Shilpa Atwal ◽  
Jitender Thakur

Background: To describe the outcome of statin therapy in patients by checking lipid profile after 3 months of starting treatment in statin naive patients Methods: Study was conducted on Patients with indications for statins presenting to cardiology OPD, Medicine OPD and Endocrinology OPD and started on statins at PGIMER, Chandigarh, within a period of 9 months. Results: The mean decrease in total cholesterol, triglycerides, VLDL and LDL levels in primary prevention group mean decrease in after 3 months of statin treatment in comparison to baseline were 17.24%,21.24%, 22.83 % and 33.19% respectively and increase in mean HDL level was 9.55%. The mean decrease in total cholesterol, triglyceride, VLDL and LDL levels in secondary prevention group after 3 months of statin treatment in comparison to baseline were 14.35% 15.80%, 16.17% and 36.92% respectively and increase in mean HDL level was 8.77%. Concluded: So there was statistically significant change in lipid profile from baseline in both primary and secondary prevention groups after 3 months of statin treatment. Keywords: Statin, LDL,VLDL, HDL

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Abdeslam Bouzeman ◽  
Maxime De Guillebon ◽  
Guillaume Duthoit ◽  
Magalie Ladouceur ◽  
Raphael Martins ◽  

Background: Tetralogy of Fallot (TOF) is the most frequent form of congenital heart disease managed by EP physicians for potential ICD. However, few studies have reported long-term outcomes of TOF patients with ICD. Methods: Between 2005 and 2014, all TOF patients with ICD in 17 French centers were enrolled in a specific evaluation aiming to determine characteristics at implantation as well as outcomes (overall mortality, appropriate ICD therapies, and device-related complications). Results: Overall 78 patients (45±13 years, 64% males) were enrolled. A majority of patients were implanted in the setting of secondary prevention (73%), whereas the remaining (27%) in primary prevention. Among the latest group, known risk factors for sudden cardiac death were: severe pulmonary regurgitation (30%,) prior palliative shunt (50%), syncope with unknown origin (25%), inducible ventricular tachycardia (45%), QRS duration ≥180ms (18%), non-sustained ventricular tachycardia (25%), and documented sustained supra ventricular tachycardia (45%).Overall, patients implanted in the setting of primary prevention presented with a mean of 3.1±1.4 risk factors. After a mean follow-up of 4.9±3.8 years, 35 patients (45%) experienced at least one appropriate therapy (25% in the primary prevention group compared to 53% in the secondary prevention group), giving annual-incidences of 6.9% (95%CI 0.14-13.7) and 21.3% (12.4-30.3) respectively (P=0,01). The mean time between ICD implantation and the first appropriate therapy was 2.2±3.2 years, without significant differences between primary and secondary prevention. Overall, ≥one ICD-related complication occurred in 30 patients (38%), including inappropriate shock (n=9), major pocket hematoma (n=1), lead dysfunction (n=12), infection (n=4), shoulder algodystrophia (n=2), device failure or dislodgement needing reintervention (n=2). Eventually, four patients were transplanted (5%), and six patients (8%) died during the course of follow-up. Conclusions: Considering relatively long-term follow-up, patients with TOF and ICDs experience high rates of appropriate ICD therapies, in both primary and secondary prevention. Major ICD-related complications remain, however, high.

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii5-ii7
M Hale ◽  
H Zaman ◽  
D Mehdizadeh ◽  
O Todd ◽  
H Callaghan ◽  

