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Latest & greatest articles for statin
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Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known.We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 (...) % in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P=0.016). Rates of prespecified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups.When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below
Comparison of Frequency of Inflammatory Bowel Disease and Noninfectious Gastroenteritis Among Statin Users Versus Nonusers Conflicting data exist regarding the effects of statin therapy on the prevalence of inflammatory bowel diseases. We aimed to examine the association of statin therapy with diagnoses of inflammatory bowel diseases and noninfectious gastroenteritis. This is a retrospective study using data of a military health care system from October 1, 2003, to March 1, 2012. Based (...) on medication fills during fiscal year 2005, patients were divided into: (1) statin users (received at least 90-day supply of statin) and (2) nonusers (never received a statin). A propensity score-matched cohort of statin users and nonusers was created using 80 variables. Primary analysis examined the risks of being diagnosed with inflammatory bowel diseases and noninfectious gastroenteritis between statin users and nonusers in the propensity score-matched cohort. Secondary analyses examined the risk
Efficacy and safety of alirocumab in high cardiovascular risk patients with inadequately controlled hypercholesterolaemia on maximally tolerated doses of statins: the ODYSSEY COMBO II randomized controlled trial To compare the efficacy [low-density lipoprotein cholesterol (LDL-C) lowering] and safety of alirocumab, a fully human monoclonal antibody to proprotein convertase subtilisin/kexin 9, compared with ezetimibe, as add-on therapy to maximally tolerated statin therapy in high cardiovascular (...) risk patients with inadequately controlled hypercholesterolaemia.COMBO II is a double-blind, double-dummy, active-controlled, parallel-group, 104-week study of alirocumab vs. ezetimibe. Patients (n = 720) with high cardiovascular risk and elevated LDL-C despite maximal doses of statins were enrolled (August 2012-May 2013). This pre-specified analysis was conducted after the last patient completed 52 weeks. Patients were randomized to subcutaneous alirocumab 75 mg every 2 weeks (plus oral placebo
Pleiotropic effects of statins in hypercholesterolaemia: a prospective observational study using a lipoproteomic based approach. The benefit of statins in the prevention of cardiovascular disease is well founded, derived from their lipid lowering and pleiotropic effects. The concept of lipoproteins as lipid transporters has evolved to encompass functions in coagulation, inflammation, and redox reactions due to their unique protein cargo. The aim of this study was to determine the effect (...) of statin therapy on lipoproteins and their protein cargo by use of an unbiased bottom-up proteomics approach in people with hypercholesterolaemia.11 people fulfilling the inclusion criteria were recruited into this UK-based single centre prospective observational study. They were started on statins for primary prevention. Blood was withdrawn at baseline and after a minimum of 2 months of statin therapy. Plasma was co-incubated with a lipoaffinity resin. Isolated proteins were digested and analysed
Statins for age-related macular degeneration. Age-related macular degeneration (AMD) is a progressive late onset disorder of the macula affecting central vision. Age-related macular degeneration is the leading cause of blindness in people over 65 years in industrialized countries. Recent epidemiologic, genetic, and pathological evidence has shown AMD shares a number of risk factors with atherosclerosis, leading to the hypothesis that statins may exert protective effects in AMD.The objective (...) of this review was to examine the effectiveness of statins compared with other treatments, no treatment, or placebo in delaying the onset and progression of AMD.We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 6), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2014), EMBASE (January 1980 to June 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS
Statins for primary prevention of venous thromboembolism. Venous thromboembolism (VTE) is common in clinical practice. The efficacy of statins in the primary prevention of VTE remains unproven. This is an update of the review first published in 2011.To assess the efficacy of statins in the primary prevention of VTE.For this update the Cochrane Peripheral Vascular Diseases (PVD) Group Trials Search Co-ordinator searched the Specialised Register (last searched February 2014) and CENTRAL (2014 (...) , Issue 1).Randomised controlled trials (RCTs) that assessed statins in the primary prevention of VTE were considered. The outcomes we evaluated were the rates of VTE, cardiovascular and cerebrovascular events, death and adverse events. Two authors (L Li, JH Tian) independently selected RCTs against the inclusion criteria. Disagreements were resolved by discussion with a third author (KH Yang).Data extraction was independently carried out by two authors (L Li, JH Tian). Disagreements were resolved
