Effect of Partial Ileal Bypass Surgery on Mortality and Morbidity from Coronary Heart Disease in Patients with Hypercholesterolemia

Buchwald, Hēnry; Varco, Richard L.; Matts, John P.; Long, John M.; Fitch, Laurie L.; Campbell, Gilbert S.; Pearce, Malcolm B.; Yellin, Albert E.; Edmiston, W. Allan; Smink, Robert D.; Sawin, Henry S.; Campos, Christian T.; Hansen, Betty J.; Tuna, Naip; Karnegis, James N.; Sanmarco, Miguel E.; Amplatz, Kurt; Castańeda-Zúńiga, W R; Hunter, David W.; Bissett, Joe K.; Weber, Frederic J.; Stevenson, James; Leon, Arthur S.; Chalmers, Thomas C.

doi:10.1056/nejm199010043231404

Cited by 925 publications

(229 citation statements)

References 47 publications

Supporting

Mentioning

205

Contrasting

Unclassified

Order By: Relevance

“…When comparing statin and non-statin lipid-lowering trials, statin-treatment trials demonstrate benefits within 5 years compared with greater than 7 years for non-statin trials [28,29]. Furthermore, subgroup analysis of WOSCOPS and CARE studies indicate that, despite comparable serum cholesterol levels among patients in the statin and placebo groups, patients who are treated with statin have 47% lower risk of developing subsequent events [2,4].…”

Section: Clinical Trials With Statinsmentioning

confidence: 99%

Pleiotropic effects of statin therapy: molecular mechanisms and clinical results

Wang

Liu

Liao

2008

Trends in Molecular Medicine

536

394

View full text Add to dashboard Cite

Statins inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which is required for cholesterol biosynthesis, and are beneficial in the primary and secondary prevention of cardiovascular disease. Most of the benefits of statin therapy are owing to the lowering of serum cholesterol levels. However, by inhibiting HMG-CoA reductase, statins can also inhibit the synthesis of isoprenoids, which are important lipid attachments for intracellular signaling molecules, such as Rho, Rac and Cdc42. Therefore, it is possible that statins might exert cholesterol-independent or 'pleiotropic' effects through direct inhibition of these small GTP-binding proteins. Recent studies have shown that statins might have important roles in diseases that are not mediated by cholesterol. Here, we review data from recent clinical trials that support the concept of statin pleiotropy and provide a rationale for their clinical importance. [6], have demonstrated the beneficial effects of statin therapy for primary and secondary prevention of cardiovascular disease. Because 60-70% of serum cholesterol is derived from hepatic synthesis and HMG-CoA reductase is the crucial, rate-limiting enzyme in the cholesterol biosynthetic pathway, inhibition of this enzyme by statins results in a dramatic reduction in circulating low-density lipoprotein (LDL)-cholesterol (Figure 1). In addition, reduction of LDL-cholesterol leads to upregulation of the LDL receptor and increased LDL clearance. The lowering of serum cholesterol levels is therefore thought to be the primary mechanism underlying the therapeutic benefits of statin therapy in cardiovascular disease [1]. Pleiotropy of statins: beyond cholesterol loweringStatins, however, might also exert cholesterol-independent or pleiotropic effects. By inhibiting the conversion of HMG-CoA to L-mevalonic acid, statins prevent the synthesis of important isoprenoids, such as farnesylpyrophosphate (FPP) and geranylgeranylpyrophosphate (GGPP), which are precursors of cholesterol biosynthesis [7] (Figure 1). These intermediates serve as important lipid attachments for the post-translational modification of proteins, such as nuclear lamins, Ras, Rho, Rac and Rap [8]. These isoprenylated proteins constitute approximately 2% of total cellular proteins [9]. Protein isoprenylation (see Glossary) enables proper subcellular localization and trafficking of intracellular proteins. Given that isoprenylated proteins might

show abstract

Section: Clinical Trials With Statinsmentioning

confidence: 99%

Pleiotropic effects of statin therapy: molecular mechanisms and clinical results

Wang

Liu

Liao

2008

Trends in Molecular Medicine

536

394

View full text Add to dashboard Cite

show abstract

“…Procedures without gastric restriction, such as intestinal bypass or duodenal bypass, can produce only a minimal weight loss 101. VBG was the first successful bariatric procedure with a pure gastric restriction effect.…”

Section: Understanding the Mechanismmentioning

confidence: 99%

Recent advancements in bariatric/metabolic surgery

Lee

Almalki

2017

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Obesity and type 2 diabetes mellitus (T2DM) are currently two pan‐endemic health problems worldwide and are associated with considerable increase in morbidity and mortality. Both diseases are closely related and very difficult to control by current medical treatment, including diet, drug therapy and behavioral modification. Bariatric surgery has proven successful in treating not just obesity but also in significantly decreasing overall obesity‐associated morbidities as well as improving quality of life in severely obese patients (body mass index [BMI] >35 kg/m2). A rapid increase in bariatric surgery started in the 2000s when the laparoscopic surgical technique was introduced into this field. Many new procedures had been developed and changed the face of modern bariatric surgery. Recently, bariatric surgery played as gastrointestinal metabolic surgery has been proposed as a new treatment modality for obesity‐related T2DM for patients with BMI >35 kg/m2. Strong evidence has demonstrated that bariatric/metabolic surgery is an effective and durable treatment for obese T2DM patients. Bariatric/metabolic surgery is now becoming an important surgical division. The present article examines and discusses recent advancements in bariatric/metabolic surgery and covers four major fields: (i) the rapid increase in numbers and better safety; (ii) new procedures with better outcomes; (iii) from bariatric to metabolic surgery; and (iv) understanding the mechanisms and personalized treatment.

show abstract

“…Most of these tiñáis have shown slowing or arrest of progression of coronary atherosclerosis. Reports concerning femoral atherosclerosis are more scarce [7,[14][15][16]21,24,25], In several recent clinical trials on plasma lipid regu lation, measurements of carotid artery intima-media thickness (IMT) have been included, because coro nary and carotid atherosclerosis share coronary events as their major cause of morbidity and mortality [38][39][40][41]. Indeed, most of these studies have also shown a slowing of progression of IMT during lipid-lowering treatment.…”

Section: Introductionmentioning

confidence: 99%

LDL-cholesterol lowering and atherosclerosis - clinical benefit and possible mechanisms: an update

Stalenhoef

1997

The Netherlands Journal of Medicine

View full text Add to dashboard Cite

The results of several lipid-lowering randomized trials have been released during the past years and have confirmed the lipid hypothesis. Reduction of cholesterol by potent drugs in clinically symptomatic or asymptomatic patients with above-average cholesterol levels will substantially reduce the risk of coronary events. The present article gives a review of potent low-density lipoprotein cholesterol-lowering treatments and discusses developments in hypolipidaemic therapy in relation to recent primary and secondary prevention studies. In addition, possible mechanisms of cholesterol lowering in retardation of the atherosclerotic process are summarised. © 1997 Elsevier Science B.V.

show abstract

Effect of Partial Ileal Bypass Surgery on Mortality and Morbidity from Coronary Heart Disease in Patients with Hypercholesterolemia

Cited by 925 publications

References 47 publications

Pleiotropic effects of statin therapy: molecular mechanisms and clinical results

Pleiotropic effects of statin therapy: molecular mechanisms and clinical results

Recent advancements in bariatric/metabolic surgery

LDL-cholesterol lowering and atherosclerosis - clinical benefit and possible mechanisms: an update

Contact Info

Product

Resources

About