Cardiovascular Benefits and Harms of Step Therapy in the Treatment of Type 2 Diabetes in Adults with and without Atherosclerotic Cardiovascular Disease Cardiovascular Benefits and Harms of Step Therapy in the Treatment of Type 2 Diabetes in Adults with and without Atherosclerotic Cardiovascular Disease Kaiser Permanente Research Affiliates Evidence-based Practice Center Corinne Evans, MPP; Nicholas Emptage, MAE; Megan Rushkin, MPH; and Jennifer S. Lin, MD, MCR Summary Question 1. In persons (...) with type 2 diabetes with or without known atherosclerotic cardiovascular disease (ASCVD) who cannot attain adequate glucose control with metformin, what is the benefit of GLP-1 agonists or SGLT-2 inhibitors on cardiovascular morbidity and mortality? • Evidence of benefit in persons with known ASCVD on cardiovascular disease (CVD) outcomes, CVD mortality and all-cause mortality (ACM) o Based on limited evidence in persons without ASCVD, no evidence of benefit on CVD outcomes • Presumed class effect

Cardiovascular Risk Reduction in Patients with Type 2 Diabetes and Atherosclerotic Cardiovascular Disease EXPERT CONSENSUS DECISION PATHWAY 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways Endorsed by the American Diabetes Association Writing Committee Sandeep R. Das, MD, MPH (...) citedasfollows:Das SR,EverettBM,BirtcherKK,BrownJM,CefaluWT,Januzzi JL Jr, Rastogi Kalyani R, Kosiborod M, Magwire ML, Morris PB, Sperling LS. 2018 ACC expert consensus decision pathway on novel therapies for car- diovascular risk reduction in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol 2018;XX:XXX–XXX. Copies:Thisdocumentisavailableonthewebsite oftheAmericanCollegeof

Effect of the PCSK9 Inhibitor Evolocumab on Total Cardiovascular Events in Patients With Cardiovascular Disease: A Prespecified Analysis From the FOURIER Trial. The PCSK9 inhibitor evolocumab reduced low-density lipoprotein cholesterol and first cardiovascular events in the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) trial, but patients remain at high risk of recurrent cardiovascular events.To evaluate the effect of evolocumab on total (...) cardiovascular events, given the importance of total number of cardiovascular events to patients, clinicians, and health economists.Secondary analysis of a randomized, double-blind clinical trial. The FOURIER trial compared evolocumab or matching placebo and followed up patients for a median of 2.2 years. The study included 27 564 patients with stable atherosclerotic disease receiving statin therapy. Data were analyzed between May 2017 and February 2019.The primary end point (PEP) was time to first

Cardiovascular Disease Risk PEER SIMPLIFIED GUIDELINE: PREVENTION AND MANAGEMENT OF CARDIOVASCULAR DISEASE RISK IN PRIMARY CARE Clinical Practice Guideline | February 2015 These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making. OBJECTIVE Alberta primary care clinicians and their teams offer primary (...) and secondary prevention for cardiovascular disease (CVD) focused on CVD risk estimation and lipid management. TARGET POPULATION Men aged 40-75 Women aged 50-75 (optional start at age 40 for simplicity) EXCLUSIONS Men and women of any age with previously diagnosed familial hypercholesterolemia RECOMMENDATIONS ? Screen for CVD risk beginning at age 40 for men and 50 for women. PRACTICE POINT Always use a risk calculator with every lipid measurement to assess CVD risk. X Fasting for lipid tests

Bioresorbable stents for the treatment of cardiovascular indications (coronary artery disease). EUnetHTA-Report. Decision Support Document 81/ Update 2019. Bioresorbable stents for the treatment of cardiovascular indications (coronary artery disease). EUnetHTA-Report - Repository of AIHTA GmbH English | Browse - - - Bioresorbable stents for the treatment of cardiovascular indications (coronary artery disease). EUnetHTA-Report Semlitsch, T. and Ciutan, M. and Scintee, S.G. (2019): Bioresorbable (...) stents for the treatment of cardiovascular indications (coronary artery disease). EUnetHTA-Report. Decision Support Document 81/ Update 2019. Preview - Sie müssen einen PDF-Viewer auf Ihrem PC installiert haben wie z. B. , oder 1MB Abstract Coronary artery disease (CAD) is a disease defined as the manifestation of arteriosclerosis in the coronary arteries and is the leading cause of death in Europe. This systematic review evaluates the current evidence on the efficacy and safety of bioresorbable

