scholarly journals Ischemic stroke in patients with atrial fibrillation – do we need to treat with statins?

2021 ◽  
Vol 12 (3) ◽  
pp. 84-91
Author(s):  
Matilda Florentin ◽  
George Ntaios ◽  
Haralampos Milionis
Keyword(s):  
Atrial Fibrillation ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Stroke Severity ◽  
Low Density Lipoprotein Cholesterol ◽  
Cardiovascular Comorbidities ◽  
Lipid Lowering Agents ◽  
Relationship Of ◽  
The Relationship

The relationship of dyslipidemia with atrial fibrillation (AF)-related stroke is not clear. The question whether patients with AF-related stroke should receive lipid lowering agents unanimously remains unanswered. Treatment with statins does not appear to be as protective as initially thought in terms of AF prevention; however, certain groups of patients may benefit from statin use. There is evidence that statins favorably affect stroke severity, in-hospital mortality, prognosis and survival of patients with AF-related stroke. Statin pretreatment is associated with better collateral circulation in patients with cardioembolic stroke. Importantly, AF frequently co-exists with several cardiovascular comorbidities, while patients with AF-related stoke may be prone to other cardiovascular events. The overall cardiovascular risk should be assessed in AF patients experiencing a stroke and treated in accordance with the proposed low density lipoprotein cholesterol (LDL-C) targets.

scholarly journals Low Levels of Low-Density Lipoprotein Cholesterol and Endothelial Function in Subjects without Lipid-Lowering Therapy

2020 ◽  
Vol 9 (12) ◽  
pp. 3796
Author(s):  
Yuji Takaeko ◽  
Masato Kajikawa ◽  
Shinji Kishimoto ◽  
Takayuki Yamaji ◽  
Takahiro Harada ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density Lipoprotein Cholesterol ◽  
Lowering Therapy ◽  
Low Levels ◽  
Relationship Of ◽  
The Relationship

An elevation of serum low-density lipoprotein cholesterol (LDL-C) levels has been associated with endothelial dysfunction in statin naïve subjects. However, there is no information on endothelial function in subjects with extremely low levels of LDL-C. The purpose of the present study was to determine the relationship of LDL-C levels, especially low levels of LDL-C, with endothelial function. Endothelial function assessed by flow-mediated vasodilation (FMD) measurement and LDL-C levels were evaluated in 7120 subjects without lipid-lowering therapy. We divided the subjects into five groups by LDL-C levels: <70 mg/dL, 70–99 mg/dL, 100–119 md/dL, 120–139 mg/dL, and ≥140 mg/dL. FMD values were significantly smaller in subjects with LDL-C levels of ≥140 mg/dL than in those with LDL-C levels of 70–99 mg/dL and 100–119 mg/dL (p < 0.001 and p = 0.004, respectively). The FMD values in the LDL-C of <70 mg/dL group were not significantly different from those in the other groups. To evaluate the relationship of extremely low LDL-C levels with endothelial function, we divided the subjects with LDL-C of <70 mg/dL into those with LDL-C levels of <50 mg/dL and 50–69 mg/dL. FMD values were similar in the LDL-C <50 mg/dL group and ≥50 mg/dL group in the propensity score-matched population (p = 0.570). A significant benefit was not found in subjects with low LDL-C levels from the aspect of endothelial function.

scholarly journals The relationship of the serum endocan level with the CHA2DS2-VASc score in patients with paroxysmal atrial fibrillation

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Gökhan Ceyhun
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Stroke Risk ◽  
Low Density Lipoprotein ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Roc Curve Analysis ◽  
Reactive Protein ◽  
Relationship Of ◽  
The Relationship

