Tag Archives: dyslipidaemia

What’s new in transplantation Are kidney donors worse off? The meeting was opened by Dr Anna Price (Queen Elizabeth University Hospital, Birmingham) who addressed the long-term cardiovascular effects of unilateral nephrectomy in living kidney donors.1 Previous studies have shown a significant prevalence of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD),2,3 but the effects of reduced renal function in living kidney donors has been unexplored until now. A recent study by Price et al. demonstrated that living kidney donors had a reduction in estimated glomerular filtration rate (eGFR) from 95 to 67 ml/min

Introduction Multiple risk factors have been identified for myocardial infarction (MI). Hypercholesterolaemia is one of the major risk factors for cardiovascular diseases, and has an important pathophysiological role in the development of acute ST-elevation myocardial infarction (STEMI).1 Endothelial dysfunction, inflammation, increased thrombogenicity, and plaque vulnerability are the main underlying mechanisms explaining the complex interaction between hypercholesterolaemia and STEMI.2–4 Low-density lipoprotein-cholesterol (LDL-C) has been shown to be a major risk factor in patients with MI, and aggressive LDL-C lowering remains a main ta

Introduction Control of hypercholesterolaemia has been established as a highly effective first-line management in acute coronary syndrome (ACS) patients.1,2 Data from a meta-analysis of randomised-controlled trials demonstrated that for each 1 mmol/L reduction in low-density lipoprotein (LDL)-cholesterol (LDL-C), statins reduced major cardiovascular (CV) events (myocardial infarction [MI], CV death, any stroke or coronary revascularisation) by an estimated 22%.3 National Institute for Health and Care Excellence (NICE) and international guidelines recommend fasting lipid profiles before, and within three months following, the initiation of hi

Introduction Heart failure (HF) is a complex disease, characterised by the reduced capacity of the heart to pump blood, supply or fill with blood, and is a cause of hospitalisation.1 HF is rapidly growing in developed and developing countries, with an estimated prevalence of more than 37 million individuals.2 HF is associated with a high rate of hospitalisation and it is a major cause of morbidity and mortality worldwide.1-3 Existing studies have shown that several comorbid factors and biomarkers are associated with HF and its prognosis.4 Recent studies have associated subclinical hypothyroidism with increased blood pressure, insulin resistan

Introduction Throughout this supplement, there has been discussion of the epidemiology of cardiovascular disease within people with diabetes, and a focus on the management of glycaemia. Given that the majority of people with diabetes ultimately die a premature cardiovascular death, diabetes management has become synonymous with cardiovascular risk reduction. However, since the United Kingdom Prospective Diabetes Study (UKPDS),1 it has become increasingly clear that the multi-factorial nature of diabetes requires a multi-factorial approach. Initially, much of this was extrapolated from existing cardiovascular data, with diabetes just being re

Introduction Atherosclerosis is a systemic disease of the large- and medium-sized muscular arteries, which is characterised by endothelial dysfunction, vascular inflammation, and the build up of lipids, cholesterol, calcium, and cellular debris within the intima of the vessel wall. This build up results in plaque formation, vascular remodelling, acute and chronic luminal obstruction, abnormalities of blood flow and diminished oxygen supply to target organs.1 Plaque rupture and thrombosis result in the acute clinical complications of atherosclerosis. The process of atherosclerosis begins early in life and progresses over many decades. Rupture

Assessing the clinical benefits of drugs for dyslipidaemia Dear Sirs, A recent editorial in the New England Journal of Medicine1 highlights several challenging issues in the development of new treatments for lipid disorders. There is now uncertainty regarding the regulatory approach of approving drugs on the basis of favourable lipid effects and evaluating clinical benefit after approval. In numerous trials and several meta-analyses of outcome trials, the reduction of low-density lipoprotein (LDL) cholesterol has been shown to be associated with outcome benefit.2–4 Most of these studies have been performed with statins. The first demonstrat

Reducing the residual cardiovascular risk that remains after statin use is a frontline challenge for preventive cardiology. After attention to other modifiable risk factors, further reduction of low-density lipoprotein cholesterol (LDL-C) levels and increasing high-density lipoprotein cholesterol (HDL-C) levels are under particular scrutiny.1,2 The cardioprotective epidemiology of HDL-C is strong and well known, and so it often comes as a shock to health professionals that there is no direct proof that raising HDL-C improves cardiovascular outcomes. Despite this, raising HDL-C remains an attractive potential approach for tackling residual ris

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

Introduction Cardiovascular events remain the leading cause of morbidity and mortality in developed countries, and the treatment of dyslipidaemia is central to the overall management of cardiovascular risk.1,2Although correction of hypercholesterolaemia remains the principal target for correction of the lipid profile, dyslipidaemia is heterogeneous in presentation, with many patients presenting with low high-density lipoprotein-cholesterol (HDL-C) in addition to elevated concentrations of ApoB-containing lipoproteins. A survey carried out in 11 European countries identified low HDL-C (<1.03 mmol/L in men and <1.29 mmol/L in women) in ab