2018. Differences were statistically significant at p <0.05. Results. Comorbid pathology is observed in patients with CVD in 87% of cases, and its growth is noted with age. It was revealed that ischemic heart disease (CHD) and obesity are associated with type 2 diabetes mellitus (DM-2). When using antihypertensive therapy, 43.2% of patients achieved blood pressure (BP) values <140/80 mm Hg. In 46.8% of cases, patients who were prescribed statins had total cholesterol (TC) values <5.0 mmol / L. Only 18.5% of patients with DM-2, following lipid-lowering therapy had a total cholesterol level <4.5 mmol / L, that was also registered only in 15.9% of patients with chronic kidney disease (CKD). Heart rate (HR) <80 beats / min was observed in 75% of patients taking drugs of b-blocker group. Conclusion. Cardiovascular comorbidity among patients is widespread and its rates are evidenced to increase with age. Antihypertensive, lipid-lowering and antithrombotic therapy do not fully comply with current clinical guidelines. It is necessary to individualize the approach to patients with combined pathology; to provide comprehensive diagnosis, treatment, and to inform the population on primary and secondary prevention adequately

scholarly journals SAT-566 Avoiding the Heartache: A Case of Familial Hypercholesterolemia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mustafa Kinaan ◽  
Arelys Ramos Rivera ◽  
Hanford Yau
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Total Cholesterol ◽  
Cardiovascular Events ◽  
Total Cholesterol Level ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
History Of

Abstract More than 70% of individuals with atherosclerotic cardiovascular disease are believed to have underlying gene-linked mechanisms leading to hyperlipidemia. It is estimated that 1 in 200 individuals in the United States has heterozygous Familial Hypercholesterolemia (FH). We present a case that highlights the importance of comprehensive care for a patient with heterozygous FH, from screening and risk stratification, to therapy. Our patient is a 43-year-old gentleman with history of hyperlipidemia. At age 25, he was diagnosed with hyperlipidemia and was started on statin therapy. He has strong family history of cardiovascular disease. His mother had her first myocardial infarction (MI) at age 40 and required coronary artery bypass. She also suffered from three strokes. His maternal aunt and uncle suffered from MIs at age 38 and 40, respectively. Additionally, his maternal grandfather passed away from MI at age 38. The patient’s daughter was found to have total cholesterol level &gt; 300 mg/dL at age 8. He does not have history of obesity, diabetes, previous cardiovascular events, or hypothyroidism. He is athletic and follows a healthy diet. He did not have any xanthomas, xanthelasmas, nor arcus cornealis. At time of initial evaluation, the patient had low-density lipid (LDL) level of 180 mg/dL despite therapy with rosuvastatin, ezetimibe, and niacin. Based on these findings, we proceeded with genetic testing. Results of testing showed a heterozygous c.6delG (p.Trp4Glyfs*202) pathogenic mutation of the LDL receptor. We also obtained cardiovascular risk stratification studies. On cardiac CT angiogram, he was found to have extensive, four-vessel disease with 80-90% stenosis of the left ascending artery (LAD) with coronary calcium score of 136 and total score of 219 (99th percentile). Exercise, stress myocardial perfusion scan showed small reversible anteroseptal perfusion abnormality suggestive of mild to moderate ischemia. LAD stenosis was confirmed on a left heart catheter, but no intervention was required. We proceeded with aggressive lipid-lowering therapy with rosuvastatin 40mg daily and alirocumab 300mg monthly. He was also started on aspirin and beta-blocker given coronary artery disease. Following initiation of therapy, the patient’s LDL level dropped to 51 mg/dL with total cholesterol level of 153 mg/dL, HDL of 47mg/dL, and triglycerides of 109 mg/dL. The patient was encouraged to seek genetic counseling for his children and first degree relatives. His daughter was started on rosuvastatin 7.5mg daily by her pediatrician. The patient has not suffered any cardiovascular events and continues to follow up for therapy. Without aggressive lipid-lowering therapy, the lifespan of FH patients can be significantly shortened. Therefore, identifying FH patients is imperative to prevent cardiovascular disease in these patients and their afflicted family members.

scholarly journals Combined Lipid-Lowering Therapy in Elderly and Senile Patients

Kardiologiia ◽  
2020 ◽  
Vol 60 (7) ◽  
pp. 103-107
Author(s):  
I. I. Shaposhnik ◽  
V. V. Genkel ◽  
A. O. Salashenko
Keyword(s):  
Cardiovascular Diseases ◽  
Secondary Prevention ◽  
Statin Therapy ◽  
Clinical Guidelines ◽  
Clinical Studies ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Primary And Secondary Prevention ◽  
Lowering Therapy

The article discusses issues of lipid-lowering therapy in elderly and senile patients. Major statements of actual clinical guidelines are provided. Issues of statin therapy in patients older than 65 and new data on statin safety in such patients are discussed in detail. The authors presented results of clinical studies 2019 on the use of ezetimibe in patients older than 75 as a part of primary and secondary prevention of cardiovascular diseases.

scholarly journals Impact of COVID-19 restrictions on diabetes health checks and prescribing for people with type 2 diabetes: a UK-wide cohort study involving 618,161 people in primary care

2021 ◽  
Author(s):  
Matthew J. Carr ◽  
Alison K. Wright ◽  
Lalantha Leelarathna ◽  
Hood Thabit ◽  
Nicola Milne ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Home Monitoring ◽  
Healthcare Services ◽  
Lipid Lowering ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Lipid Lowering Therapy ◽  
Historical Trends ◽  
Health Checks

AbstractOBJECTIVETo compare rates of performing NICE-recommended health checks and prescribing in people with type 2 diabetes (T2D), before and after the first COVID-19 peak in March 2020, and to assess whether trends varied by age, sex and deprivation.METHODSWe constructed a cohort of 618,161 people with T2D followed between March and December 2020 from 1744 UK general practices registered with the Clinical Practice Research Datalink (CPRD; Aurum and GOLD databases). We focused on the following six health checks and prescribing: HbA1c, serum creatinine, cholesterol, urinary albumin excretion, blood pressure and BMI assessment, comparing trends using regression models and 10-year historical data.RESULTSIn April 2020, in English practices, rates of performing health checks were reduced by 76-88% when compared to 10-year historical trends, with older people from deprived areas experiencing the greatest reductions. Between May and December 2020, the reduced rates recovered gradually but overall remained 28% and 47% lower compared to historical trends, with similar findings in other UK nations. In England, rates of prescribing of new medication fell during April with reductions varying from 10% (4-16%) for antiplatelet agents to 60% (58-62%) for antidiabetic medications. Overall, between March and December 2020, the overall rate of prescribing new diabetes medications was reduced by 19% (15-22%) and new antihypertensive medication by 22% (18-26%). Similar trends were observed in other UK nations, except for a reduction in new lipid-lowering therapy prescribing March to December 2020 (reduction: 16% (10-21%)).CONCLUSIONSOver the coming months, healthcare services will need to manage this backlog of testing and prescribing. Effective communications should ensure that patients remain engaged with diabetes services, monitoring and opportunities for prescribing, and make use of home monitoring and remote consultations.

Quality of lipid-lowering therapy in outpatient practice: RECVAS Register data

2016 ◽  
Vol 19 (1) ◽  
pp. 9 ◽  
Author(s):  
A. V. Zagrebelnyi ◽  
S. Yu. Martsevich ◽  
M. M. Lukyanov ◽  
A. N. Vorobyev ◽  
K. A. Moseichuk ◽  
...  
Keyword(s):  
Register Data ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Outpatient Practice
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