scholarly journals Akut coronariaszindróma miatt 2015-ben kezelt betegeink lipidcsökkentő terápiája

2018 ◽  
Vol 159 (12) ◽  
pp. 478-484
Author(s):  
László Márk ◽  
Mária Nagy ◽  
Győző Dani ◽  
Csaba Baranyai ◽  
Marianna Borbély ◽  
...  
Keyword(s):  
High Intensity ◽  
Goal Attainment ◽  
Cardiovascular Prevention ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Coronary Syndrome ◽  
Medical Visits ◽  
Lowering Therapy ◽  
Significant Difference

Abstract: Introduction: The actual guidelines of cardiovascular prevention lay special emphasis on the lipid-lowering therapy of patients suffering from acute coronary syndrome (ACS). Aim: To evaluate the occurrence of high-intensity statin therapy, recommended by guidelines, at discharge in a Hungarian county hospital with hemodynamic laboratory in patients who underwent percutaneous intervention, furthermore the LDL-cholesterol (LDL-C) levels and goal attainment rate in the first year. Method: Retrospective data collection from the hospital database regarding the therapy at discharge and the lipid levels in the year following the intervention due to ACS in 2015. Results: Due to ACS event, 454 patients had coronary intervention in 2015, at discharge more than 90% of them received high-intensity statin (more than 80% rosuvastatin, 40 mg) or corresponding combination therapy. In 154 cases we found half-year lipid results; the median of LDL-C was 1.9 mmol/L, the 1.8 mmol/L target value attainment rate was 48.7%. Results after one year were found in 292 cases (73% without the deceased and foreign patients); the LDL-C median proved to be 2.0 mmol/L, the target level attainment rate was 37.3%. There was no significant difference between the results of patients from the three different ACS forms and between those of men and women. Conclusions: The lipid lowering therapy of the revascularized patients who come back for medical visits is acceptable, but greater emphasis has to be laid on increasing the rate of controlled patients compared to the present two-thirds. Orv Hetil. 2018; 159(12): 478–484.

P830Differences in the usefulness of aggressive lipid-lowering therapy among single-vessel and multi-vessel coronary artery disease patients: HIJ-PROPER sub-study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Ogido ◽  
H Nomura ◽  
M Nakawaza ◽  
E Kawada-Watanabe ◽  
H Sekiguchi ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Invasive Strategy ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Single Vessel ◽  
Lowering Therapy ◽  
Significant Difference ◽  
Early Invasive Strategy

Abstract Background Acute coronary syndrome (ACS) patients with multi-vessel disease (MVD) are at high risk of recurrent cardiovascular events. Previous study, examining stable atherosclerotic cardiac disease, reported that aggressive lipid-lowering therapy was more beneficial in MVD patients than in single-vessel disease (SVD) patients. However, no report has investigated the effects of aggressive lipid-lowering treatment according to the number of diseased coronary arteries in ACS patients. Purpose The purpose of the present study was to elucidate the efficacy of aggressive lipid-lowering therapy in ACS patients with MVD and SVD in modern early invasive strategy era. Methods The study population was derived from the HIJ-PROPER study, in which, ACS patients with dyslipidemia were randomized to pitavastatin + ezetimibe therapy (targeting LDL-C less than 70mg/dl) or pitavastatin-monotherapy (targeting LDL-C less than 90mg/dl). In the present study, the treatment efficacy was compared between patients with MVD and SVD. The primary end point was a composite of major advanced cardiovascular events (MACEs), including all-cause death, non-fatal myocardial infarction, non-fatal stroke, and ischemia driven revascularization. Results We identified 1702 eligible patients (mean age, 65.6 years; male, 75.6%); 869 patients (51.1%) had MVD and 833 (48.9%) patients had SVD. The rate of acute revascularization was 96.2%. The incidence of MACEs was significantly higher in MVD group compared to SVD group (43.7% vs 25.9%, hazard ratio 1.95, 95% confidence interval 1.65–2.31, p<0.001). In MVD group, there was no significant difference in MACEs between pitavastatin + ezetimibe therapy and pitavastatin-monotherapy group. (43.5% vs. 43.9%, 1.0, 0.82–1.23; p=0.95). However, in SVD group, pitavastatin + ezetimibe therapy showed significantly fewer MACEs than pitavastatin-monotherapy (34.6% vs. 47.4%, 0.72, 0.55–0.94, p=0.02). (Figure) Conclusion This study showed that ACS patients with SVD enjoyed significantly greater benefits from pitavastatin + ezetimibe therapy compared with pitavastatin monotherapy, whereas the patients with MVD did not. High rate of revascularization in acute phase of ACS might affect the efficacy of aggressive lipid-lowering therapy and our results in the present study suggest different treatment approach would be necessary in ACS patients with MVD in modern early invasive strategy era.

