Residual cardiovascular risk in patients who received lipid-lowering treatment in a real-life setting: retrospective study

Increased cardiovascular risk has been associated with reduced response to proerectile drugs. The Italian Society of Andrology and Sexual Medicine (SIAMS) promoted an independent, multicenter study performed in 604 men (55 ± 12 yrs) suffering from erectile dysfunction (ED) to assess multiple health outcomes and response to 6-month vardenafil challenge in a real-life setting. Overall, 30.8% men had metabolic syndrome. Cardiovascular risk stratification revealed a greater number of ED subjects with moderate risk of a major adverse cardiovascular event than the general population (P<0.01). Age-adjusted pulse pressure was positively correlated with ED severity and negatively with androgens and waist circumference (P<0.01). A decline in total testosterone was observed with increasing arterial pulse pressure (P<0.05), which was not accompanied by compensatory LH rise. Follow-up on 185 men treated with vardenafil in an nonrandomized, open, single-arm trial documented a significant rise in IIEF-5 (delta = 6.1 ± 4.8) that was maintained in men with high cardiovascular risk. Mild adverse events occurred in <5%, with no differences between cardiovascular risk classes. In summary, ED is a frequent symptom in patients with an elevated, but often unknown, risk of future cardiovascular events. Androgens predict vascular resistance in ED patients. Vardenafil’s response and safety profile were preserved in subjects with higher cardiovascular risk.

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Individualized lipid-lowering therapy to further reduce residual cardiovascular risk

The Journal of Steroid Biochemistry and Molecular Biology ◽

10.1016/j.jsbmb.2016.05.016 ◽

2017 ◽

Vol 169 ◽

pp. 198-201 ◽

Cited By ~ 7

Author(s):

Oliver Weingärtner ◽

Dieter Lütjohann ◽

Torsten Plösch ◽

Albrecht Elsässer

Keyword(s):

Cardiovascular Risk ◽

Lipid Lowering ◽

Lipid Lowering Therapy ◽

Residual Cardiovascular Risk ◽

Lowering Therapy

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Activity of aflibercept (Afli) in combination with FOLFIRI (F) for patients with metastatic colorectal cancer (mCRC) in a real-life setting in Spain: Final results of the retrospective study Named Patient Program.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.689 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 689-689

Author(s):

Javier Sastre ◽

Jaime Feliu ◽

Purificación Martinez ◽

Cristina Buges ◽

Jose Carlos Mendez ◽

...

Keyword(s):

Retrospective Study ◽

Safety Profile ◽

Prognostic Model ◽

Objective Response ◽

Real Life ◽

Progression Free Survival ◽

Vascular Events ◽

The Real ◽

Real Life Setting ◽

Metastatic Sites

689 Background: InVELOUR trial the addition of aflibercept to FOLFIRI regimen, demonstrated a statistically significant overall survival improvement in mCRC patients (pts) who progressed on or after a prior oxaliplatin based regimen with or without biologic agents. Our goal is to assess in the real-life setting the activity and safety profile of Afli+F in mCRC. Methods: Retrospective data collection (baseline characteristics, progression free survival [PFS], objective response rate [ORR], salvage surgeries, and safety profile) of pts who received Afli+F as a 2nd line treatment on a compassionate use program in Spain. GERCOR prognostic model has been applied to evaluate PFS. These are the final results of the analysis (Cut-off date June 2015). Results: The retrospective study population comprised 71 pts (34 hospitals); 60.6% men and 39.4% women, median age 64 years (19.7% > 70) and 98.6% had ECOG scores = 0-1. 63.4% (n = 45) had ≥ 2 metastatic sites (liver [81.7%], lung [38.0%]) and 67.7% (46/68) patients were K-RAS mutated. 60.6% (n = 43) had received prior bevacizumab (BVZ) treatment, 16.9% (n = 12) had received prior cetuximab and 5.6% (n = 4) panitumumab. Patients received a median of 6 cycles (range: 1-30) of Afli+F. Median PFS with Afli+F was 5.3 months (CI 95%: 3.7-8.6); which was not significantly modified by the presence of K-RAS mutation (HR: 1.1663; 95%CI: 0.6676-2.0373; p = 0.5867), by prior BVZ treatment (HR: 1.2424; 95%CI: 0.7238-2.1327; p = 0.4283) or by anti-EGFRs treatment (HR: 0.5681; 95%CI: 0.3117-1.0356; p = 0.0604). ORR was 19.7% (CI 95%: 11.2-30.9) and 8.5% (n = 6) of salvage surgeries. The most frequent adverse events grade ≥ 3 related with treatment were asthenia (n = 8), neutropenia (n = 7) and diarrhea (n = 6). The characteristic anti-angiogenic events were hypertension (n = 8), proteinuria (n = 1), vascular events (n = 1), and one intestinal perforation resulting in death. GERCOR prognostic model: Median PFS = 8.30 months [1.28-18.71] low risk, 5.29 [4.08-9.93] intermediate risk and 2.56 [1.94-4.57] high risk. Conclusions: In spite of the differences in sample size, in the real-life setting, Afli+F achieve a PFS comparable to VELOUR, regardless of K-RAS status or prior BVZ and anti-EGFR’s treatment, with an appropriate safety profile. Funding: Sanofi.