Abstract Background In this study considering the relationship between serum endocan and CHA2DS2-VASc score, we assumed that endocan level could be a new biomarker for stroke risk in patients with paroxysmal atrial fibrillation (PAF). It was examined that endocan could be an alternative to determine the risk of stroke and anticoagulation strategy in patients with PAF. The CHA2DS2-VASc scores were calculated for 192 patients with PAF, and their serum endocan levels were measured. The patients were divided into two groups as those with low to moderate (0-1) and those with high (≥ 2) CHA2DS2-VASc scores, and the endocan levels were compared between these two groups. Results The serum endocan level was significantly higher in the high CHA2DS2-VASc score group (p < 0.001). In the multivariate logistic regression analysis, endocan, C-reactive protein, and low-density lipoprotein were found to be independent determinants of the CHA2DS2-VASc score. The predictive value of endocan was analyzed using the ROC curve analysis, which revealed that endocan predicted a high stroke risk (CHA2DS2-VASc ≥ 2) at 82.5% sensitivity and 71.2% specificity at the cutoff value of 1.342. Conclusion This study indicates that endocan is significantly associated with CHA2DS2-VASc score. We demonstrated that endocan could be a new biomarker for the prediction of a high stroke risk among patients diagnosed with PAF.

Association of SLCO1B1 Polymorphisms and Atorvastatin Safety and Efficacy: A Meta-analysis

2019 ◽  
Vol 24 (34) ◽  
pp. 4044-4050 ◽  
Author(s):  
Yaming Du ◽  
Sizheng Wang ◽  
Zhangyong Chen ◽  
Shusen Sun ◽  
Zhigang Zhao ◽  
...  
Keyword(s):  
Statistical Tests ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Dominant Model ◽  
Safety And Efficacy ◽  
Atorvastatin Therapy ◽  
Relationship Of ◽  
The Relationship

Background: Atorvastatin is the best-selling statin in the market. However, some patients have to reduce drug doses or discontinue atorvastatin therapy mainly due to adverse drug reactions (ADRs). Genetic factors play an important role in the occurrence of ADRs. Aim: This study aimed to investigate the association between SLCO1B1 polymorphisms (c.521T>C or c.388A>G) and atorvastatin safety and efficacy. Methods: We systematically searched PubMed, Web of Science and Embase to screen relevant studies published before Sep 2018. This meta-analysis was performed to identify the relationship between SLCO1B1 c.521T>C or c.388A>G polymorphisms and atorvastatin-related ADRs by the odds ratios (ORs) and 95% confidence intervals (CIs). The relationship of SLCO1B1 polymorphisms and lipid-lowering effects [low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC)] was assessed in pooled data by calculating the mean difference (MD) with 95% CIs. All statistical tests were performed by the Review Manager 5.3 software. Results: A total of 13 studies involving 1,550 atorvastatin users were included in this analysis. There was a significant association between the SLCO1B1 c.521T>C polymorphism and atorvastatin-related ADRs associated with risk allele C (dominant model: OR=1.57, P=0.01). Allele C is associated with increased lipid-lowering efficacy in people with Hyperlipidemias as compared to allele T (LDL-C/dominant model: MD=6.19, P<0.00001 and (TC)/dominant model: MD=2.07, P=0.008). No association between the SLCO1B1 c.388A>G polymorphism and ADRs or efficacy was observed (P>0.05). Conclusion: SLCO1B1 c.521T>C polymorphism is a valuable biomarker for the evaluation of atorvastatin safety and efficacy.

scholarly journals Lipid-Lowering Agents

2019 ◽  
Vol 124 (3) ◽  
pp. 386-404 ◽  
Author(s):  
Robert A. Hegele ◽  
Sotirios Tsimikas
Keyword(s):  
Ldl Cholesterol ◽  
Mendelian Randomization ◽  
Genetic Disorders ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Lipid Lowering Agents

