scholarly journals Diabeteses dyslipidaemia és atherosclerosis

2016 ◽  
Vol 157 (19) ◽  
pp. 746-752 ◽  
Author(s):  
László Márk ◽  
Győző Dani
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
High Risk ◽  
Statin Therapy ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Small Dense Ldl ◽  
Target Values ◽  
Postprandial Triglyceride ◽  
Low Hdl

The incidence and the public health importance of diabetes mellitus are growing continuously. Despite the improvement observed in the latest years, the leading cause of morbidity and mortality of diabetics are cardiovascular diseases. The diagnosis of diabetes mellitus constitutes such a high risk as the known presence of vascular disease. Diabetic dyslipidaemia is characterised by high fasting and postprandial triglyceride levels, low HDL level, and slightly elevated LDL-cholesterol with domination of atherogenic small dense LDL. These are not independent components of the atherogenic dyslipidaemia, but are closely linked to each other. Beside the known harmful effects of low HDL and small dense LDL, recent findings confirmed the atherogenicity of the triglyceride-rich lipoproteins and their remnants. It has been shown that the key of this process is the overproduction and delayed clearance of triglyceride-rich lipoproteins in the liver. In this metabolism the lipoprotein lipase has a determining role; its function is accelerated by ApoA5 and attenuated by ApoC3. The null mutations of the ApoC3 results in a reduced risk of myocardial infarction, the loss-of-function mutation of ApoA5 was associated with a 60% elevation of triglyceride level and 2.2-times increased risk of myocardial infarction. In case of diabetes mellitus, insulin resistance, obesity, metabolic syndrome and chronic kidney disease the non-HDL-cholesterol is a better marker of the risk than the LDL-cholesterol. Its value can be calculated by subtraction of HDL-cholesterol from total cholesterol. Target values of non-HDL-cholesterol can be obtained by adding 0.8 mmol/L to the LDL-cholesterol targets (this means 3.3 mmol/L in high, and 2.6 mmol/L in very high risk patients). The drugs of first choice in the treatment of diabetic dyslipidaemia are statins. Nevertheless, it is known that even if statin therapy is optimal (treated to target), a considerable residual (lipid) risk remains. For its reduction treatment of low HDL-cholesterol and high triglyceride levels is obvious by the administration of fibrates. In addition to statin therapy, fenofibrate can be recommended. Orv. Hetil., 2016, 157(19), 746–752.

Abstract P347: Serum 25-hydroxy Vitamin D, Cardiovascular Risk Markers, And Incident Myocardial Infarction In A High Risk Community Population

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jaeun Yang ◽  
Christopher Naugler ◽  
Lawrence de Koning
Keyword(s):  
Myocardial Infarction ◽  
Vitamin D ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Ldl Cholesterol ◽  
Fasting Glucose ◽  
Hdl Cholesterol ◽  
Risk Markers ◽  
25 Oh Vitamin D

Background: It is unclear whether vitamin D deficiency is associated with a higher risk of cardiovascular disease, and through what biochemical pathways this could occur. We investigated the relationship between serum 25-OH vitamin D and typical cardiovascular risk markers as well as incident myocardial infarction (MI) in a large group of high-risk individuals from the community of Calgary, Alberta, Canada. Methods: Calgary Laboratory Services databases were queried for age, sex, body mass index (BMI), personal healthcare number (PHN) and first available serum 25-OH vitamin D measure from patients who received an electrocardiogram or urine creatinine clearance test from 2010-2013. Data was linked by PHN to first available laboratory results for total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, fasting glucose and HbA1c as well as Alberta Health Services hospital discharge data for first myocardial infarction (ICD-10: I21.1-9) occurring after 25-OH vitamin D measurement. Multiple linear and logistic regression were used to examine all associations. Results: There were 36 000-50 000 complete patient records for analysis of each of the risk markers, with a median follow-up of 8-11 months. A 30 mmol/L increase in serum 25-OH vitamin D was associated with significantly (p<0.001) lower total cholesterol (-0.07 mmol/L), LDL cholesterol (-0.06 mmol/L), triglycerides (-0.14 mmol/L), fasting glucose (-0.12 mmol/L), and HbA1c (-0.13% mmol/L), but higher HDL cholesterol (+0.06 mmol/L) after adjusting for age, sex, BMI, monthly hours of sun-exposure and time between measures. Among these individuals, there were 458 cases of MI occurring after 25-OH vitamin D measurement, with a median follow-up of 1 year. In a case-cohort analysis that included 2500 controls, a 30 mmol/L increase in 25-OH vitamin D was associated with a 21% (p<0.001) lower odds of MI after multivariate adjustment. This association was strongly attenuated after adjusting LDL, HDL, fasting glucose and HbA1c. Conclusion: In a high-risk group of community patients from Calgary, Alberta, Canada, higher serum 25-OH vitamin D was associated with a lower risk of MI, which was explained by changes in commonly measured cardiovascular risk markers. Further study is needed to determine whether changes in cardiovascular risk markers are causally related to changes in 25-OH vitamin D.

