scholarly journals The usual dosage regimen of statins and adherence to target LDL-cholesterol levels by Czech patients in the secondary prevention of coronary heart disease

Cor et Vasa ◽  
2009 ◽  
Vol 51 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Otto Mayer ◽  
Jaroslav Šimon ◽  
Jan Bruthans ◽  
Markéta Galovcová ◽  
Jana Hrbková ◽  
...  
2017 ◽  
Vol 4 (1) ◽  
pp. 39-44
Author(s):  
Ni Made Restina Juliani ◽  
I Putu Oka Dharmawan ◽  
Putu Ayu Parwati

Introduction: Low Density Lipoprotein (LDL) is a type of low-density lipoprotein and the most widely transported cholesterol in the body. Increased levels of LDL in the body can be affected by genetics, age, gender, obesity, physical activity, lifestyle, drug consumption and smoking. Substances in a cigarette can cause an increase of LDL levels. Increased of LDL cholesterol levels can cause Coronary Heart Disease (CHD). The purpose of this research is to know the description of Low Density Lipoprotein (LDL) levels on smoker and non-smoker adolescent in Buyan Hamlet, Pancasari Village, Sukasada District, Buleleng Bali. Method: The type of this research is descriptive. This research was conducted in April-May 2017, which used fasting blood samples of 42 respondents. Result: From the average result of LDL level in smoker adolescent that is 134,91 mg/dL higher than the average of LDL level in non-smoker adolescent that is 74,90 mg/dL. The result of LDL cholesterol levels was determined by 21 smoker adolescent respondents with the close to optimal category (100-129 mg/dL) as many as 9 people (42,8%), and 12 people (57,3%) with worry category (130-159 mg/dL). Whereas in 21 non-smoker adolescent respondents obtained  result of LDL cholesterol level test with optimal category (<100 mg/dL) counted 18 people (87,71%) and 3 person (14,30%) with close to optimal category (100-129 mg/dL). Discussion: Based on the results of this research can be concluded that in smoker adolescent obtained LDL levels with close to optimal category and worrying whereas in non-smoker adolescents obtained LDL levels in the optimal category and close to optimal.


Author(s):  
Dona Liazarti ◽  
May Valzon

Increased cholesterol levels are the main cause of coronary heart disease. The results of examining LDL must be precise and accurate, but direct LDL examination (LDL-Direct) is quite expensive to do in a place with limited facilities so various experiments are carried out to get LDL formula (LDL-Cal) that is appropriate than formula commonly used, Friedewald formula. The aimed of this study was to determine the correlation between LDL cholesterol from calculation a number formulas with direct LDL cholesterol in order to obtain the best formula to be applied in laboratory of Lubuk Sikaping Hospital. This research was conducted on 75 patients who did lipid profile examination in laboratory of Lubuk Sikaping Hospital, who meet the inclusion criteria. Examination of total cholesterol, HDL, LDL and triglycerides were carried out by enzymatic methods on clinical chemistry analyzer. LDL cholesterol also calculated by several formulas namely Friedelwald formula (TC- (TG/5) -HDL), Chen formula (90% nonHDLC-10% TG), Anandaraja formula (0.9 TC- (0.9 TG/5) -28), Puavilai formula (TC-HDLC-TG/6), Vujovic formula (TC-HDLC-TG/3), and Cordova formula (3/4 (TC-HDLC.) Bland & Altman plot was used to compare the calculated LDL cholesterol level of each formula with the direct LDL. The mean LDL levels were 136.41 (35.92); 116.64 (32.72); 117.03 (30.83); 121.95 (32.79); 121.83 (33.23); 96.84 (32.47); 109.97 (28.24) for Direct, Friedelwald, Chen, Anandaraja, Puavilai, Vujovic, and Cordova respectively. Based on the Bland & Altman Plot, the calculation of LDL cholesterol from the Chen formula has the best compatibility with LDL-Direk with the mean difference of 19.3867 ± 19.0489 mg / dl at triglyceride levels <400 mg / dl, so it can be applied at RSUD Lubuk Sikaping with limited facilities. Keywords: LDL Cholesterol; LDL-Direct; LDL-CalAbstrakPeningkatan kadar kolesterol merupakan penyebab utama penyakit jantung koroner. Hasil pemeriksaan kadar LDL serum harus tepat dan akurat, namun pemeriksaan kadar LDL secara langsung (LDL-Direk) cukup mahal untuk dilakukan di tempat dengan fasilitas terbatas sehingga dilakukan berbagai percobaan untuk mendapatkan formula perhitungan LDL (LDL-Cal) yang lebih tepat dibandingkan formula yang telah umum digunakan yaitu formula Friedewald. Penelitian ini bertujuan untuk mengetahui kesesuaian antara kolesterol LDL hasil perhitungan sejumlah formula dengan kolesterol LDL direk sehingga diperoleh formula perhitungan terbaik untuk dapat diterapkan di laboratorium RSUD Lubuk Sikaping. Penelitian ini dilakukan terhadap 75 orang pasien yang melakukan pemeriksaan profil lipid lengkap ke Laboratorium RSUD Lubuk Sikaping. yang memenuhi kriteria inklusi. Pemeriksaan kolesterol total, HDL, LDL dan trigliserida dilakukan dengan metode enzimatik pada alat kimia klinik otomatis. Untuk kolesterol LDL juga dihitung dengan beberapa rumus yaitu formula Friedelwald (TC-(TG/5)-HDL). formula Chen (90%nonHDLC-10%TG), formula Anandaraja (0.9 TC- (0.9 TG/5)-28), formula Puavilai (TC-HDLC-TG/6), formula Vujovic (TC-HDLC-TG/3), dan formula Cordova (3/4 (TC-HDLC). Bland & Altman plot digunakan untuk membandingkan antara kadar kolesterol LDL hasil hitung masing-masing formula dengan LDL direk. Rerata kadar LDL (mg/dl) berturut-turut adalah 136,41 (35,92); 116,64 (32,72); 117,03 (30,83); 121,95 (32,79); 121,83 (33,23); 96,84 (32,47); 109,97 (28,24) untuk LDL-Direk, Friedelwald, Chen, Anandaraja, Puavilai, Vujovic, dan Cordova. Berdasarkan Bland & Altman Plot, perhitungan kolesterol LDL Formula Chen memiliki kesesuaian paling baik dengan LDL-Direk dengan selisih rerata 19,3867 ± 19,0489 mg/dl pada kadar trigliserida < 400 mg/dl, sehingga dapat diterapkan di RSUD Lubuk Sikaping dengan fasilitas yang terbatas.


