American Association Of Clinical Endocrinologists And American College Of Endocrinology Guidelines For Management Of Dyslipidemia And Prevention Of Cardiovascular Disease - Executive Summary

Jellinger, Paul S.; Handelsman, Yehuda; Rosenblit, Paul D.; Bloomgarden, Zachay T.; Fonseca, Vivian; GARBER, A; Grunberger, George; Guerin, Chris; Bell, DavidS H.; Mechanick, Jeffrey I.; Pessah-Pollack, Rachel; Wyne, Kathlen; Smith, Donal; Brinton, Eliot A.; Fazio, Sergio; Davidson, Michel; Zangeneh, Farhd; Bush, Michel A.

doi:10.4158/ep171764.gl

Cited by 185 publications

(127 citation statements)

References 9 publications

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“…Patients with a history of premature ASCVD were also included in the Extreme Risk group. Treatment goals included an LDL-C <55 mg/dL, with consideration also given to non-HDL-C and Apo B levels [10].…”

Section: Introductionmentioning

confidence: 99%

Lipid Control Post Coronary Artery Bypass Graft: One Year Follow-Up of a Middle-Eastern Cohort

Atallah

Khaddage

Sadik

et al. 2020

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Background: Data on patient characteristics and provider practices in the management of lipids per the new guidelines in specific secondary prevention patients in the Middle East is limited. Objective: To explore patient characteristics and lipid management practices according to the new cholesterol guidelines in secondary prevention patients, up to one year following discharge for coronary artery bypass graft surgery (CABG). Methods: A retrospective chart review of patients discharged post CABG between February 2017 and February 2018 at a quaternary care centre in the Middle East. Patients were characterized by baseline demographics, comorbidities, and use of lipid lowering medications. Results: 189 patients were included in the analysis. Most were diabetic (70.9%) and classified as very high risk per the ACC/AHA guidelines (84.1%) and as extremely high risk per the AACE guidelines (85.2%). Most patients (93.1%) were discharged on high intensity statin. About one third (28.6%) were never seen or only followed once within the first 2 weeks post discharge. Of those who continued to follow up beyond 3 months and within 1 year of discharge (44.4%), about half (51.2%) had follow-up lipid panels performed. Patients who followed up and were seen by a cardiologist were five times more likely to have lipid panels ordered than those seen solely by a CT surgeon. Of those with follow-up lipid panels beyond 3 months: 59.3% achieved LDL goal of <70 mg/dL and 29% achieved LDL <55 mg/dL based on their respective goals. Conclusions: Most patients undergoing CABG in a quaternary care centre in the Middle East are high risk ASCVD. Nonetheless, lipid goals are not commonly achieved nor routinely monitored. Providers will need to transition from the previous risk stratification and statin-only focused approach to adopt the most recent guidelines.

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Section: Introductionmentioning

confidence: 99%

Lipid Control Post Coronary Artery Bypass Graft: One Year Follow-Up of a Middle-Eastern Cohort

Atallah

Khaddage

Sadik

et al. 2020

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confidence: 99%

Prevalence of United States adults with triglycerides ≥ 135 mg/dL: NHANES 2007–2014

et al. 2019

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Hypertriglyceridemia is associated with increases in atherosclerotic cardiovascular disease (ASCVD) risk and remains prevalent among adults in the United States (US) due to an increasing prevalence of obesity, insulin resistance, diabetes mellitus, and other risk factors. Guidelines suggest target triglycerides (TG) should be < 150 mg/dL [1]. However, a number of studies have suggested that reduced cardiovascular risk is associated with lower TG [2][3][4]. Indeed, ASCVD risk remains even in patients with moderately elevated TG despite the control of low-density lipoprotein cholesterol (LDL-C) with statin therapy [2,[4][5][6]. The recently completed REDUCE-IT trial investigated the effects of icosapent ethyl 4 g/day in statin-treated patients with established cardiovascular disease, diabetes and other risk factors and TG 135-499 mg/dL. REDUCE-IT found a significant reduction in major adverse cardiovascular events when compared with a placebo (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.68-0.83; p < 0.001) over a median follow-up time of 4.9 years [4]. Subgroup analyses showed similar risk reduction both in persons with or without baseline TG ≥ 150 mg/dL [4]. Based on the findings of REDUCE-IT, the American Diabetes Association Standards of Care now includes a Level A recommendation that icosapent ethyl be considered for reducing cardiovascular risk in statin-treated patients with controlled LDL-C, elevated TG (135-499 mg/dL), diabetes, ASCVD or other cardiac risk factors [7].The objective of this analysis was to examine the prevalence of TG ≥ 135 mg/dL in the overall US adult population and in those treated with statins, in accordance with the presence of ASCVD and/ /or diabetes.This analysis included laboratory data, medical history, and prescription data from subjects aged 20 years and older who participated in the US National Health and Nutrition Examination Survey (NHANES;2007-2014 and had morning fasting TG available. For the current report, the proportion and number (weighted in millions to the US population) of individuals with TG ≥ 135 mg/dL was estimated according to the following factors: statin use, LDL-C < 100 mg/dL, diabetes, ASCVD, and/or age ≥ 45 years, as well as the proportion and number of individuals with multiple risk factors. All analyses used the NHANES 8-year sample weighting to project the US population in millions. The general methodology of NHANES data collection was published previously [8].Diabetes was defined as fasting glucose ≥ 126 mg/dL, non-fasting glucose ≥ 200 mg/dL, taking insulin or other medications to lower blood sugar, or diagnosed by a healthcare provider. LDL-C was calculated by the Friedewald equation.The study sample included 40,617 individuals in the NHANES 2007-2014 survey. A total of 9593 subjects, projected to represent 219.9 million US adults, met the entry criteria and were included in the analysis. As shown in Table 1, the overall proportion of US adults with TG ≥ 135 mg/dL was 32.1% (representing 70.5 million individuals). Among statin-treated adults, ...

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“…Aggressive actions to reduce LDL cholesterol are recommended for patients at a higher risk of developing cardiovascular disease (CVD). [3,4] Statins are currently used as first-line therapy for dyslipidemia because they have clear prognostic benefits, such as decreasing CVD incidence and increasing survival rate by lowering LDL cholesterol, with relatively low side effects. [5] Atorvastatin is Atorvastatin and ezetimibe are frequently co-administered to treat patients with dyslipidemia for the purpose of low-density lipoprotein cholesterol control.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic drug interaction between atorvastatin and ezetimibe in healthy Korean volunteers

Park

Kim

Jin

et al. 2017

Transl Clin Pharmacol

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American Association Of Clinical Endocrinologists And American College Of Endocrinology Guidelines For Management Of Dyslipidemia And Prevention Of Cardiovascular Disease - Executive Summary

Cited by 185 publications

References 9 publications

Lipid Control Post Coronary Artery Bypass Graft: One Year Follow-Up of a Middle-Eastern Cohort

Lipid Control Post Coronary Artery Bypass Graft: One Year Follow-Up of a Middle-Eastern Cohort

Prevalence of United States adults with triglycerides ≥ 135 mg/dL: NHANES 2007–2014

Pharmacokinetic drug interaction between atorvastatin and ezetimibe in healthy Korean volunteers

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