Tag Archives: statins

Introduction Statins are the gold-standard lipid-lowering therapy based on their efficacy in reducing serum low-density lipoprotein cholesterol (LDL-C) and general tolerability.1 While statins have an extensive body of evidence that have shown them to reduce the risk of cardiovascular (CV) events,2,3 there are concerns around side effects. An increase in cases of treatment-induced comorbidities, such as new-onset diabetes mellitus (NODM) has been observed.4-6 When combined with patient and media concerns, this has led to a reported 50% drop-out rate within 12 months.1 In response, other LDL-C lowering medications have been developed. Proprote

Introduction Cholesterol is a key risk factor for atheroma and coronary heart disease. The evidence-base for high-intensity lipid-lowering therapy in secondary prevention of cardiovascular disease is unequivocal.1-4 Despite the introduction of novel drugs, including ezetimibe5,6 and monoclonal antibodies,7 statins remain first-line therapy.8,9 Statins decrease hepatic cholesterol synthesis by competitively inhibiting 5-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase receptors, as they have an affinity up to 10,000 times greater than the natural substrate.10 Through reducing intra-cellular cholesterol concentration, statins up-regulate

Stat tests loaded into the VITROS XT 7600 Moderate alcohol consumption does not protect against stroke Blood pressure and stroke risk increase steadily with increasing alcohol intake, and previous claims that one to two alcoholic drinks a day might protect against stroke are not borne out by new evidence from a genetic study involving 160,000 adults. Studies of East Asian genes, where two common genetic variants strongly affect what people choose to drink, show that alcohol itself directly increases blood pressure and the chances of having a stroke, according to a new study published in The Lancet (doi: 10.1016/S0140-6736(18)31772-0). Researc

Non-inferior cardiovascular outcome for DPP-4 inhibitor Results from the CAROLINA cardiovascular outcome study show that the DPP-4 inhibitor linagliptin (Trajenta®, Boehringer Ingelheim and Eli Lilly) is non-inferior to the sulphonylurea glimepiride in the treatment of adults with type 2 diabetes and cardiovascular risk. The study met its primary end point – defined as the non-inferiority of linagliptin versus glimepiride in time to first occurrence of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke. The study, carried out over six years in 6,033 adults with type 2 diabetes and increased cardiovascular risk or est

The initiative was launched in February 2015 and in a relatively short period of time, the project achieved success in all three areas with measurable improvement in outcomes, including a reduction in hospitalisations. Over 24 months, there have been around 21,000 clinical interventions, with the emphasis being on delivering change at scale, whilst being fastidious about minimising any extra workload on primary care. In this period, 13,000 patients either started statins or had their statins changed, more than 1,000 patients with atrial fibrillation were anticoagulated, and more than 5,200 hypertensive patients reached a blood pressure targe

Presented in a hotline session by Dr Martin Landray (University of Oxford), the trial’s co-principal investigator, and simultaneously published in the New England Journal of Medicine (https://doi.org/10.1056/NEJMoa1706444), this large-scale, placebo-controlled study was carried out on 30,449 patients with cardiovascular disease, who were all receiving lipid-lowering treatment with atorvastatin. Those patients also receiving anacetrapib (100 mg once daily) showed a significant reduction in the primary outcome, the risk of major coronary events (coronary death, myocardial infarction or coronary re-vascularisation) by 9% relative to those pati

The Gospel of Matthew tells us, “…the last can be first…” Nowhere is this truer than the towering UK success of that fundamental cornerstone of cardiovascular prevention, cholesterol-lowering therapy. In 2002, BJC published a paper showing how far the UK lagged behind other countries in Europe when it came to prescribing lipid-lowering drugs.1 At the same time, a number of other very large UK surveys were published.2 All showed that the UK was the sick man of Europe, with limited statin prescribing in the face of a huge burden of cardiovascular disease. Figure 1. Coronary heart disease (CHD) mortality compared to statin sales: Aug

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Introduction Atherosclerotic cardiovascular disease (ASCVD), including peripheral arterial disease (PAD), coronary artery disease (CAD), acute coronary syndrome (ACS), and cerebrovascular disease (CeVAD), together account for approximately half of the morbidity and mortality in the adult population of Europe aged 50 years and older.1,2 The 2012 Coronary Heart Disease Statistics from the British Heart Foundation reported nearly 180,000 deaths in the UK from cardiovascular disease (CVD), 292 million prescriptions for CVD treatments, and over 87,000 percutaneous coronary interventions (PCIs) during a one-year span.3 In addition, diabetes mellitu

Introduction Coronary heart disease (CHD) is the leading cause of death worldwide. Chronic subclinical inflammation is a key recognised process in the pathogenesis of CHD, and may play an important role in atherogenesis. Figure 1. Atherosclerotic plaque rupture Atherosclerosis is a complex multi-factorial disease process, which is initiated at the endothelium in response to various forms of injurious stimuli (shear stress, oxidative stress, arterial pressure changes) including inflammation. These factors appear to alter the endothelial cell’s capacity to maintain homeostasis and vascular tone and leads to the so-called endothelial ‘dysfun