Several new or emerging drugs for dyslipidemia owe their existence, in part, to human genetic evidence, such as observations in families with rare genetic disorders or in Mendelian randomization studies. Much effort has been directed to agents that reduce LDL (low-density lipoprotein) cholesterol, triglyceride, and Lp[a] (lipoprotein[a]), with some sustained programs on agents to raise HDL (high-density lipoprotein) cholesterol. Lomitapide, mipomersen, AAV8.TBG.hLDLR, inclisiran, bempedoic acid, and gemcabene primarily target LDL cholesterol. Alipogene tiparvovec, pradigastat, and volanesorsen primarily target elevated triglycerides, whereas evinacumab and IONIS-ANGPTL3-L Rx target both LDL cholesterol and triglyceride. IONIS-APO(a)-L Rx targets Lp(a).

scholarly journals Evaluation of two highly effective lipid-lowering therapies in subjects with acute myocardial infarction

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aline Klassen ◽  
Andrea Tedesco Faccio ◽  
Carolina Raissa Costa Picossi ◽  
Priscilla Bento Matos Cruz Derogis ◽  
Carlos Eduardo dos Santos Ferreira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Low Density Lipoprotein Cholesterol ◽  
Residual Cardiovascular Risk ◽  
St Segment Elevation ◽  
Lipidomic Analysis ◽  
St Segment ◽  
Highly Effective

AbstractFor cardiovascular disease prevention, statins alone or combined with ezetimibe have been recommended to achieve low-density lipoprotein cholesterol targets, but their effects on other lipids are less reported. This study was designed to examine lipid changes in subjects with ST-segment elevation myocardial infarction (STEMI) after two highly effective lipid-lowering therapies. Twenty patients with STEMI were randomized to be treated with rosuvastatin 20 mg QD or simvastatin 40 mg combined with ezetimibe 10 mg QD for 30 days. Fasting blood samples were collected on the first day (D1) and after 30 days (D30). Lipidomic analysis was performed using the Lipidyzer platform. Similar classic lipid profile was obtained in both groups of lipid-lowering therapies. However, differences with the lipidomic analysis were observed between D30 and D1 for most of the analyzed classes. Differences were noted with lipid-lowering therapies for lipids such as FA, LPC, PC, PE, CE, Cer, and SM, notably in patients treated with rosuvastatin. Correlation studies between classic lipid profiles and lipidomic results showed different information. These findings seem relevant, due to the involvement of these lipid classes in crucial mechanisms of atherosclerosis, and may account for residual cardiovascular risk.Randomized clinical trial: ClinicalTrials.gov, NCT02428374, registered on 28/09/2014.

scholarly journals Subclinical Hypothyroidism and Indices for Metabolic Syndrome in Japanese Women: One-Year Follow-Up Study

2013 ◽  
Vol 98 (8) ◽  
pp. 3280-3287 ◽  
Author(s):  
Yasuyo Nakajima ◽  
Masanobu Yamada ◽  
Masako Akuzawa ◽  
Sumiyasu Ishii ◽  
Yasuhiro Masamura ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Odds Ratio ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Free T4 ◽  
The Relationship

Context: Subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) increase with age; however, their relationship remains unclear. Objective: Our objective was to investigate the relationship between SCH and indices of metabolic syndrome and follow up subjects for 1 year. Design: Cross-sectional and longitudinal follow-up studies of cases were collected from Takasaki Hidaka Hospital between 2003 and 2007. Participants: Overall, 11 498 participants of health checkups were analyzed. The mean age was 48 ± 9 years. Main Outcome Measures: The relationship between SCH and indices of MetS were examined. Results: Serum free T4 levels were lower in women than men in most of the age groups, and the prevalence of SCH, 6.3% in women vs 3.4% in men, increased with age, reaching 14.6% in 70-year-old women. Multivariate logistic-regression analyses revealed that waist circumference and the serum triglyceride and low-density lipoprotein-cholesterol levels were significantly higher in subjects with SCH than without among women. Reflecting these findings, the adjusted odds ratio of MetS in patients with SCH was higher than in the euthyroid subjects in women with an odds ratio of 2.7 (95% confidence interval 1.1–5.6; P = .017) but not in men. Furthermore, progression from euthyroid into SCH resulted in a significant increase in the serum triglyceride levels but not low-density lipoprotein-cholesterol in women. Conclusion: Japanese women exhibited a high prevalence of SCH associated with low free T4 levels. There was a strong association between SCH and several indices of metabolic syndrome in women. SCH may affect serum triglyceride levels and be a risk factor for metabolic syndrome.