Abstract Background Statins reduce the risk of major adverse cardiovascular events (MACE), however, their clinical benefit for primary and secondary prevention among older adults with frailty is uncertain. This review investigates whether statins prescribed for primary and secondary prevention are associated with reduced MACE among adults aged ≥65 years with frailty. Methods Systematic review of studies published between 01.01.1952 and 01.01.2019 in MEDLINE, Embase, Scopus, Web of Science, Cochrane Library and the International Pharmaceutical Abstracts. Studies that investigated the effect of statins on MACE among adults ≥65 years with a validated frailty assessment were included. Data were extracted from the papers as per a pre-published protocol, PROSPERO: CRD42019127486. Risk of bias was assessed using the Cochrane Risk of Bias in non-randomised studies of interventions. Finding 18794 abstracts were identified for screening. From these, six cohort studies fulfilled the inclusion criteria. There were no randomised clinical trials. Of studies involving statins for primary and secondary prevention (n = 6), one found statins were associated with reduced mortality (hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.37–0.93) and another found they were not (p = 0.73). One study of statins used for secondary prevention found they were associated with reduced mortality (HR 0.28, 95%CI 0.21–0.39). No studies investigated the effect of statins for primary prevention or the effect of statins on the frequency of MACE. Discussion This review summarizes the existing available evidence for decision making for statin prescribing for older adults with frailty. This study identified only observational evidence that, among older people with frailty, statins are associated with reduced mortality when prescribed for secondary prevention, and an absence of evidence evaluating statin therapy for primary prevention. The findings of this study highlight that randomised trial data are urgently needed to better inform the use of statins among older adults living with frailty.

Mary Ann Cohen ◽  
Harold W. Goforth

Since HIV disease was first recognized three decades ago, numerous efforts have been made to prevent its continued transmission. The Centers for Disease Control and Prevention (CDC) estimates that more than 56,000 Americans become infected each year—one person every 9 1/2 minutes—and that more than one million people in this country are now living with HIV (CDC, 2008, 2009;Hall et al., 2008). The CDC estimates that roughly 1 in 5 people infected with HIV in the United States is unaware of his or her infection and may be unknowingly transmitting the virus to others (CDC, 2008). Over the past 15 years, many behavioral HIV risk reduction interventions have been developed, with prevention efforts targeting mostly HIV-negative individuals and focusing almost exclusively on HIV testing and counseling. More recently, comprehensive HIV prevention has involved both primary and secondary prevention activities to decrease the number of new HIV infections and associated complications, respectively (Marks et al., 2006; O’Leary and Wolitski, 2009). Psychiatric factors both complicate and perpetuate the HIV pandemic as a result of unsafe sexual practices and substance use disorders. In this chapter, we describe some of the psychiatric and psychodynamic factors that lead to HIV transmission and present novel strategies to assist clinicians and health-care policymakers in prevention efforts. Primary prevention is defined as any activity that reduces the burden of morbidity or mortality from disease; it is to be distinguished from secondary prevention, in which activities are designed to prevent the complications of already existing disease. In the case of HIV, primary prevention efforts focus on strategies designed to prevent the transmission of HIV—keeping seronegative people seronegative. In the HIV pandemic, however, many prevention strategies share characteristics of both primary and secondary efforts, so the distinction is somewhat artificial. Multiple prevention strategies have been devised, and these center around HIV counseling, substance abuse programs, and HIV prevention and intervention programs for children. Counseling healthy pregnant women, uninfected children, adolescents, adults, and older persons about HIV risk reduction and providing information about sexual health are important components to primary prevention strategies, but few physicians and other clinicians actually do this unless it is a part of a program specifically designed to prevent HIV transmission.

2020 ◽  
Vol 315 ◽  
pp. e179-e180
S. Stoica ◽  
A. Dumitrescu ◽  
C. Hudrea ◽  
L. Gaita ◽  
D. Gaita

2018 ◽  
Vol 89 (10) ◽  
pp. A12.3-A12
Kempe Isla ◽  
Grosset Katherine A ◽  
Grosset Donald G

BackgroundVascular prevention is appropriate for patients with a vascular history (secondary prevention) and increased risk (primary prevention). Cerebrovascular disease adds to gait and cognitive problems in patients with Parkinson’s disease (PD).MethodsA convenience cross-sectional sample of consecutive PD patients attending the Neurology Movement Disorder clinic was assessed, and QRISK3 scored when appropriate (cases without vascular events, age <85 years).ResultsOf 100 cases, mean age 66.5 (SD 9.0) years, 52.0% male, with PD duration 8.3 (SD 5.5) years, 15 had a vascular history meriting statin therapy, of whom 12 (80.0%) were prescribed statins. 22 had a high vascular risk (QRISK3 >20%), mean QRISK3 28.6 (SD 7.7) of whom 2 (9.1%) were prescribed statins. We are now actively assessing QRISK3 and recommending statin therapy where appropriate.ConclusionsSecondary vascular prevention with statins is more commonly implemented than primary prevention, in patients with PD. In patients without a vascular diagnosis, vascular risk should be assessed and statin therapy offered where appropriate, noting that around one-fifth of patients have a high vascular risk and are not on statin treatment.