scholarly journals GLYCEMIC AND LIPIDEIC STATUS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

2014 ◽  
Vol 04 (01) ◽  
pp. 009-014
Author(s):  
A. Harish Rao
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Fasting Glucose ◽  
Hdl Cholesterol ◽  
Serum Levels ◽  
Glucose Levels ◽  
Low Hdl ◽  
One Year

Abstract: Objective: to know the glycemic and lipidaemic status in patients with acute myocardial infarction, and with the secondary objective to know the effect of age, gender, diabetes, smoking, hypertension on fasting glucose and lipid levels. Methods and materials: The 74 patients admitted for acute myocardial infarction during the study period of one year were analysed for fasting glucose values and serum levels of total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Results: The mean serum concentrations of total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol were 233.28±45.34, 139.22±41.71, 171.43±36.53 and 27.07±36.53 respectively. Mean levels of total cholesterol, HDL cholesterol, triglycerides and fasting glucose values were not affected by age, gender, BMI, hypertension and smoking. BMI >30kg/m2 was associated with increased levels of total cholesterol(p=0.013) and LDL cholesterol(p=0.014). Also increase LDL cholesterol was seen in male gender(p=0.04). The prevalence of hypercholesterolemia, hypertriglyceridemia and low HDL cholesterol was 82.4%,77% and 78% respectively. Diabetes had no effect on lipid profile. Conclusion: our study highlighted the prevalence of dyslipidemias associated with myocardial infarction but not significant impact of fasting glucose levels.

scholarly journals Acute myocardial infarction in a 17-year-old Bangladeshi boy-possibility of existence of a Bangladeshi paradox

2016 ◽  
Vol 3 (3) ◽  
pp. 62
Author(s):  
Prabir Kumar Das ◽  
F. Hossain ◽  
M.R. Karim
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hdl Cholesterol ◽  
Anterior Wall ◽  
Emerging Risk ◽  
Low Hdl ◽  
Artery Disease ◽  
Conventional Risk Factors

Coronary artery disease (CAD) and acute myocardial infarction (AMI) are  diseases of older age. AMI is uncommon in young age  and rare in adolescence. A seventeen years old Bangladeshi boy developing acute anterior wall MI is described here. Risk factor analysis for CAD revealed absence of most of the conventional risk factors, like  smoking, diabetes mellitus, hypertension. An  elevated lipoprotein(a) and a low HDL cholesterol  was detected in  blood  which are emerging risk factors  of  CAD  in young Bangladeshis.

scholarly journals Alirocumab effectiveness and rapidity in achieving and maintaining target LDL, HDL cholesterol and triglyceride values in patients at very high cardiovascular risk

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Cavarra ◽  
E Salerno ◽  
G Chiaranda"
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Case Studies ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
High Cardiovascular Risk ◽  
Target Value ◽  
Target Values ◽  
Very High

