Tag Archives: Cholesterol

Introduction Lipoprotein(a) (Lp[a]) was discovered in 1963 as an antigen causing rare blood transfusion reactions.1 The antigen was found to be present in the lipoprotein fraction of plasma, hence the name lipoprotein(antigen). As methods for its measurement improved, researchers realised that Lp(a) had a continuous population frequency distribution, which in people of European descent, was markedly positively skewed.2,3 It was also reported that in those with higher concentrations, the prevalence of coronary heart disease was increased. Furthermore, higher levels were inherited; the concentration of Lp(a) was twice as much in men who had ex

Familial hypercholesterolaemia or not? The importance of considering polygenic hypercholesterolaemia in those with no monogenic cause for familial hypercholesterolaemia (FH), was outlined by Professor Steve Humphries (UCL Institute of Cardiovascular Science, London).1 By looking for the presence of specific high low-density lipoprotein cholesterol (LDL-C), single nucleotide polymorphisms (SNPs) and combining these to generate a SNP-score, those with the most variants can be identified. Professor Steve Humphries Individuals who are in the top five deciles of the SNP-score are highly likely to have a polygenic explanation for their high LDL-C

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

The first day of the conference focused on hyperlipidaemia in children. In the opening address Professor Albert Wiegman (University of Amsterdam, The Netherlands) presented compelling data on the importance of screening and identifying children with familial hypercholesterolaemia (FH) so they can be effectively treated and early cardiovascular events prevented. Professor Albert Wiegman (University of Amsterdam, The Netherlands) FH is one of the most common genetic disorders in the world. Both heterozygous, and to a greater extent homozygous FH, can be disabling at a young age and shorten life expectancy. Homozygous familial hypercholesterolae

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Dr Gilbert Wagener (Transcrip Partners LLP) Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new target for the treatment of hyperlipidaemia. PCSK9 is apparently complimentary to 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibition with statins.6,7 Most advanced in the development path are two monoclonal antibodies (mAbs) against PCSK9, alirocumab (SAR236533) and evolocumab (AMG145), both subcutaneous injectable drugs administered at bi-weekly or four-weekly intervals. Both compounds demonstrated solid reductions in LDL-C, however, dose selection for both focused on the most effective dose and did not consider titration ac

EVINCI study completed The prevalence of “significant” coronary artery disease in patients with chest pain symptoms is lower than expected in Europe, according to preliminary findings from the The EValuation of INtegrated Cardiac Imaging (EVINCI) study. Once the final analysis is completed, the EVINCI study is expected to demonstrate that performing adequate non-invasive imaging screening of patients with suspected coronary artery disease could safely avoid invasive procedures in 75 out of 100 patients.  The study will have sufficient power to answer the question of which is the most cost-effective non-invasive imaging strategy for the j

NHA joins with BHS The Nurses Hypertension Association (NHA) has become part of the British Hypertension Society (BHS) after the BHS decided to invite nurses working in the field of hypertension and cardiovascular disease to be full members of the society. “This acknowledges the shift of care towards specialist nurses, particularly in primary care,” said Naomi Stetson, former head of the NHA. “In the current economic climate, it also made good business sense to have one united organisation.” All members of the NHA are now full BHS members and so the NHA has disbanded. “There is a strong Nurses Working Party within the society, which

A preview of the EAS statement was announced during the EAS 2010 Congress held in June in Hamburg, Germany, by Dr Børge Nordestgaard (University of Copenhagen, Denmark). He said bringing a patient’s Lp(a) level under 50 mg/dL should be a treatment priority, after the management of LDL cholesterol. It is thought that about 20% of people have plasma Lp(a) levels over 50 mg/dL, with no gender differences, but there are some racial differences, with whites and Asians having lower levels while black and Hispanics generally have somewhat higher levels. Since lifestyle appears to have little impact on Lp(a) level, the EAS recommends that 1 to 3 g

ARBITER 6: niacin superior to ezetimibe for slowing atherosclerosis Use of extended-release niacin resulted in a significant benefit on atherosclerosis compared with ezetimibe in patients already taking statins in the ARBITER 6-HALTS trial. The trial, presented at the meeting by Dr Allen Taylor (Medstar Research Institute, Washington DC, US), compared two distinct lipid-modifying strategies in patients with known vascular disease already on statins who had LDL-cholesterol levels <100 mg/dL (2.56 mmol/L) and moderately low HDL-cholesterol levels (<50 mg/dL [1.28 mmol/L]). Among the 363 patients enrolled in the study, half were randomised