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Adherence to Medical Therapy and the Global Burden of Cardiovascular Disease ∗
Ischemic heart disease and cerebrovascular disease account for>20% of worldwide mortality and are the 2 leading causes of death on a global basis (1). Although mortality from ischemic heart disease is greater than that from stroke worldwide, the mortality from stroke is actually higher than from ischemic heart disease in 39% of countries. For example, mortality from stroke is generally higher than that for ischemic heart disease in China, Africa, and South America. In addition, stroke disability–adjusted life-year loss rates exceed ischemic heart disease-related disability in 32% of countries (2). Because of this, strate...
Source: Journal of the American College of Cardiology - March 29, 2016 Category: Cardiology Source Type: research

Selecting Patients for Statin Therapy in Primary Prevention If We Could Only Predict the Future ∗
Statins are effective in the primary and secondary prevention of coronary heart disease and stroke. Although many would agree that primary prevention of atherosclerotic cardiovascular disease (ASCVD) is preferable to secondary prevention, no consensus exists on how to best identify individuals at risk for the disease, when to commence screening and risk assessment, at what age to start (or stop) treatment, how to treat, and how intensively to treat. The 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines concluded that net benefit was sufficient to recommend statin treatment for ...
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Treatment of Dyslipidemia in Elderly Patients With Coronary Heart Disease There Are Miles to Go Before We Sleep ∗
The treatment of dyslipidemia with statin therapy is a cornerstone in the management of patients in both the primary and secondary prevention settings. Dyslipidemia is widely prevalent in its various forms (1). The lowering of low-density lipoprotein cholesterol (LDL-C) with a statin in patients with established coronary heart disease (CHD) has shown unequivocal capacity to safely reduce risk for clinical sequelae such as nonfatal myocardial infarction, ischemic stroke, cardiovascular and all-cause mortality, as well as the need for revascularization (2,3). The American College of Cardiology/American Heart Association Guid...
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research

Next Steps in Primary Prevention of Coronary Heart Disease Rationale for and Design of the ECAD Trial
Atherosclerotic cardiovascular disease (ASCVD) events, including coronary heart disease and stroke, are the most frequent cause of death and major disability in the world. Current American College of Cardiology/American Heart Association primary prevention guidelines are mainly on the basis of randomized controlled trials of statin-based low-density lipoprotein cholesterol (LDL-C)–lowering therapy for primary prevention of ASCVD events. Despite the clear demonstration of statin-based LDL-C lowering, substantial 10-year and lifetime risks of incident ASCVD continue. Although the 10-year risk is low in young and middle-age...
Source: Journal of the American College of Cardiology - October 12, 2015 Category: Cardiology Source Type: research

Coronary Calcium Score and the New Guidelines Back to Square One? ∗
Previous guidelines for cardiovascular risk assessment recommended the use of a modified Framingham score to estimate the 10-year risk of hard coronary heart disease (CHD) events, defined as myocardial infarction and CHD death (1). Coronary artery calcium (CAC) scoring for refined stratification received Class IIa or IIb recommendations for those at intermediate (10% to 20%) or low to intermediate (6% to 10%) risk, respectively (2). In 2013, the American College of Cardiology (ACC) and American Heart Association (AHA) released guidelines (3,4) endorsing new sex- and race-specific predictive equations derived from 5 large p...
Source: Journal of the American College of Cardiology - October 5, 2015 Category: Cardiology Source Type: research

Relationship of Oxidized Phospholipids on Apolipoprotein B-100 to Cardiovascular Outcomes in Patients Treated With Intensive Versus Moderate Atorvastatin Therapy The TNT Trial
ConclusionsElevated OxPL-apoB levels predict secondary MACE in patients with stable CHD, a risk that is mitigated by atorvastatin 80 mg. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691)
Source: Journal of the American College of Cardiology - March 30, 2015 Category: Cardiology Source Type: research

The Current State of Niacin in Cardiovascular Disease Prevention: A Systematic Review and Meta-Regression
Conclusions: The consensus perspective derived from available clinical data supports that niacin reduces CVD events and, further, that this may occur through a mechanism not reflected by changes in high-density lipoprotein cholesterol concentration.
Source: Journal of the American College of Cardiology - December 26, 2012 Category: Cardiology Authors: Paul M. Lavigne, Richard H. Karas Tags: Cardiometabolic Risk Source Type: research