2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia

Virani, Salim S.; Morris, Pamela B.; Agarwala, Anandita; Ballantyne, Christie M.; Birtcher, Kim K.; Kris‐Etherton, Penny M.; Ladden-Stirling, Amanda B.; Miller, Michael; Orringer, Carl E.; Stone, Neil J.

doi:10.1016/j.jacc.2021.06.011

Cited by 173 publications

(135 citation statements)

References 104 publications

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“…Developed by authors of this review, the checklist includes core health behaviors (smoking, physical activity, diet, weight) and risk factors (blood pressure, cholesterol, diabetes). The checklist is based on the 2011 AHA and American College of Cardiology Foundation secondary prevention guidelines update, 27 the AHA My Life Check – Life’s Simple 7, 28 and the updated guidelines and expert consensus decision pathways from the AHA, American College of Cardiology, and the European Society of Cardiology/European Atherosclerosis Society for the management of blood pressure, 29 dyslipidemias, 20 , 30 , 31 , 32 overweight and obesity, 33 and diabetes. 34 …”

Section: Checklist Developmentmentioning

confidence: 99%

A Checklist Approach for Enhanced Outpatient Guideline-Directed Management in the Secondary Prevention of Atherosclerotic Cardiovascular Disease

Taha

Avenatti

et al. 2021

Methodist DeBakey Cardiovascular Journal

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Compelling results from clinical trials supporting intensive risk-reduction therapies to reduce associated morbidity and mortality in patients with established atherosclerotic cardiovascular disease (ASCVD) provided the impetus for medical societies to integrate these evidence-based results into clinical practice guidelines. Current evidence, however, points toward gaps in the management of patients with established ASCVD. Some of these gaps are related to barriers to guideline implementation, and strategies are needed to overcome these barriers. In this review, we propose a framework incorporating comprehensive tools for enhanced guideline-directed management in secondary prevention of ASCVD. This aid includes a 13-point checklist with supporting educational and system-based tools for effective evidence-based pharmacological and nonpharmacological care. This proposed tool targets primary care providers and cardiologists in the outpatient setting who provide direct medical care for patients with established ASCVD.

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Section: Checklist Developmentmentioning

confidence: 99%

A Checklist Approach for Enhanced Outpatient Guideline-Directed Management in the Secondary Prevention of Atherosclerotic Cardiovascular Disease

Taha

Avenatti

et al. 2021

Methodist DeBakey Cardiovascular Journal

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“…Limited data are available on ASCVD risk reduction using TG risk-based non-statin therapies for primary prevention in non-diabetic patients with persistent As early as the second year of life mild to moderate HTG [7]. Management of these patients is described in Fig.…”

Section: Management Of Htg In Patients Without Ascvd or Diabetes Mellitus (Dm)mentioning

confidence: 99%

“…Hypertriglyceridemia is defined as a fasting plasma/serum TG level > 150 mg/dL or a non-fasting TG level > 175 mg/dL. We endorse the definition proposed by the American College of Cardiology on persistent hypertriglyceridemia; Fasting triglycerides ≥ 150 mg/dL following a minimum of 4–12 weeks of lifestyle intervention, a stable dose of maximally tolerated statin therapy when indicated, as well as evaluation and management of secondary causes of hypertriglyceridemia [ 7 ].…”

Section: Scope Of the Articlementioning

confidence: 99%

“…HTG is an underappreciated risk factor that is often overshadowed by low-density lipoprotein cholesterol (LDL-C) and other chronic conditions [ 6 ]. Studies have shown that despite the use of statin therapy, atherosclerotic cardiovascular disease (ASCVD) event rates remain high in patients with elevated TG [ 7 ]. The importance of lowering plasma levels of TG is currently considered an integral part of residual cardiovascular risk reduction strategies [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Secondary causes of hypertriglyceridemiaSecondary causes of hypertriglyceridemia[7]:DiseasesUncontrolled diabetes mellitus, chronic kidney disease, nephrotic syndrome, hypothyroidism, Cushing's disease Metabolic and dietary disorders Overweight/obesity, metabolic syndrome, sedentary lifestyle, alcohol abuse or alcohol excess, diets high in saturated fat, sugar, or high-glycemic index foods, total parenteral nutrition with lipid emulsions Drugs Propofol, beta blockers, diuretics, thiazide and loop diuretic agents, bile acid sequestrants, glucocorticosteroids, anabolic steroids, oral estrogens, tamoxifen, HIV protease inhibitors, atypical antipsychotics, tacrolimus, sirolimus, cyclosporine, interferons…”

mentioning

confidence: 99%

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Egyptian practical guidance in hypertriglyceridemia management 2021

et al. 2021

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Hypertriglyceridemia (HTG) is a very common, yet underappreciated problem in clinical practice. Elevated triglyceride (TG) levels are independently associated with atherosclerotic cardiovascular disease (ASCVD) risk. Furthermore, severe HTG may lead to acute pancreatitis. Although LDL-guided statin therapy has improved ASCVD outcomes, residual risk remains. Recent trials have demonstrated that management of high TG levels, in patients already on statin therapy, reduces the rate of major vascular events. Few guidelines were issued, providing important recommendations for HTG management strategies. The goal of treatment is to reduce the risk of ASCVD and acute pancreatitis. The management stands on lifestyle modification, detection of secondary causes of HTG and pharmacological therapy, when indicated. In this guidance we review the causes and classification of HTG and summarize the current methods for risk estimation, diagnosis and treatment. The present guidance provides a focused update on the management of HTG, outlined in a simple user-friendly format, with an emphasis on the latest available data.

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Monocyte Differentiation‐Surveilling Nano‐Shuttles for Activatable Targeted Inhibition of Atherosclerotic Plaque Progression

Tao

Chen

et al. 2023

Adv Funct Materials

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Atherosclerosis can form intimal plaques in the arteries and undergo plaque rupture with followed stroke or myocardial infarction under certain pathological conditions. However, suboptimal intraplaque accumulation, along with severe off‐target effects, remain formidable obstacles for efficient pharmacotherapy of atherosclerosis. A characteristic feature of the progression of atherosclerosis is the continuous recruitment of inflammatory monocytes that differentiate into foamy macrophages with the generation of legumain in the plaques. In this study, a bio‐activatable nano‐shuttle based on human serum albumin is conceived that contained curcumin to allow the precise inhibition of atherosclerosis progression. Following intravenous injection, the nano‐shuttles are almost exclusively engulfed by inflammatory monocytes in an efferocytosis‐mimetic manner and selectively co‐migrated with the monocytes towards the plaques. The nano‐shuttles are readily activated to release the initially arrested curcumin in response to the generation of legumain upon the differentiation of monocytes into foamy macrophages within the plaques. Treatment assessments on atheroprone apolipoprotein‐E‐deficient mice indicated that the nano‐shuttles substantially inhibit the progression of atherosclerosis by attenuating the plaque inflammation burden without any obvious adverse effects. The integration of highly selective accumulation and specific drug activation of the nano‐shuttles in plaques can arouse an advanced therapeutic strategy to prevent atherosclerotic cardiovascular disease.

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2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia

Cited by 173 publications

References 104 publications

A Checklist Approach for Enhanced Outpatient Guideline-Directed Management in the Secondary Prevention of Atherosclerotic Cardiovascular Disease

A Checklist Approach for Enhanced Outpatient Guideline-Directed Management in the Secondary Prevention of Atherosclerotic Cardiovascular Disease

Egyptian practical guidance in hypertriglyceridemia management 2021

Monocyte Differentiation‐Surveilling Nano‐Shuttles for Activatable Targeted Inhibition of Atherosclerotic Plaque Progression

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