scholarly journals U-Shaped Relationship of Low-Density Lipoprotein Cholesterol With Risk of Severe COVID-19 From a Multicenter Pooled Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiao Gong ◽  
Yaqiong Chen ◽  
Yusheng Jie ◽  
Mingkai Tan ◽  
Zhaofang Jiang ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Odds Ratios ◽  
Lowering Therapy ◽  
Severe Group

Low-density lipoprotein cholesterol (LDL-C) is a well-known risk factor for coronary heart disease but protects against infection and sepsis. We aimed to disclose the exact association between LDL-C and severe 2019 novel coronavirus disease (COVID-19). Baseline data were retrospectively collected for 601 non-severe COVID-19 patients from two centers in Guangzhou and one center in Shenzhen, and patients on admission were medically observed for at least 15 days to determine the final outcome, including the non-severe group (n = 460) and the severe group (severe and critical cases) (n = 141). Among 601 cases, 76 (12.65%) received lipid-lowering therapy; the proportion of patients taking lipid-lowering drugs in the severe group was higher than that in the non-severe group (22.7 vs. 9.6%). We found a U-shaped association between LDL-C level and risk of severe COVID-19 using restricted cubic splines. Using univariate logistic regression analysis, odds ratios for severe COVID-19 for patients with LDL-C ≤1.6 mmol/L (61.9 mg/dL) and above 3.4 mmol/L (131.4 mg/dL) were 2.29 (95% confidence interval 1.12–4.68; p = 0.023) and 2.02 (1.04–3.94; p = 0.039), respectively, compared to those with LDL-C of 2.81–3.40 mmol/L (108.6–131.4 mg/dL); following multifactorial adjustment, odds ratios were 2.61 (1.07–6.37; p = 0.035) and 2.36 (1.09–5.14; p = 0.030). Similar results were yielded using 0.3 and 0.5 mmol/L categories of LDL-C and sensitivity analyses. Both low and high LDL-C levels were significantly associated with higher risk of severe COVID-19. Although our findings do not necessarily imply causality, they suggest that clinicians should pay more attention to lipid-lowering therapy in COVID-19 patients to improve clinical prognosis.

Lipid disorders in pregnancy

2021 ◽  
Vol 27 ◽  
Author(s):  
Anastasios Liberis ◽  
Stamatis Petousis ◽  
Panagiotis Tsikouras
Keyword(s):  
Pregnant Women ◽  
Low Density Lipoprotein ◽  
Safety Data ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Disorders ◽  
Severe Hypertriglyceridemia ◽  
History Of ◽  
Lipid Lowering Agents ◽  
In Pregnancy

: Dyslipidemia represents a major risk factor for cardiovascular disease. In addition, severe hypertriglyceridemia is an important cause of acute pancreatitis. Accordingly, the increase in serum lipid levels that are observed during pregnancy have potentially important implications. The management of dyslipidemia in pregnancy is further complicated by the lack of safety data during this period for most of the lipid-lowering agents. In the present review, we discuss the most important lipid disorders in pregnant women and their management. Pregnancy is characterized by increases in both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, which might result in severe complications both for the mother and the fetus. Accordingly, LDL-C and triglyceride levels should be monitored during pregnancy, particularly in women with a history of dyslipidemia. Diet is the mainstay of management of dyslipidemia in pregnant women and apheresis can also be considered in patients with homozygous familial hypercholesterolemia or severe hypertriglyceridemia. However, there is a pressing need for studies that with evaluate the safety of lipid-lowering agents during pregnancy.

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