Tag Archives: statins

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

Dear Sirs, Research on sex difference in mortality after myocardial infarction (MI) since the 1990s has been debated and increased. Several observational studies have shown that younger women, in particular, seemed to have higher mortality rates than men of similar age during the two-year or longer follow-up, although these studies were mainly from the USA.1-3 Recent American studies have also found that, even after full adjustment for potential risk factors, excess risk for in-hospital mortality for women was still noted, particularly among those <50 years old with acute ST-segment elevation MI, leading to 98% (odds ratio [OR] 1.98, 95% c

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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

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Introduction Since their discovery in the 1970s, statins are widely used in clinics for the treatment of atherosclerosis and other cardiovascular diseases (CVD). Statins attenuate the intracellular levels of cholesterol by inhibiting the rate-limiting enzyme 3-hydroxy-3-methylglutaryl (HMG)-CoA reductase, either by competing with the normal substrate in the enzyme’s active site, or by altering the conformation of the enzyme by binding to its active site. Lipid-mediated effects Statins exert their lipid-mediated action by decreasing the production of cholesterol and low-density lipoproteins (LDL), by up-regulation of LDL-receptors and uptake

Background Statins are first choice for treatment of dyslipidaemia in both secondary and primary cardiovascular disease prevention. For every 1.0 mmol/L reduction in low-density lipoprotein cholesterol (LDL‑C), the risk of coronary heart disease (CHD) mortality decreases by 19% and overall mortality decreases by 12%.1 Despite statin treatment, a substantial number of cardiovascular events still occur, and one reason may be persistent lipid abnormalities including total cholesterol and LDL-C not at target, or low levels of high-density lipoprotein cholesterol (HDL-C) or elevated triglycerides. Results from the DYSlipidaemia International Stu

While the researchers say that that the benefits of statin therapy for the prevention of cardiovascular disease in people with an increased risk of type 2 diabetes are still unequivocal, they suggest that such patients on statins need to focus even more on intensive lifestyle intervention, with a healthy diet, non-smoking, and physical activity. In the study, 2,798 patients at high risk of diabetes were followed for one year. Patients were given counselling on lifestyle interventions; fasting blood glucose was measured at baseline and one year. Results showed that 484 individuals (17.3%) used statins at baseline. Of these patients, 7.5% devel

In the present study, researchers analysed data from the WHI on 153,840 post-menopausal women, of whom 7% were taking statins at baseline. During the study period, 10,242 incident cases of diabetes were reported. In an unadjusted risk model, statin use at baseline was associated with a 71% increased risk of diabetes, but after adjusting for other risk factors, this was reduced to a 48% increased risk. The association appeared to be a class effect. Risk was increased particularly in white, Hispanic, and Asian women, but not in African American women. The association was also observed at all levels of body mass index (BMI) but women with the lo

Introduction Cardiovascular disease (CVD) is the leading cause of death in England and Wales (124,000 deaths in 2005) and for every fatality, there are at least two people who have a major non-fatal CVD event.1 Myocardial infarction (MI) is associated with substantial morbidity and mortality. There is a high risk of recurrence after the initial event. Recommendations on the secondary prevention of cardiovascular disease for patients in primary and secondary care have been published in guidelines from the National Institute for Health and Clinical Excellence (NICE) in England.1,2 In the May 2008 CG67 guideline, high-intensity dosage of statin