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Still too few patients after an acute cardiocerebrovascular event reach C-LDL values recommended by guidelines even in therapy with statins and ezetimibe, thus maintaining a high risk of new cardiovascular episodes. Purpose To evaluate, in a long follow-up, the effectiveness and the rapidity of alirocumab in the attainment and maintenance of LDL-cholesterol target values in patients at very high risk and intolerant to statins. Methods Our case studies consist of 72 patients, 80% males (58) and 20% females (14), with an average age of 61.9. 90.2% of patients were hypertensive. 5.5% had chronic kidney disease (CKD stage III). 65.2% had an ACS and the 34.7% had CeVD. 84.7% of the patients were in therapy only with ezetimibe while 15.3% in association with PUFA N-3. The average value of C-LDL was 169.2 mg/dl. The follow up was 24 months with clinical checks and C-LDL at 3,6,12 and 24 months. The dosage of alirocumab was both 75 and 150 mg Results At 3 months the reduction of C-LDL was 52.24%; at 6 months of 51.18%; at 12 months of 51.36% and at 24 months of 52.47%. The 37 patients who had started with 150 mg, had a very high average C-LDL base, 183.0 mg/dl, and showed a reduction of C-LDL to 3 months of 59.04%, to 6 months of 58.45%, to 12 months of 65.05%, to 24 months of 55.76%. The target value of C-LDL recommended by the ESC guidelines was reached for 42.10% at 3 months; for 52.63% at 6 months; for 63.15% at 12 months and for 73.68% at 24 months. 5.5% of patients with a CKD showed a 73.68% reduction in C-LDL values to 3 months, 65.22% to 6 months, 57.49% to 12 months and 53.95% to 24 months. The follow-up to the Tg study showed a reduction of 3.55% to 3 months, an increase of 8.75% to 6 months, a reduction of 1.65% to 12 months and 7.95% to 24 months. C-HDL values showed an increase of 4.55% at 3 months, 3.69% at 6 months, 10.97% at 12 months and 7.82% at 24 months.  Conclusions Our case studies have confirmed the effectiveness of alirocumab in reducing C-LDL values in patients at very high cardiovascular risk and the rapidity in reaching the target value set by guidelines for the management of cardiovascular risk. Our study also confirmed the its effectiveness in increasing the values of C-HDL while it was not possible to confirm the reduction of Tg values. % Alirocumab Efficacy C-LDL TGs C-HDL 3 MONTHS -52,24% -3,55% +4,55% 6 MONTHS -51,18% +8,75% +3,69% 12 MONTHS -51,36% -1,65% +10,97% 24 MONTHS -52,47% -7,95% +7,82% C-LDL: LDL-CHOLESTEROL TGs TRIGLYCERIDES C-HDL: HDL-CHOLESTEROL Abstract Figure. % Alirocumab Efficacy

scholarly journals GAMBARAN PROFIL LIPID PADA PENDERITA SINDROM KORONER AKUT DI RSUP. PROF. DR. R. D. KANDOU PERIODE JANUARI – SEPTEMBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Eva Nur Faridah ◽  
Janry A. Pangemanan ◽  
Starry H. Rampengan
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Ldl Cholesterol ◽  
Plaque Rupture ◽  
Hdl Cholesterol ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Cholesterol Levels ◽  
Low Hdl ◽  
St Elevation

Abstract: Acute coronary syndrome (ACS) is due to plaque rupture or erosion of atherosklerosis, including unstable angina pectoris, non-ST elevation myocardial infarction, and ST-elevation myocardial infarction. In indonesia, ACS is still regarded as the highest death contributor. One of the risk factors of ACS is dyslipidemia, that is abnormality condition of lipid in blood. Objective: This study aims to determine description of lipid profile in patients with acute coronary syndrome. Methods: This was a descriptive observational method, based on the secondary data from patients in CVBC Prof. Dr. R. D. Kandou Hospital during January to September 2015. Result: The result showed that from 80 patients of ACS were 37 patients (46,25%) with high total cholsterol levels (≥ 200 mg/dL), 70 patients (87,5%) with low HDL cholesterol levels (≤ 40 - 50 mg/dL), there are 58 patients (72,5%) with high LDL cholesterol levels (> 100 mg/dL) and 32 patients (40%) with high triglycerides levels (≥ 150 mg/dL). Conclusion: Most of ACS patients in this research had high LDL cholesterol levels and low HDL cholesterol levels.Keywords: Acute coronary syndrome, dyslipidemia, lipid profileAbstrak: Sindrom koroner Akut ( SKA ) terjadi karena adanya ruptur atau erosi dari plak aterosklerosis, termasuk angina pektoris tidak stabil, non-ST elevasi miokard infark, dan ST elevasi miokard infark. Di Indonesia, SKA masih di anggap sebagai penyumbang angka kematian tertinggi. Salah satu faktor risiko SKA adalah dislipidemia, yaitu berupa gangguan metabolisme lipid. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran profil lipid pada penderita sindrom koroner akut. Metode: Penelitian ini bersifat deskriptif observasional dengan menggunakan data sekunder dari penderita SKA di CVBC RSUP. Prof. Dr. R. D. Kandou periode januari – september 2015. Hasil: Hasil penelitian ini menunjukkan dari 80 penderita SKA didapatkan 37 orang (46,25%) adalah penderita yang memiliki kadar kolesterol total tinggi (≥ 200 mg/dL), sebanyak 70 orang (87,5%) memiliki kadar HDL rendah (≤ 40 – 50 mg/dL), adapun yang memiliki kadar LDL tinggi (> 100 mg/dL) yaitu 58 orang (72,5%) dan 32 orang (40%) adalah penderita yang memiliki kadar trigliserida tinggi (≥ 150 mg/dL). Kesimpulan: Penderita sindrom koroner akut dalam penelitian ini sebagian besar memiliki kadar kolesterol LDL yang tinggi dan kadar kolesterol HDL yang rendah.Kata kunci: Sindrom koroner akut, dislipidemia, profil lipid