2014 ◽  
Vol 3 (1) ◽  
pp. 7-12 ◽  
Indrawati Wurdianing ◽  
SA Nugraheni ◽  
Zen Rahfiludin

Background: Lipid profile effects is a risk factor for Coronary Heart Disease. Soursop leaves (Annona muricata L) isa traditional medicine plant containing metabolic compounds that contribute to the improvement of the lipid profile.Objective: To determine the effects of soursop leaves extract on lipid profile (total cholesterol, LDL cholesterol, HDLcholesterol and triglyceride).Methods: An experimental study using randomized pre-posttest with control group design. Sample consisted of 28 maleWistar rats, were divided into four groups. The control group (K) was only given High Fat High Cholesterol (HFHC)diet and treatment groups (P1, P2, P3) were given a HFHC diet plus Annona muricata L extract with doses of 100, 200and 300 mg/kgBB per day for 28 days respectively. Data were analyzed by Wilcoxon test, Kruskal-Wallis and MannWhitney.Results: The mean total cholesterol level significantly decreased in the treatment group P1 (p = 0.028) from 60.7 mg/dl(47.6-75.3) to 45.5 mg/dl (38.4-62.4). Mean HDL cholesterol level significantly increased in the treatment group P2(p=0.043) from 26.0 mg/dl (19.7-35.3) to 27.9 mg/dl (18.8-38.0). The mean levels of LDL cholesterol and triglyceridedecreased but not significantly.Conclusion: The administration of Annona muricata L extract can decrease total cholesterol and increase HDLcholesterol significantly.

2020 ◽  
Vol 74 (4) ◽  
pp. 147-154
V. Buheruk ◽  
O. Voloshyna ◽  
O. Dukova ◽  
I. Lysij ◽  
E. Naydionova ◽  

Aim. Current review summarized and analysed existing evidence of diabetogenic effect of statins and potential ways to overcome this problem in non-diabetic and diabetic patients. Materials and methods. Systematic literature review included results of experimental and clinical studies, multi-center placebo-controlled trials (JUPITER, ТNТ, IDEAL, SPARCL, METSIM, WOSCOPS, ALLHAT-LLT, PROSPER, etc.), systematic reviews and meta-analyses, current guidelines on statin prescription in high-risk patients and non-diabetic patients.Results of the reviewed clinical trials assessing the effects of long-term statin administration, data from randomized clinical trials and genetic studies provide convincing evidence of small, yet significant increase in absolute risk of new-onset diabetes (1 case of diabetes per 1000 patients per 1 year of treatment), concurrently preventing 5 new cases of cardiovascular disease. Diabetogenic properties are identified as probable class-effect of statins, with risk increased in high-intensity statin therapy. Diabetogenic effects are mediated through reduction in pancreatic β-cell function and impaired insulin resistance. Based on current international guidelines (ESC 2019, ADA 2020), the article highlights that despite modest diabetogenic potential, statins are recommended for primary and secondary prevention in patients with high risk of cardiovascular complications, including patients with diabetes. Conclusions. Statin therapy, especially high-intensity dosing can promote new cases of diabetes, particularly in patients with pre-existing metabolic syndrome and insulin resistance. Despite moderate diabetogenic effect statins are routinely recommended (ESC 2019, ADA 2020) for primary and secondary prevention in patients at high risk of cardiovascular complications, including diabetic patients. Statin therapy should be tailored to patient’s age, sex, concomitant diseases, parameters of lipid and glucose metabolism and presence of additional diabetogenic risk factors. Patients require lifestyle modification to reduce the risk of diabetes.

