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Treating Coronary Artery Disease With Treat-to-Target or High-Intensity Statin —Reply
In Reply We appreciate Dr Kawada ’s comments about our study, which demonstrated that a treat-to-target LDL-C strategy of 50 to 70 mg/dL as the goal was noninferior to a high-intensity statin therapy for the 3-year composite of death, myocardial infarction, stroke, or coronary revascularization.
Source: JAMA - August 1, 2023 Category: General Medicine Source Type: research

Ischemic Stroke in Patients With Asymptomatic Severe Carotid Stenosis Without Surgical Intervention
To the Editor We would like to raise several points about the recent study that estimated stroke outcomes among patients with asymptomatic severe carotid stenosis without surgical intervention. First, the standard-of-care medical treatment of asymptomatic carotid artery stenosis has made great advances recently and includes use of statins, antiplatelet agents, anticoagulants, and antihypertensives. Therefore, we believe that this study would benefit from a subgroup analysis of medication use in these patients. In addition, higher rates of medication adherence have been observed in patients with previous arterial surgical i...
Source: JAMA - September 27, 2022 Category: General Medicine Source Type: research

The USPSTF Recommendation Statement About Screening Asymptomatic Adults for Carotid Stenosis
To the Editor The USPSTF recommends against screening asymptomatic adults for carotid stenosis. However, we believe that detection of asymptomatic carotid stenosis might encourage treatment adherence to pharmacological —and nonpharmacological—primary prevention strategies. Demonstration of an objective lesion in the carotid artery may increase patient awareness of the presence of a risk factor for stroke. One article demonstrated that a higher rate of carotid stenosis detection was associated with better adher ence to statin and aspirin treatment in asymptomatic patients with vascular risk factors. A letter commenting ...
Source: JAMA - July 6, 2021 Category: General Medicine Source Type: research

Do Omega-3 Fatty Acids Benefit Health?
An important clinical trial of omega-3 fatty acids in patients at high risk of cardiovascular disease is published in JAMA. In the STRENGTH trial (the Long-Term Outcomes Study to Assess Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia), 13  078 patients were randomized to receive 4 g/d of a carboxylic acid formulation of omega-3 fatty acids (a combination of eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) or corn oil as a comparator. After a median follow-up of 42 months, there was no significant difference between the o mega-3 fatty acid group (6539 patients) a...
Source: JAMA - December 8, 2020 Category: General Medicine Source Type: research

Association of Statin Use With All-Cause and Cardiovascular Mortality in US Veterans 75 and Older
This retrospective cohort study uses Veterans Health Administration data on adults free of atherosclerotic cardiovascular disease (ASCVD) to evaluate the association between new statin use and all-cause and cardiovascular mortality, and a composite of ASCVD events (myocardial infarction, ischemic stroke, and revascularization with CABG surgery or PCI), in veterans 75 years and older.
Source: JAMA - July 7, 2020 Category: General Medicine Source Type: research

Error in USPSTF Report on Statin Use
The 2016 review for the US Preventive Services Task Force on statins for prevention of cardiovascular disease in adults had errors in the analysis of statins vs placebo and cardiovascular mortality. For the JUPITER trial, we interpreted “MI, stroke or cardiovascular death” as reported in the main trial publication as “myocardial death, stroke death, or cardiovascular death,” when it meant “nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death.” Therefore, the analysis erroneously included nonfatal myo cardial infarction and stroke events (83/8901 vs 157/8901 in the rosuvastatin vs placebo gro...
Source: JAMA - February 18, 2020 Category: General Medicine Source Type: research

Benefits May Persist After Antihypertensive and Statin Treatment
Patients with hypertension may benefit from antihypertensive treatment with a calcium channel blocker and a lipid-lowering statin years after taking the medications, reported a long-term follow-upstudy in theLancet. Patients who received amlodipine-based antihypertensive treatment had fewer stroke deaths —independent of blood pressure levels—and patients taking lipid-lowering atorvastatin had fewer cardiovascular deaths.
Source: JAMA - October 23, 2018 Category: General Medicine Source Type: research

Adverse Effects of Statins
To the Editor In his Viewpoint, Dr Thompson wrote, “Although statins reduce total stroke, they increase the risk of hemorrhagic stroke consistent with the observation that low cholesterol levels are associated with an increase in hemorrhagic stroke.” The statement could be misleading and requires clarification.
Source: JAMA - March 14, 2017 Category: Journals (General) Source Type: research