#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Why not to interfere with LDL-cholesterol freefall and why not to talk badly about statins


Authors: Jan Piťha 1,2
Authors‘ workplace: Interní klinika 2. LF UK a FN Motol, Praha 1;  Laboratoř pro výzkum aterosklerózy Centra experimentální medicíny IKEM, Praha 2
Published in: Vnitř Lék 2018; 64(12): 1169-1175
Category:

Overview

Thanks to new drugs and treatments it is now possible, and therefore also advisable, to achieve very low LDL-cholesterol levels. This is primarily the inhibition of the proproteinconvertase subtilisin kexin 9 and LDL apheresis. Despite these new procedures, they remain the main antagonist of atherosclerosis and atherogenic dyslipidemia of statins. Statins are the basis of treatment always. If they are not enough or if they actually cause uncontrollable difficulties, they can be supplemented or replaced by other medications or treatments that reduce values of LDL-cholesterol. Often, however, their full potential is not fully exploited, and there are still completely unjustified concerns about their frequent and dangerous undesirable effects. We did our best to discuss this topic in more detail in this article.

Key words:

aggressive treatment – LDL-cholesterol – statins


Sources
  1. Welty FK. Hypobetalipoproteinemia and abetalipoproteinemia. Curr Opin Lipidol 2014; 25(3): 161–168. Dostupné z DOI: <http://dx.doi.org/10.1097/MOL.0000000000000072>.
  2. Cohen JC, Boerwinkle E, Mosley TH Jret al. Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N Engl J Med 2006; 354(12): 1264–1272. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa054013>.
  3. Piťha J Novinky v léčbě hyperlipidémií. Med Promoci 2016; 17(2): 134–139. Dostupné z WWW: <https://www.tribune.cz/clanek/39383-novinky-v-lecbe-hyperlipidemii>.
  4. Buchwald H, Varco RL, Matts JP et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. Report of the Program on the Surgical Control of the Hyperlipidemias (POSCH). N Engl J Med 1990; 323(14): 946–955. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM199010043231404>.
  5. Buchwald H, Rudser KD, Williams SE et al. Overall mortality, incremental life expectancy, and cause of death at 25 years in the program on the surgical control of the hyperlipidemias. Ann Surg 2010; 251(6): 1034–1040. Dostupné z DOI: <http://dx.doi.org/10.1097/SLA.0b013e3181deb4d0>.
  6. Elam M, Lovato LC, Ginsberg H. Role of fibrates in cardiovascular disease prevention, the ACCORD-Lipid perspective. Curr Opin Lipidol 2011; 22(1): 55–61. Dostupné z DOI: <http://dx.doi.org/10.1097/MOL.0b013e328341a5a8>.
  7. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344(8934): 1383–1389.
  8. LaRosa JC, He J, Vupputuri S. Effect of statins on risk of coronary disease: a meta-analysis of randomized controlled trials. JAMA 1999; 282(24): 2340–2346.
  9. Kang S, Liu Y, Liu XB. Effects of aggressive statin therapy on patients with coronary saphenous vein bypass grafts: a systematic review and meta-analysis of randomized, controlled trials. Clin Ther 2013; 35(8): 1125–1136. Dostupné z DOI: <http://dx.doi.org/10.1016/j.clinthera.2013.06.006>.
  10. Soška V, Vrablík M, Bláha V et al. PCSK9 inhibitors – new possibilities in the treatment of hypercholesterolemia: For which patients will be indicated? Czech atherosclerosis society statement. Vnitř Lék 2016; 62(4): 329–333.
  11. Bláha V, Bláha M, Lánská M et al. Position of lipoprotein apheresis in present. Vnitř Lék 2015; 61(11): 958–964.
  12. Bláha V, Bláha M, Lánská M et al. The role of PCSK9-inhibitors and of lipoprotein apheresis in the treatment of homozygous and severe heterozygous familial hypercholesterolemia: A rivalry, or are things quite different? Vnitř Lék 2018; 64(1): 43–50.
  13. Giugliano RP, Pedersen TR, Park JG et al. FOURIER Investigators. Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. Lancet 2017; 390(10106): 1962–1971. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(17)32290–0>.
  14. LaRosa JC, He J, Vupputuri S. Effect of statins on risk of coronary disease: a meta-analysis of randomized controlled trials. JAMA 1999; 282(24): 2340–2346.
  15. Costantine MM, Cleary K, Hebert MF et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Obstetric-Fetal Pharmacology Research Units Network. Safety and pharmacokinetics of pravastatin used for the prevention of preeclampsia in high-risk pregnant women: a pilot randomized controlled trial. Am J Obstet Gynecol 2016; 214(6): 720. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ajog.2015.12.038>.
  16. Vavlukis M, Vavlukis A. Adding ezetimibe to statin therapy: latest evidence and clinical implications. Drugs Context 2018; 7: 212534. Dostupné z DOI: <http://dx.doi.org/10.7573/dic.212534>.
  17. Nielsen SF, Nordestgaard BG. Negative statin-related news stories decrease statin persistence and increase myocardial infarction and cardiovascular mortality: a nationwide prospective cohort study. Eur Heart J 2016; 37(11): 908–916. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehv641>.
  18. Gupta A, Thompson D, Whitehouse A et al. [ASCOT Investigators]. Adverse events associated with unblinded, but not with blinded, statin therapy in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm (ASCOT-LLA): a randomised double-blind placebo-controlled trial and its non-randomised non-blind extension phase. Lancet 2017; 389(10088): 2473–2481. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(17)31075–9>.
  19. Pella D, Gvozdjáková A, Lietava A et al. Myopatie asociovaná se statiny: klinické doporučení Slovenskej asociácie aterosklerózy a České společnosti pro aterosklerózu. AtheroRev 2016; 1(1): 7–13.
  20. Sattar N, Preiss D, Murray HM et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet 2010; 375(9716): 735–742. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)61965–6>.
  21. Athyros VG, Tziomalos K, Gossios TD et al. [GREACE Study Collaborative Group]. Safety and efficacy of long-term statin treatment for cardiovascular events in patients with coronary heart disease and abnormal liver tests in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study: a post-hoc analysis. Lancet 2010; 376(9756): 1916–1922. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(10)61272-X>.
  22. Dunkelgrun M, Schouten O, Feringa HH et al. Beneficial effects of statins on perioperative cardiovascular outcome. Curr Opin Anaesthesiol 2006; 19(4): 418–422. Dostupné z DOI: <http://dx.doi.org/10.1097/01.aco.0000236142.53969.7e>.
  23. Awad K, Serban MC, Penson P et al. Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Effects of morning vs evening statin administration on lipid profile: A systematic review and meta-analysis. J Clin Lipidol 2017; 11(4): 972–985. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacl.2017.06.001>.
  24. Ferenczi EA, Asaria P, Hughes AD et al. Can a statin neutralize the cardiovascular risk of unhealthy dietary choices? Am J Cardiol 2010; 106(4): 587–592. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjcard.2010.03.077>.
  25. Piťha J. How to create cooperative patient for antihypertensive and hypolipidemic therapy. Vnitř Lék 2017; 63(4): 272–276.
Labels
Diabetology Endocrinology Internal medicine
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#