Intensive lipid-lowering therapy, time to think beyond low-density lipoprotein cholesterol

Published on Sep 26, 2021in World Journal of Cardiology
· DOI :10.4330/WJC.V13.I9.472
Ahmed Abdalwahab , Ayman Al-Atta + 1 AuthorsMohammad Alkhalil1
Estimated H-index: 1
(Freeman Hospital)
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Abstract
References56
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#1Peter S. Sever (NIH: National Institutes of Health)H-Index: 85
#2Ioanna Gouni-Berthold (University of Cologne)H-Index: 35
Last. Michelle L. O'Donoghue (Brigham and Women's Hospital)H-Index: 43
view all 10 authors...
AimsSome trials have reported diminished efficacy for statins in the elderly, and in women compared with men. We examined the efficacy and safety of evolocumab by patient age and sex in the FOURIER...
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#1Mohammad Alkhalil (Freeman Hospital)H-Index: 1
#2Michał Kuzemczak (Poznan University of Medical Sciences)H-Index: 3
Last. Vladimír DžavíkH-Index: 1
view all 5 authors...
Background Polyvascular atherosclerotic disease is associated with an increased risk of future cardiovascular events. Intensive lipid‐lowering therapy (ILT) may mitigate this risk. The aims of this...
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Abstract Current pharmacological and mechanical therapies have reduced future cardiovascular risk. Nonetheless, a significant proportion of patients remained at high risk of recurrent events despite achieving guideline-directed therapeutic targets. This residual risk poses challenges despite tackling ‘traditional’ risk factors. Targeting the residual risk has been the focus of numerous pharmacotherapies which were associated with variable success. Incomplete understanding of the mechanistic natu...
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#1Prakash Deedwania (UCSF: University of California, San Francisco)H-Index: 85
#2Sabina A. Murphy (Brigham and Women's Hospital)H-Index: 107
Last. Robert P. Giugliano (Brigham and Women's Hospital)H-Index: 94
view all 11 authors...
Importance The PCSK9 inhibitor evolocumab reduced low-density lipoprotein cholesterol and cardiovascular events in the FOURIER randomized clinical trial. Patients with metabolic syndrome (MetS) are at increased cardiovascular risk. Objective To investigate outcomes with evolocumab in patients with and without MetS. Design, Setting, and Participants The FOURIER trial randomized patients worldwide with stable atherosclerotic cardiovascular disease receiving statin to evolocumab vs placebo with fol...
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#1Ron C. Hoogeveen (BCM: Baylor College of Medicine)H-Index: 61
#2Christie M. Ballantyne (BCM: Baylor College of Medicine)H-Index: 151
BACKGROUND Current guidelines target low-density lipoprotein cholesterol (LDL-C) concentrations to reduce atherosclerotic cardiovascular disease (ASCVD) risk, and yet clinical trials demonstrate persistent residual ASCVD risk despite aggressive LDL-C lowering. CONTENT Non-LDL-C lipid parameters, most notably triglycerides, triglyceride-rich lipoproteins (TGRLs), and lipoprotein(a), and C-reactive protein as a measure of inflammation are increasingly recognized as associated with residual risk af...
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#1Ozan Dikilitas (Mayo Clinic)H-Index: 6
#2Benjamin A. Satterfield (Mayo Clinic)H-Index: 11
Last. Iftikhar J. Kullo (Mayo Clinic)H-Index: 61
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Background Atherosclerosis in >1 vascular bed (ie, polyvascular disease), often a feature of peripheral artery disease (PAD), is associated with high morbidity and mortality. We sought to identify ...
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#1Olga Castañer (ISCIII: Carlos III Health Institute)H-Index: 30
#2Xavier Pintó (ISCIII: Carlos III Health Institute)H-Index: 63
Last. Montserrat Fitó (ISCIII: Carlos III Health Institute)H-Index: 62
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Abstract Background Genetic, observational, and clinical intervention studies indicate that circulating levels of triglycerides and cholesterol transported in triglyceride-rich lipoproteins (remnant cholesterol) can predict cardiovascular events. Objectives This study evaluated the association of triglycerides and remnant cholesterol (remnant-C) with major cardiovascular events in a cohort of older individuals at high cardiovascular risk. Methods This study determined the baseline lipid profile ...
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#1Mie Balling (Copenhagen University Hospital)H-Index: 1
#2Shoaib Afzal (UCPH: University of Copenhagen)H-Index: 34
Last. Børge G. Nordestgaard (Copenhagen University Hospital)H-Index: 165
view all 6 authors...
Abstract Background Plasma apolipoprotein B (apoB) is a composite measure of all apoB-containing lipoproteins causing atherosclerotic cardiovascular disease; however, it is unclear which fraction of risk is explained by cholesterol and triglycerides, respectively, in very low-density lipoproteins (VLDLs). Objectives The authors tested the hypothesis that VLDL cholesterol and triglycerides each explain part of the myocardial infarction risk from apoB-containing lipoproteins. Methods Nested within...
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AIMS: Lowering low-density lipoprotein cholesterol (LDL-C) reduces cardiovascular risk irrespective of age, but the evidence is less strong for older patients. METHODS AND RESULTS: This prespecified analysis from ODYSSEY OUTCOMES compared the effect of alirocumab vs. placebo in 18 924 patients with recent acute coronary syndrome (ACS) according to age. We examined the effect of assigned treatment on occurrence of the primary study outcome, a composite of coronary heart disease death, myocardial ...
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Abstract Background and aims The recent reported analysis from the ODYSSEY OUTCOMES trial showed that patients with previous coronary bypass graft surgery (CABG) conferred enhanced clinical benefits in response to intensive low-density lipoprotein-cholesterol (LDL-c). Nonetheless, the impact on cardiovascular and all-cause mortality was difficult to ascertain given the relatively small number. Methods We conducted a meta-analysis investigating the role of more versus less intensive lipid-lowerin...
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