scholarly journals Coronary lesion complexity in patients with heterozygous familial hypercholesterolemia hospitalized for acute myocardial infarction: data from the RICO survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hermann Yao ◽  
Michel Farnier ◽  
Laura Tribouillard ◽  
Frédéric Chague ◽  
Philippe Brunel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Ldl Cholesterol ◽  
Statin Treatment ◽  
Lipid Lowering ◽  
Syntax Score ◽  
Lipid Lowering Therapy ◽  
Lipid Clinic ◽  
Acute Mi ◽  
Artery Disease

Abstract Background Although patients with familial heterozygous hypercholesterolemia (FH) have a high risk of early myocardial infarction (MI), the coronary artery disease (CAD) burden in FH patients with acute MI remains to be investigated. Methods The data for all consecutive patients hospitalized in 2012–2019 for an acute MI and who underwent coronary angiography were collected from a multicenter database (RICO database). FH (n = 120) was diagnosed using Dutch Lipid Clinic Network criteria (score ≥ 6). We compared the angiographic features of MI patients with and without FH (score 0–2) (n = 234) after matching for age, sex, and diabetes (1:2). Results Although LDL-cholesterol was high (208 [174–239] mg/dl), less than half of FH patients had chronic statin treatment. When compared with non-FH patients, FH increased the extent of CAD (as assessed by SYNTAX score; P = 0.005), and was associated with more frequent multivessel disease (P = 0.004), multiple complex lesions (P = 0.022) and significant stenosis location on left circumflex and right coronary arteries. Moreover, FH patients had more multiple lesions, with an increased rate of bifurcation lesions or calcifications (P = 0.021 and P = 0.036, respectively). In multivariate analysis, LDL-cholesterol levels (OR 1.948; 95% CI 1.090–3.480, P = 0.024) remained an independent estimator of anatomical complexity of coronary lesions, in addition to age (OR 1.035; 95% CI 1.014–1.057, P = 0.001). Conclusions FH patients with acute MI had more severe CAD, characterized by complex anatomical features that are mainly dependent on the LDL-cholesterol burden. Our findings reinforce the need for more aggressive preventive strategies in these high-risk patients, and for intensive lipid-lowering therapy as secondary prevention.

scholarly journals Influence of Peripheral Artery Disease and Statin Therapy on Apolipoprotein Profiles

2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Andrew W. Gardner ◽  
Petar Alaupovic ◽  
Donald E. Parker ◽  
Polly S. Montgomery ◽  
Omar L. Esponda ◽  
...  
Keyword(s):  
Physical Activity ◽  
Myocardial Infarction ◽  
Statin Therapy ◽  
Peripheral Artery Disease ◽  
Apolipoprotein B ◽  
Ldl Cholesterol ◽  
Risk Profile ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Plasma Apolipoprotein

Apolipoprotein B is a stronger predictor of myocardial infarction than LDL cholesterol, and it is inversely related to physical activity and modifiable with exercise training. As such, apolipoprotein measures may be of particular relevance for subjects with PAD and claudication. We compared plasma apolipoprotein profiles in 29 subjects with peripheral artery disease (PAD) and intermittent claudication and in 39 control subjects. Furthermore, we compared the plasma apolipoprotein profiles of subjects with PAD either treated (n=17) or untreated (n=12) with statin medications. For the apolipoprotein subparticle analyses, subjects with PAD had higher age-adjusted Lp-B:C (P<0.05) and lower values of Lp-A-I:A-II (P<0.05) than controls. The PAD group taking statins had lower age-adjusted values for apoB (P<0.05), Lp-A-II:B:C:D:E (P<0.05), Lp-B:E + Lp-B:C:E (P<0.05), Lp-B:C (P<0.05), and Lp-A-I (P<0.05) than the untreated PAD group. Subjects with PAD have impaired apolipoprotein profiles than controls, characterized by Lp-B:C and Lp-A-I:A-II. Furthermore, subjects with PAD on statin medications have a more favorable risk profile, particularly noted in multiple apolipoprotein subparticles. The efficacy of statin therapy to improve cardiovascular risk appears more evident in the apolipoprotein sub-particle profile than in the more traditional lipid profile of subjects with PAD and claudication. This trial is registered with ClinicalTrials.govNCT00618670.

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