2001 ◽  
Vol 7 (1) ◽  
pp. 28-32
Author(s):  
Mary Seed ◽  
R Mandeno ◽  
C Le Roux

This review summarises current evidence for therapeutic options for hyperlipidaemia in post menopausal women. The two situations in which treatment is recommended are: 1. Primary prevention, which requires assessment of total risk factors for coronary heart disease. a) Statins. AFCAPS/TEXCAPS is the only randomised controlled trial (RCT) to include women. Fewer coronary heart disease (CHD) events, but no difference in mortality was found. b) Hormone replacement therapy (HRT). While there are numerous reports of positive observational epidemiological studies for HRT, there are no completed RCTs. There is little evidence for statin use in women except for familial hypercholesterolaemia. HRT is therefore not only appropriate for its multiple effects on lipoproteins, vascular function and insulin sensitivity but also for prevention of osteoporosis. 2. Secondary prevention, to achieve target total and low density lipoprotein (LDL) cholesterol. a) Statins. The major measurable effect of these drugs is to reduce total and LDL cholesterol. In the RCTs 4S, CARE and LIPID, where 20% of subjects were female, CHD events, but neither CHD mortality nor total mortality were significantly reduced in women. b) HRT. Data available from two RCTs using conjugated equine oestrogens and medroxyprogesterone acetate show no benefit. Other studies of HRT have been observational and positive. The effects of treatment on lipoproteins with statins, HRT and the combination have been investigated. In secondary prevention for hyperlipidaemic women to achieve cholesterol <5 and LDL<3 mmol/L statins will be first choice, with HRT a possible addition for its other benefits on cardiovascular risk factors. Choice of HRT medication. The route of administration will affect specific risk factors, eg, oral oestrogen reduces Lp(a) and LDL, increases HDL, while the transdermal route is less effective at reducing Lp(a) and LDL but does not increase triglyceride. Both routes reduce fibrinogen, factor VII and adhesion molecules and improve blood flow. The choice of progestogen will also affect cardiovascular risk factors. The most important lipid risk factors in women are HDL, triglyceride and Lp(a). The risk associated with raised triglyceride and LDL is offset by high HDL. Thus, in women with risk factors in primary prevention, theoretically oral HRT with a non-androgenic progestogen is likely to be of most benefit. However, since long-term adherence to therapy is important in reducing cardiovascular risk, the individual's choice of route and type of HRT is paramount.