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Long-Term Effectiveness of Liraglutide for Treatment of Type 2 Diabetes in a Real-Life Setting: A 24-Month, Multicenter, Non-interventional, Retrospective Study

Advances in Therapy ◽

10.1007/s12325-017-0652-2 ◽

2017 ◽

Vol 35 (2) ◽

pp. 243-253 ◽

Cited By ~ 10

Author(s):

Annunziata Lapolla ◽

◽

Cesare Berra ◽

Massimo Boemi ◽

Antonio Carlo Bossi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Retrospective Study ◽

Real Life ◽

Real Life Setting

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PCSK9 inhibitors: The breakthrough lipid-lowering treatment at real-life setting. A 2-year regional lipid clinic experience

Atherosclerosis ◽

10.1016/j.atherosclerosis.2020.10.812 ◽

2020 ◽

Vol 315 ◽

pp. e257-e258

Author(s):

G. Anastasiou ◽

G. Liamis ◽

H. Milionis ◽

M. Elisaf ◽

E. Christopoulou ◽

...

Keyword(s):

Real Life ◽

Lipid Lowering ◽

Pcsk9 Inhibitors ◽

Lipid Clinic ◽

Real Life Setting ◽

Clinic Experience

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Abstract P027: Individualized Protein Based Cardiovascular Risk Stratification: Impact On Patient And Physician Decision Making In Patients With Real World Cardiovascular Disease

Circulation ◽

10.1161/circ.143.suppl_1.p027 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Austin Erben ◽

Sandra Housholder ◽

Rosalynn Gill ◽

Stephen A Williams ◽

Nelson P Trujillo

Keyword(s):

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Ace Inhibition ◽

Risk Identification ◽

Lipid Lowering ◽

Class Iii ◽

Residual Cardiovascular Risk ◽

Goal Directed Therapy ◽

Physician Decision Making ◽

Physician Recommendations

There is a growing population of patients with established cardiovascular disease and residual cardiovascular risk. Identification of patients who would benefit most from more advanced risk reduction strategies would be ideal. Hypothesis: Identification of secondary risk of MACE may change both physician recommendations and patient choices regarding goal directed therapy (GDT). Methods: Retrospective review of 244 patients with established CAD with traditional assessment of secondary cardiovascular risk and SomaScan proteomic risk assessment followed over 3 years. Patients were evaluated for GDT and standard measurements were made at baseline. SomaScan protein risk score was obtained. Patients received advice regarding risk and offered GDT with established secondary prevention goals. Willingness to change, physician recommendations to change therapy and therapy changes were recorded. Patients were followed over three years. Results: 244 patients were included in the cohort; 186 males (76%), 58 females (24%). Mean age of 66, range 32-84. Diagnosis of coronary artery disease was made based on imaging in 121 patients (49%) and clinical events including CABG, MI, PCI in 123 patients (51%). Secondary cardiovascular risk of MACE by SomaScan was assessed in 5 predefined risk classes. There were 70 patients in class I (0-9.9%), 116 patients in Class II (10-19.9%), 41 patients in Class III (20-29.9%), 12 patients in Class IV (30-59%) and I patient in Class V (60-100%). GDT was already present in 143 patients including statin therapy, ACE inhibition and daily aspirin. In the cohort, 101 patients were sub-optimally treated. After reviewing results of SomaScan results, 20 patients initiated GDT, 52 patients intensified GDT. This included addition of second lipid lowering agent, initiation of PCSK-9 inhibitors, ACE-inhibition and intense lifestyle management. Overall, 30% of the overall cohort had a change in therapy: 39 patients were advised to alter therapy and did not, 17 patients would not begin goal directed therapy, 22 patients would not intensify management to meet accepted goals. Two deaths occurred during the study period. There were 14 episodes of MACE. Conclusions: In this population of patients with established cardiovascular disease only 58% were on guideline-based therapy. Use of SomaScan results in conjunction with standard assessment allowed an additional 30% of patients to change therapy with initiation of GDT and intensification of GDT to meet current guidelines.

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