Abstract 1520: Are Contemporary Patients Hospitalized with Acute Coronary Syndrome Being Discharged on Intensive Lipid Lowering Therapy?: An Analysis Of 22, 807 Hospitalizations In GWTG-CAD

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Prakash C Deedwania ◽  
Gregg C Fonarow ◽  
Christopher P Cannon ◽  
David Dai
Keyword(s):  
Acute Coronary Syndrome ◽  
Intensive Therapy ◽  
Female Gender ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Coronary Syndrome ◽  
Lowering Therapy ◽  
The Usa ◽  
And Gender ◽  
Get With The Guidelines

Background: Based on the documented benefits of intensive lipid lowering therapy (LLT) with statins in patients with acute coronary syndrome (ACS) guidelines recommend intensive LLT in ACS patients. However, little information is available regarding application of these guidelines in hospitalized ACS patients. Methods: The Get With The Guidelines database was analyzed for all ACS hospitalizations from 07/2005 to 04/2007 at 329 hospitals across the USA of which 277 sites reported the dose of LLT. Intensive LLT was defined as that expected to provide a >50% reduction in LDL: atorvastatin 40/80 mg, rosuvastatin 20/40 mg, simvastatin 80 mg, and any statin combined with ezetimibe. All other LLTs were considered less intensive therapy. Results: Of 60,453 ACS hospitalizations, 84.4% eligible were discharged on LLT. LLT dosing was available in 22,807 (37.7%). Of these patients only 8400 (36.8%) of ACS patients were treated at time of discharge with intensive LLT, whereas 63.2% were discharged on less intensive LLT. Comparison of demographic characteristic and clinical features revealed that older age and female gender were associated with use of less intensive LLT whereas patients undergoing PCI with a stent and history of smoking were more likely to receive intensive LLT. Admission LDL level was modestly predictive of more intensive LLT. Conclusions: In this large cohort of contemporary ACS patients, close to two-thirds of eligible patients were not discharged on intensive LLT. Age and gender appear to be significant contributors to less intensive LLT. These findings emphasize the ongoing need for implementation of current guidelines for intensive LLT in ACS patients.

FEATURES OF THE LIPID SPECTRUM IN PATIENTS WITH ACUTE CORONARY SYNDROME IN THE LONG-TERM PERIOD AFTER CORONARY ARTERY BYPASS GRAFTING

2021 ◽  
pp. 8-12
Author(s):  
М.А. НУРЖАНОВА ◽  
А.Е. ТЕМУРОВА ◽  
Ж.Ш. БАБАК ◽  
Г.Б. БЕКТІБАЙ ◽  
Ш.Б. БАТЫР ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Bypass Grafting ◽  
Coronary Syndrome ◽  
Lowering Therapy ◽  
Lipid Spectrum

В данной статье представлены особенности липидного спектра у пациентов с острым коронарным синдромом в отдаленном периоде после операции коронарного шунтирования (КШ), в сравнении групп с Инфарктом миокарда (ИМ) и Нестабильной стенокардии (НС), а также результаты приверженности к гиполипидемической терапии с особенностями достижения целевых уровней липидного спектра. Полученные результаты представляют, что по липидному спектру группы идентичны между собой и отличаются от нормы, пациенты с низкой приверженности к гиполипидемической терапии и не достигают целевых уровень по холестерин липопротеинов низкой плотности (ХС-ЛПНП) рекомендованным Европейского кардиологического общества (ESC, ЕОК) от 2019г. This article presents the features of the lipid spectrum in patients with acute coronary syndrome in the long-term period after coronary artery bypass grafting (CABG) surgery, in comparison with the groups with myocardial infarction and Unstable angina pectoris, as well as the results of adherence to lipid-lowering therapy with particularities of achieving target levels of the lipid spectrum. The results obtained represent that in terms of the lipid spectrum the groups are identical and differ from the norm, patients with low adherence to lipid-lowering therapy and do not reach the target levels for low-density lipoprotein cholesterol (LDL-C) recommended by the European Society of Cardiology (ESC) from 2019.