2018 ◽  
Vol 18 (1) ◽  
pp. 7-13 ◽  
Fariha Naeem ◽  
Gerard McKay ◽  
Miles Fisher

Treatment with statins is one of the most effective ways of reducing cardiovascular events in those with diabetes. Many studies containing thousands of subjects with diabetes have demonstrated that statins reduce cardiovascular events when there is no known cardiovascular disease (primary prevention) and in those with confirmed atherosclerotic disease (secondary prevention). High-dose statins appear to be even more effective in established cardiovascular disease, but at the expense of increased drug side effects. In this paper we review the evidence for the benefits of statins in diabetes. In a second review we will examine the evidence for possible benefits of other lipid-lowering therapies when these are added to background statin therapy in diabetes.

Jurnal BIOMA ◽  
2015 ◽  
Vol 11 (2) ◽  
pp. 131
Pratiwi Widyamurti ◽  
Rusdi Rusdi ◽  
Sri Rahayu

ABSTRACT Increased blood pressure more than 140/90 mmHg taken from three measurement in 24 hours can be diagnosed as hypertension. Abnormality of lipid values condition was found at many hypertensive. Based on this reason examination of lipid profile in hypertensive and normotensive should be done. The aim of this research was to measure and compare lipid profile on blood serum in hypertensive    and normotensive. Lipid profile was measured by Konelab 20XT clinical chemistry analyzer. Ex     Post Facto used as method and Cross-sectional used as design. A total of 50 blood samples collected from Hypertensive (N1=25) and normotensive (N2=25) from June to August 2014. SPSS 16.0 was used to analyze the data, T-test was used to compare value of LDL cholesterol, HDL cholesterol and total cholesterol while U Mann-Whitney test was used to compare value of triglyceride. The result      of this research showed that the mean value of triglyceride was 146.56 mg/dL in hypertensive and 143.92 mg/dL in normotensive (p=0.11). The mean value of LDL cholesterol was 129.80 mg/dL in hypertensive and 136.72 mg/dL in normotensive (p=0.62). The mean value of HDL cholesterol was  38.80 mg/dL in hypertensive and 45.04 mg/dL in normotensive (p=0.1). The mean value of total cholesterol was 201.04 mg/dL in hypertensive and 221.88 mg/dL in normotensive (p=0.25). In conclusion, there was no different of lipid profile on blood serum in hypertensive and normotensive.  Keywords: hypertension, lipid profile, normotensive

2006 ◽  
Vol 59 (1-2) ◽  
pp. 57-62
Bosa Mirjanic-Azaric ◽  
Mirjana Djeric ◽  
Maja Vrhovac ◽  
Dusanka Sukalo

Introduction. The aim of this study was to estimate if negative lifestyle habits such as alcohol consumption, smoking and physical inactivity affect the lipid profile values. Material and methods. The study included 250 workers on regular examination in the Gradiska Health Center in the period from 2001 to 2002. There were 113 (45.2%) men and 137 (54.8%) women. The examinees were divided into three groups according age (25-39, 40-49 and 50-60 respectively). Standard laboratory methods were used to establish the following: total cholesterol, triglyceride and HDL-cholesterol level, LDL cholesterol, atherosclerosis index (AI) and total cholesterol/HDL cholesterol. Results Using a questionnaire, we have found out that out of 250 examinees 48.80% consume alcohol regularly, 50.80% are smokers and 36% are physically. The mean total cholesterol was high in all groups and it was 6.41 mmol/l. The mean triglyceride level was 1.88 mmol/l and mean HDL cholesterol was 1.48 mmol/l, I A was 2.99 and total cholesterol/HDL cholesterol ratio was 4.69. Statistical analysis showed that there was a statistically significant relationship between triglyceride values and alcohol consumption, smoking and physical activity (p<0.05). Also, we showed that there was a statistically high relationship between HDL cholesterol values, AJ, total cholesterol/HDL cholesterol and smoking in the examined groups (p<0.01). Discussion In our study the lipid profile parameters were above the desired levels, probably due to unhealthy lifestyle, including smoking, alcohol consumption and insufficient physical activity. Our results are in concordance with the results of similar studies. Conclusion It is of utmost importance to take steps to improve lifestyle habits of our population.

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