Additive Therapies for Cardiovascular Disease: Final Policy Recommendations ©Institute for Clinical and Economic Review, 2019 Additive Therapies for Cardiovascular Disease: Final Policy Recommendations October 17, 2019 ©Institute for Clinical and Economic Review, 2019 Page 1 Additive CVD Therapies - Final Policy Recommendations The following policy recommendations from the September 26, 2019 meeting reflect the main themes and points made during the Policy Roundtable discussion about how best (...) to apply the evidence on rivaroxaban and icosapent ethyl to policy and practice associated with the treatment of cardiovascular disease (CVD). This conversation, which can be accessed here, [https://www.youtube.com/watch?v=1FPdZEes7Ps&feature=youtu.be], immediately followed the Midwest CEPAC voting portion of the meeting. The Policy Roundtable members included two patients, two clinical experts, two payers, and one representative from a pharmaceutical manufacturer. The discussion reflected multiple

, functional disability and risk factors for the development of Cardiovascular Diseases (CVD), including Insulin Resistance (IR), arterial stiffness and Metabolic Syndrome (MS) [ , ]. Given this, sarcopenia is one of the growing public health concerns in aging populations. Obesity, especially visceral obesity, is a fundamental condition of metabolic disorder, considered a chronic disease and directly or indirectly interrelated with other pathological conditions contributing to morbidity and mortality (...) Saúde (Latin America and Caribbean Health Sciences Literature) and Capes Journals, using the following search terms in English, Spanish and Portuguese: “obesity sarcopenic” OR “sarcopenic obesity” in the title AND “cardiometabolic disease” OR “cardiovascular disease” OR “metabolic syndrome” OR “insulin resistance” in the title/abstract AND “aged” in all fields of search with the variation of the “muscle strength” descriptor in all fields of this research. Articles were selected according

Association of Genetic Variants Related to Gluteofemoral vs Abdominal Fat Distribution With Type 2 Diabetes, Coronary Disease, and Cardiovascular Risk Factors. Body fat distribution, usually measured using waist-to-hip ratio (WHR), is an important contributor to cardiometabolic disease independent of body mass index (BMI). Whether mechanisms that increase WHR via lower gluteofemoral (hip) or via higher abdominal (waist) fat distribution affect cardiometabolic risk is unknown.To identify genetic (...) cholesterol, triglycerides, fasting glucose, fasting insulin, type 2 diabetes, and coronary disease risk (follow-up analyses).Among 452 302 UK Biobank participants of European ancestry, the mean (SD) age was 57 (8) years and the mean (SD) WHR was 0.87 (0.09). In genome-wide analyses, 202 independent genetic variants were associated with higher BMI-adjusted WHR (n = 660 648) and unadjusted WHR (n = 663 598). In dual-energy x-ray absorptiometry analyses (n = 18 330), the hip- and waist-specific polygenic

.2013.10.005 Haider A, Yassin A, Haider KS, Doros G, Saad F, Rosano GM. Men with testosterone deficiency and a history of cardiovascular diseases benefit from long-term testosterone therapy: observational, real-life data from a registry study. Vasc Health Risk Manage 2016;12:251–61. https://doi.org/10.2147/VHRM.S108947 Heufelder AE, Saad F, Bunck MC, Gooren L. Fifty-two-week treatment with diet and exercise plus transdermal testosterone reverses the metabolic syndrome and improves glycemic control in men (...) Cardiovascular benefits and risks of testosterone replacement therapy in hypogonadal men with type 2 diabetes mellitus and/or the metabolic syndrome: a systematic review Cardiovascular benefits and risks of testosterone replacement therapy in hypogonadal men with type 2 diabetes mellitus and/or the metabolic syndrome: a systematic review | Quang | British Journal of Diabetes User Username Password Remember me 5th Joint Meeting of ABCD & The Renal Association 24/25 February 2021 All issues 2014

Finding the Balance Between Benefits and Harms When Using Statins for Primary Prevention of Cardiovascular Disease: A Modeling Study. Many guidelines use expected risk for cardiovascular disease (CVD) during the next 10 years as a basis for recommendations on use of statins for primary prevention of CVD. However, how harms were considered and weighed against benefits is often unclear.To identify the expected risk above which statins provide net benefit.Quantitative benefit-harm balance modeling

Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial. Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves (...) prevention.Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound

The Role of Physical Activity Prescription in Cardiovascular Disease Prevention Amongst South Asian Canadians Unequivocal evidence suggests an increased prevalence of cardiovascular disease (CVD) amongst South Asian Canadians (SACs) compared to other ethnic cohorts, due to a combination of their unique cardiometabolic profile and environmental factors. This unfavorable CVD profile is characterized by an elevated risk of dyslipidemia, high apolipoprotein B/apolipoprotein A1 ratio, hypertension (...) , glucose intolerance, type 2 diabetes mellitus, as well as increased BMI, body fat percentage, abdominal and visceral adiposity. Despite the overwhelming evidence for the effectiveness of physical activity (PA) in circumventing the onset of CVD and in the reduction of CVD risk factors, SACs are among the most physically inactive cohorts in Canada. This relates to a set of common and unique socio-cultural barriers, such as gender, beliefs and perceptions about illness, immigration, unfavorable PA

Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease. It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovascular disease, and data from randomized trials are limited.We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1 g per day for the prevention of cancer (...) and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo.A total of 25,871 participants, including

Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer. Higher intake of marine n-3 (also called omega-3) fatty acids has been associated with reduced risks of cardiovascular disease and cancer in several observational studies. Whether supplementation with n-3 fatty acids has such effects in general populations at usual risk for these end points is unclear.We conducted a randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (at a dose (...) of 2000 IU per day) and marine n-3 fatty acids (at a dose of 1 g per day) in the primary prevention of cardiovascular disease and cancer among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes) and invasive cancer of any type. Secondary end points included individual components of the composite cardiovascular end point, the composite

Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovascular diseases (CVDs). In 2012, the Global Alliance for Chronic Diseases funded eight studies which focused on task-shifting to NPHWs

Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. Patients who have had an acute coronary syndrome are at high risk for recurrent ischemic cardiovascular events. We sought to determine whether alirocumab, a human monoclonal antibody to proprotein convertase subtilisin-kexin type 9 (PCSK9), would improve cardiovascular outcomes after an acute coronary syndrome in patients receiving high-intensity statin therapy.We conducted a multicenter, randomized, double-blind, placebo (...) to receive alirocumab subcutaneously at a dose of 75 mg (9462 patients) or matching placebo (9462 patients) every 2 weeks. The dose of alirocumab was adjusted under blinded conditions to target an LDL cholesterol level of 25 to 50 mg per deciliter (0.6 to 1.3 mmol per liter). The primary end point was a composite of death from coronary heart disease, nonfatal myocardial infarction, fatal or nonfatal ischemic stroke, or unstable angina requiring hospitalization.The median duration of follow-up was 2.8

Association of Blood Pressure Classification in Korean Young Adults According to the 2017 American College of Cardiology/American Heart Association Guidelines With Subsequent Cardiovascular Disease Events. Among young adults, the association of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) High Blood Pressure Clinical Practice Guidelines with risk of cardiovascular disease (CVD) later in life is uncertain.To determine the association of blood pressure categories (...) person-years [95% CI, 11-18]; adjusted HR, 1.16 [95% CI, 1.08-1.25]), and stroke (incidence, 79 vs 51 per 100 000 person-years; difference, 28 per 100 000 person-years [95% CI, 24-32]; adjusted HR [1.37, 95% CI, 1.29-1.46]). Results for state 2 hypertension were consistent.Among Korean young adults, stage 1 and stage 2 hypertension, compared with normal blood pressure, were associated with increased risk of subsequent cardiovascular disease events. Young adults with hypertension, defined by the 2017

Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention: JACC Health Promotion Series The primary objective of this study was to analyze the most up-to-date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review. Three separate, systematic literature searches identified 2,343 papers in total. Overall, 44 studies were included for data extraction and analysis (...) . The included systematic reviews and meta-analyses published between January 1, 2016, and December 31, 2017, were of good to very good quality (median Overview Quality Assessment Questionnaire score = 17). Identified evidence suggests that cardiovascular disease (CVD) prevention services should consider regulation of blood glucose as a key target for intervention. Furthermore, the recommendations for effective intervention and service development/training described here for prevention of CVD should

Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic Cardiovascular Disease Risk Calculator Coronary artery calcium (CAC) is a powerful novel risk indicator for atherosclerotic cardiovascular disease (ASCVD). Currently, there is no available ASCVD risk prediction tool that integrates traditional risk factors and CAC.To develop a CAC ASCVD risk tool for younger individuals in the general population, subjects aged 40 to 65 without prior (...) cardiovascular disease from 3 population-based cohorts were included. Cox proportional hazards models were developed incorporating age, sex, systolic blood pressure, total and high-density lipoprotein cholesterol, smoking, diabetes mellitus, hypertension treatment, family history of myocardial infarction, high-sensitivity C-reactive protein, and CAC scores (Astro-CHARM model [Astronaut Cardiovascular Health and Risk Modification]) as dependent variables and ASCVD (nonfatal/fatal myocardial infarction

Evolocumab (Repatha) - In adults with established atherosclerotic cardiovascular disease (myocardial infarction, stroke or peripheral arterial disease) Published 12 November 2018 Statement of advice SMC2133 evolocumab 140mg solution for injection in pre-filled syringe / 140mg solution for injection in pre-filled pen / 420mg solution of injection in cartridge (Repatha®) Amgen Ltd 5 October 2018 ADVICE: in the absence of a submission from the holder of the marketing authorisation evolocumab (...) (Repatha®) is not recommended for use within NHSScotland. Indication under review: In adults with established atherosclerotic cardiovascular disease (myocardial infarction, stroke or peripheral arterial disease) to reduce cardiovascular risk by lowering LDL-C levels, as an adjunct to correction of other risk factors: ? in combination with the maximum tolerated dose of a statin with or without other lipid- lowering therapies or, ? alone or in combination with other lipid-lowering therapies in patients