scholarly journals Application of the 2019 ESC/EAS dyslipidaemia guidelines to nationwide data of patients with a recent myocardial infarction: a simulation study

2020 ◽  
Vol 41 (40) ◽  
pp. 3900-3909 ◽  
Author(s):  
Ali Allahyari ◽  
Tomas Jernberg ◽  
Emil Hagström ◽  
Margrét Leosdottir ◽  
Pia Lundman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Intensity ◽  
Low Density Lipoprotein ◽  
Monte Carlo Model ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Pcsk9 Inhibitors ◽  
Recent Myocardial Infarction ◽  
Lowering Therapy

Abstract Aims To estimate the proportion of patients with a recent myocardial infarction (MI) who would be eligible for additional lipid-lowering therapy according to the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines for the management of dyslipidaemias, and to simulate the effects of expanded lipid-lowering therapy on attainment of the low-density lipoprotein cholesterol (LDL-C) target as recommended by the guidelines. Methods and results Using the nationwide SWEDEHEART register, we included 25 466 patients who had attended a follow-up visit 6–10 weeks after an MI event, 2013–17. While most patients (86.6%) were receiving high-intensity statins, 82.9% of the patients would be eligible for expanded lipid-lowering therapy, as they had not attained the target of an LDL-C level of &lt;1.4 mmol and a ≥50% LDL-C level reduction. When maximized use of high-intensity statins followed by add-on therapy with ezetimibe was simulated using a Monte Carlo model, the LDL-C target was reached in 19.9% using high-intensity statin monotherapy and in another 28.5% with high-intensity statins and ezetimibe, while 50.7% would still be eligible for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. When use of alirocumab or evolocumab was simulated in those who were eligible for PCSK9 inhibitors, around 90% of all patients attained the LDL-C target. Conclusion  Our study suggests that, even with maximized use of high-intensity statins and ezetimibe, around half of patients with MI would be eligible for treatment with PCSK9 inhibitors according to the 2019 ESC/EAS guidelines. Considering the current cost of PCSK9 inhibitors, the financial implications of the new guidelines may be substantial.

scholarly journals Prevalence of Dyslipidemia and Goal Attainment with Lipid-Lowering Therapy: Insights from Thai Multicenter Study and Overview of the Major Guidelines

Dyslipidemia ◽  
2019 ◽  
Author(s):  
Songkwan Silaruks ◽  
Charn Sriratanasathavorn ◽  
Petch Rawdaree ◽  
Rapeephon Kunjara-Na-Ayudhaya ◽  
Bandit Thinkhamrop ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Goal Attainment ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy

Becoming more focused therapeutic lipid patterns: results from the Hungarian MULTI GAP 2010

2011 ◽  
Vol 152 (21) ◽  
pp. 822-827 ◽  
Author(s):  
István Reiber ◽  
György Paragh ◽  
László Márk ◽  
Gyula Pados
Keyword(s):  
High Risk ◽  
Goal Attainment ◽  
Treatment Strategies ◽  
Hdl Cholesterol ◽  
High Risk Group ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Frequent Use ◽  
Risk Patients

Previous studies have found that many high-risk patients are not achieving their LDL-cholesterol goals, and many patients, despite being treated with lipid-lowering therapy, also have elevated triglycerides and/or low levels of HDL-cholesterol. Aims: Authors analyzed the treatment strategies for dyslipidemic subjects following cardiovascular events similarly to their former survey from 2008 and 2009. Methods: In the MULTI GAP (MULTI Goal Attainment Problem) 2010 trial data from standard and structured questionnaires of 2332 patients were processed. Authors analyzed the proportion of the patients reaching target levels for total cholesterol, LDL-C, HDL-C, A-C (atherogen cholesterol) and triglyceride. Results: 15% (n = 355) of the patients did not receive any lipid lowering treatment. 44% of the patients treated by specialists reached the target LDL-C level of 2.5 mmol/l. In „high risk” group target levels for HDL-C were reached by 61% of the patients, and for triglyceride by 43% of the subjects. 43% of the patients with the best compliance (>90%) reached the target LDL-C level of 2.5 mmol/l. Conclusion: There is a need for more effective lipid lowering therapy with more frequent use of higher doses of statins or combinations of lipid lowering drugs. Orv. Hetil., 2011, 152, 822–827.

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