2021 ◽  
Author(s):  
Thomas Wittlinger ◽  
Bernhard Schwaab ◽  
Heinz Voeller ◽  
Christa Bongarth ◽  
Viktoria Heinze ◽  
...  

Abstract BackgroundCardiac rehabilitation (CR) in patients with coronary heart disease (CHD) aims to increase adherence to a healthy lifestyle and to secondary preventive medication. CR is able to improve quality of life and prognosis in CHD patients. This is particularly relevant for CHD patients with diabetes mellitus.DesignA prospective, multicenter registry study with patients from six rehabilitation centers in Germany.MethodsDuring CR, 1100 patients with a minimum age of 18 years and CHD documented by coronary angiography were included in a LLT registry.ResultsIn 369 patients (33.9 %), diabetes mellitus was diagnosed. Diabetic patients were older (65.5 ± 9.0 vs. 62.2 ± 10.9 years, p < 0.001) than nondiabetic patients and more likely to be obese (BMI: 30.2 ± 5.2 kg/m2 vs. 27.8 ± 4.2 kg/m2, p < 0.001). Analysis indicated that diabetic patients were more likely to show LDL cholesterol levels below 55 mg/dL than patients without diabetes at the start of CR (Odds Ratio (OR) 1.9; 95 % CI 1.3 to 2.9) until 3 months of follow-up (OR 1.9; 95 % CI 1.2 to 2.9). During 12 months of follow-up, overall and LDL cholesterol levels decreased within the first 3 months and remained at the lower level thereafter (p < 0.001), irrespective of prevalent diabetes. At the end of the follow-up, LDL cholesterol did not differ significantly between patients with or without diabetes mellitus (p = 0.413).ConclusionWithin 3 months after CR, total and LDL cholesterol were significantly reduced, irrespective of prevalent diabetes mellitus. In addition, CHD patients with diabetes responded faster to LTT than nondiabetic patients, suggesting that diabetic patients benefit more from LLT treatment during CR.


Cor et Vasa ◽  
2019 ◽  
Vol 61 (1) ◽  
pp. 20-27
Author(s):  
Pavla Vorlíčková ◽  
Otto Mayer ◽  
Jan Bruthans ◽  
Jitka Seidlerová ◽  
Julius Gelžinský ◽  
...  

2021 ◽  
Vol 9 (E) ◽  
pp. 798-804
Author(s):  
Juniarty Naim ◽  
Wahiduddin Wahiduddin ◽  
Masni Masni ◽  
Ridwan Amiruddin ◽  
Irwandy Irwandy ◽  
...  

BACKGROUND: Cardiovascular diseases (CVDs) are the main causes of death worldwide, including in the hajj pilgrims. Coronary heart disease (CHD) is the most common CVDs in Indonesian hajj pilgrims hospitalized in Saudi Arabia. AIM: This study aimed to determine the determinants of the CHD incidence among Indonesian hajj pilgrims hospitalized in Saudi Arabia in 2019. METHODS: This study was an observational analytic study with a case–control design. The study was conducted in Makassar using data from the integrated Hajj computerized system in the health sector (siskohatkes) Hajj Health Center (Puskeshaji) in January–June 2021. Cases were pilgrims hospitalized in Saudi Arabia with a diagnosis of CHD, about 186 people, and controls were pilgrims hospitalized with diagnoses other than CVDs. Selection of controls by matching age and sex with a ratio of 1:1. The determinants analyzed included education, high blood pressure, high blood sugar levels, high low-density lipoprotein (LDL) cholesterol levels, excess body mass index (BMI), and smoking. Data analysis was using the STATA program with an odds ratio (OR) test and multiple logistic regression. RESULTS: The most respondents were 65 years (48.39%), female respondents, about 61.83%. Most respondents’ education was in elementary school, about 31.99%. Multivariate analysis showed that high blood pressure (OR = 2.32, 95% confidence index [CI] = 1.50–3.57), high blood sugar levels (RO = 1.90, 95% CI = 1.06–3.40), high LDL cholesterol levels (RO = 1.82, 95% CI = 1.15–2.88), and excess BMI (RO = 1.73, 95% CI = 1.07–2.68) were risk factors for the CHD incidence. However, education and smoking were not risk factors for CHD. CONCLUSION: By multiple logistic regression analyzes, the study revealed that the probability of CHD when having those four risk factors was 85.69%.


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