Association between frequency of primary care provider visits and evidence-based statin prescribing and statin adherence: Findings from the veterans affairs system

Publication date: Available online 7 December 2019Source: American Heart JournalAuthor(s): Sarah T. Ahmed, Dhruv Mahtta, Hasan Rehman, Julia Akeroyd, Mahmoud Al Rifai, Fatima Rodriguez, Hani Jneid, Khurram Nasir, Zainab Samad, Mahboob Alam, Laura A. Petersen, Salim S. ViraniBackgroundStatin use remains suboptimal in patients with atherosclerotic cardiovascular disease (ASCVD). We assessed if the frequency of visits with primary care providers (PCPs) is associated with higher use of evidence-based statin prescriptions and adherence among patients with ASCVD.MethodsWe identified patients with ASCVD aged ≥18 years receiving care in 130 facilities and associated community-based outpatient clinics in the entire Veterans Affairs Health Care System between October 1, 2013 and September 30, 2014. Patients were divided into frequent PCP visitors (annual PCP visits ≥ median number of PCP visits for the entire cohort) and infrequent PCP visitors (annual PCP visits
Source: American Heart Journal - Category: Cardiology Source Type: research

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Today, The Department of Justice issued an announcement that was “the first ever criminal action against an EHR vendor.” Criminal action The core of the criminal action was something inevitable:  the tension between better health and better profit.  Here’s what I saw … all of which caused me to be not-so-surprised today when the news broke. In 2008 I was the CMIO at Allscripts.  Much of my work was focused on how our customers could use our products to improve the health of our patients.  We implemented clinical practice guidelines in the software as a way to help clinical teams...
Source: Docnotes - Category: Primary Care Authors: Tags: Uncategorized Source Type: blogs
Clinical guidelines from the US and Europe do not recommend treatment with statins for primary prevention in persons with hypercholesterolemia who are older than 75 years. Data from 35 randomized controlled trials in this age group where statin therapy for primary prevention was compared to placebo or usual care were analyzed. Using all-cause death as the outcome we performed two types of analyses: frequentist and Bayesian. Frequentist analysis indicated no significant difference in mortality between cases (on statins) and controls (on placebo or usual care, p=0.16).
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSIONS: Low EPA/AA ratio at baseline and treatment without statins could predict mortality, recurrent ischemic stroke, cardiovascular and peripheral artery diseases, and hemorrhagic stroke among patients with acute ischemic stroke. The combination of baseline EPA/AA ratio and statin therapy could be critical in predicting the long-term prognosis of ischemic stroke patients. PMID: 31969533 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
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Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
This article overviews available literature on changes in the definition of severe dengue, pathogenesis of liver involvement in dengue, clinical manifestations, and predictors of mortality in severe dengue with liver involvement, impact of viral hepatitis co-infections and hepatotoxic drugs, and hemophagocytic lymphohistiocytosis.Expert opinion: Hepatitis is commonly seen in dengue however the degree of elevation of transaminases did not correlate well with severity of illness in observational studies, except in the elderly. The underlying pathogenesis of liver injury is still being elucidated and further studies are requi...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
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Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Meds Cardiology Source Type: blogs
CONCLUSIONS: The LDL cholesterol, total cholesterol, and triglyceride lowering effect of cerivastatin was linearly dependent on dose. Cerivastatin log dose-response data were linear over the commonly prescribed dose range. Based on an informal comparison with fluvastatin, atorvastatin and rosuvastatin, cerivastatin was about 250-fold more potent than fluvastatin, 20-fold more potent than atorvastatin and 5.5-fold more potent than rosuvastatin in reducing LDL cholesterol, and 233-fold greater potency than fluvastatin, 18-fold greater potency than atorvastatin and six-fold greater potency than rosuvastatin at reducing total ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
A 28-year old woman with a rare combination of homozygous LDLR and heterozygous PCSK9 mutations had a phenotype consistent with homozygous familial hypercholesterolemia (HoFH). She reported a clinical history of coronary and extracoronary atherosclerosis treated with three coronary stenting procedures, one coronary bypass, and aortic and mitral valve replacements. Since the patient refused lipoprotein apheresis, lipid lowering therapy with statins, ezetimibe and evolocumab was started. The desired low-density lipoprotein cholesterol (LDL-C) target was not achieved.
Source: Journal of Clinical Lipidology - Category: Lipidology Authors: Tags: Case Report Source Type: research
The lovastatin hydrolase PcEST from the fungus Penicillium chrysogenum exhibits enormous potential for industrial-scale applications in single-step production of monacolin J, the key precursor for synthesis of the cholesterol-lowering drug simvastatin. This enzyme specifically and efficiently catalyzes the conversion of lovastatin to monacolin J but cannot hydrolyze simvastatin. Understanding the catalytic mechanism and the structure–function relationship of PcEST is therefore important for further lovastatin hydrolase screening, engineering, and commercial applications. Here, we solved four X-ray crystal structures,...
Source: Journal of Biological Chemistry - Category: Chemistry Authors: Tags: Enzymology Source Type: research
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