LDL-C: lower is better for longer—even at low risk

Penson, Peter E.; Pirro, Matteo; Banach, Maciej

doi:10.1186/s12916-020-01792-7

Cited by 88 publications

(60 citation statements)

References 48 publications

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“…In the general population, it is dyslipidemia that is the major contributing factor to atherosclerosis, and CVD [ 17 , 18 ]. Our previous studies, among others, have demonstrated that profound lipid abnormalities in renal transplant recipients are present, and not limited solely to increased cholesterol and triglycerides concentrations, but consisting also of severe disturbances of the FA profile [ 6 , 7 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Serum Fatty Acids Profile in Kidney Transplant Recipients

et al. 2021

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Patients with end-stage kidney disease, treated with renal transplantation, are at increased risk of cardio-vascular disease (CVD) and cardio-vascular mortality. They are also characterized by an atherogenic dyslipidemia. Alterations of the fatty acids (FA) profile contribute to increased cardio-vascular risk in the general population. In the current study, we test the hypothesis that kidney transplantation is associated with ab-normalities in FA profile. The FA profile was analyzed by gas chromatography–mass spectrometry in 198 renal transplant recipients, and 48 control subjects. The most profound differences between renal transplant patients and controls were related to the content of branched chain FA, monounsaturated FA, and n-6 polyunsaturated FA, respectively. The FA profile significantly separated the patients from the controls in the principal component analysis (PCA). The abnormalities of FA profile showed a tendency for normalization in long-term kidney recipients, as compared to patients with recent transplants. The n-3 PUFA content demonstrated a strong inverse association with the presence of inflammation. Most profound alterations of the FA profile were observed in patients with impaired graft function (glomerular filtration rate < 45 mL/min). The study demonstrated significant disorders of the FA profile in kidney transplant recipients, which might contribute to cardio-vascular risk in this vulnerable patient population.

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Section: Discussionmentioning

confidence: 99%

Analysis of Serum Fatty Acids Profile in Kidney Transplant Recipients

et al. 2021

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“…It is also important that patients are at LDL-C goal as early as possible and as long as possible, preferably lifelong. Therefore, clinicians should always consider "the lower the better" together with "the earlier the better" and "the longer the better" management strategies [17,18].…”

Section: Ldl-cholesterol Managementmentioning

confidence: 99%

Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force

et al. 2021

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Background and aims: This European Atherosclerosis Society (EAS) Task Force provides practical guidance for combination therapy for elevated low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) in highrisk and very-high-risk patients. Methods: Evidence-based review. Results: Statin-ezetimibe combination treatment is the first choice for managing elevated LDL-C and should be given upfront in very-high-risk patients with high LDL-C unlikely to reach goal with a statin, and in primary prevention familial hypercholesterolaemia patients. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be added if LDL-C levels remain high. In high and very-high-risk patients with mild to moderately elevated TG levels (>2.3 and < 5.6 mmol/L [>200 and < 500 mg/dL) on a statin, treatment with either a fibrate or high-dose omega-3 fatty acids (icosapent ethyl) may be considered, weighing the benefit versus risks. Combination with fenofibrate may be considered for both macro-and microvascular benefits in patients with type 2 diabetes mellitus. Conclusions: This guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.

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“…Elevated serum low-density lipoprotein cholesterol (LDL-C) is an established risk factor for atherosclerotic cardiovascular (CV) disease [1][2][3]. For the general population and those at increased CV risk, decreasing the LDL-C by dietary adjustment represents the primary method of CV risk reduction and therefore deserves special emphasis in the evaluation of lifestyle changes [2].…”

Section: Introductionmentioning

confidence: 99%

Postmarketing nutrivigilance safety profile: a line of dietary food supplements containing red yeast rice for dyslipidemia

et al. 2021

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IntroductionIn the absence of a European standardized postmarketing food supplement surveillance system (nutrivigilance), some member states and companies have developed their own approaches to monitoring potential adverse reactions to secure a high level of product safety. This paper describes the use of a nutrivigilance system in monitoring the incidence of spontaneously reported suspected adverse reactions associated with food supplements containing red yeast rice (RYR).Material and methodsWe report the data from a widely used product marketed under the trademark Armolipid/Armolipid Plus. Postmarketing information was collected in a voluntary nutrivigilance system established by the manufacturing company (Meda Pharma SpA, a Viatris Company, Monza, Italy). From 1st October 2004 to 31st December 2019, this system captured cases of suspected adverse reactions spontaneously reported by consumers, healthcare professionals, health authorities, regardless of causality.ResultsThe total number of case reports received mentioning the RYR food supplement product line was 542, in which 855 adverse events (AEs) were reported. The total reporting rate of AEs was estimated to be 0.037% of 2,287,449 exposed consumers. Of the 542 cases, 21 (0.0009% of exposed consumers) included suspected serious adverse events (SAEs). After careful investigation, 6 cases (0.0003% of consumers exposed) and 6 AEs were assessed by the manufacturer as serious and potentially related to exposure to the above-mentioned RYR-based nutraceutical.ConclusionsThis nutrivigilance-derived data analysis clearly demonstrates a low prevalence of suspected adverse events associated with the red yeast rice product line. Consumer safety of food supplements could be generally improved by raising awareness of the importance of following the indications and warnings detailed in a food supplement’s labeling.

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LDL-C: lower is better for longer—even at low risk

Cited by 88 publications

References 48 publications

Analysis of Serum Fatty Acids Profile in Kidney Transplant Recipients

Analysis of Serum Fatty Acids Profile in Kidney Transplant Recipients

Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients: A statement from a European Atherosclerosis Society Task Force

Postmarketing nutrivigilance safety profile: a line of dietary food supplements containing red yeast rice for dyslipidemia

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