coronary heart disease (CHD) serious adverse events (SAEs), but have no effect on total SAEs. This suggests that there are unidentified SAEs caused by statins that counterbalance the reduction in CHD SAEs. Concerns about SAEs related to HMG-CoAreductaseinhibitors (statins) were first raised in 2001, when cerivastatin was withdrawn from the market after being linked to over 100 deaths from muscle damage occurring at a rate much higher than other statins. This Letter examines proven and associated (...) harms with statin use. Proven harms are those that have been established in systematic reviews or randomized controlled trials (RCTs); associated harms are those identified from observational studies, case series and case reports. How do statins work? Statins inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase at an early stage of the mevalonate pathway. Cholesterol is generated by this pathway, but so are a number of other products with a pivotal role in bodily functions
Further Insight Into the Cardiovascular Risk Calculator: The Roles of Statins, Revascularizations, and Underascertainment in the Women's Health Study While the pooled cohort equations from the recent American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Assessment of Cardiovascular Risk have overestimated cardiovascular risk in multiple external cohorts, the reasons for the discrepancy are unclear.To determine whether increased use of statins over time, incident (...) % or higher risk. Rates of statin use and revascularizations increased over follow-up time and by risk group, and in sensitivity analyses, we estimated the hypothetical rates if no women were prescribed statins or underwent revascularization procedures. After adjustment for intervention effects of statins and revascularization as well as hypothetical confounding by indication, ratios of predicted to observed rates remained 1.80 or higher in the lower 2 risk groups and over 1.30 higher in the upper 2 risk
, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam, the Netherlands. eng Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't United States JAMA 7501160 0098-7484 0 Hydroxymethylglutaryl-CoAReductaseInhibitors 0 Lipids KXO2KT9N0G Pravastatin AIM IM Adolescent Carotid Intima-Media Thickness Child Female Follow-Up Studies Humans Hydroxymethylglutaryl-CoAReductaseInhibitors therapeutic use Hyperlipoproteinemia Type II blood drug therapy Linear Models Lipids blood (...) Ten-year follow-up after initiation of statin therapy in children with familial hypercholesterolemia. 25203086 2014 10 01 2016 10 17 1538-3598 312 10 2014 Sep 10 JAMA JAMA Ten-year follow-up after initiation of statin therapy in children with familial hypercholesterolemia. 1055-7 10.1001/jama.2014.8892 Kusters D Meeike DM Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. Avis Hans J HJ Department of Vascular Medicine, Academic Medical Center, Amsterdam
Comparative effectiveness of generic and brand-name statins on patient outcomes: a cohort study. Statins are effective in preventing cardiovascular events, but patients do not fully adhere to them.To determine whether patients are more adherent to generic statins versus brand-name statins (lovastatin, pravastatin, or simvastatin) and whether greater adherence improves health outcomes.Observational, propensity score-matched, new-user cohort study.Linked electronic data from medical and pharmacy (...) claims.Medicare beneficiaries aged 65 years or older with prescription drug coverage between 2006 and 2008.Initiation of a generic or brand-name statin.Adherence to statin therapy (measured as the proportion of days covered [PDC] up to 1 year) and a composite outcome comprising hospitalization for an acute coronary syndrome or stroke and all-cause mortality. Hazard ratios (HRs) and absolute rate differences were estimated.A total of 90,111 patients who initiated a statin during the study was identified
Non-cardiovascular effects associated with statins. Statins form the pharmacologic cornerstone of the primary and secondary prevention of atherosclerotic cardiovascular disease. In addition to beneficial cardiovascular effects, statins seem to have multiple non-cardiovascular effects. Although early concerns about statin induced hepatotoxicity and cancer have subsided owing to reassuring evidence, two of the most common concerns that clinicians have are myopathy and diabetes. Randomized (...) controlled trials suggest that statins are associated with a modest increase in the risk of myositis but not the risk of myalgia. Severe myopathy (rhabdomyolysis) is rare and often linked to a statin regimen that is no longer recommended (simvastatin 80 mg). Randomized controlled trials and meta-analyses suggest an increase in the risk of diabetes with statins, particularly with higher intensity regimens in people with two or more components of the metabolic syndrome. Other non-cardiovascular effects
What statins tell us about the mess in evidence based medicine What statins tell us about the mess in evidence based medicine – Bad Science Search TED Talk Collected Journalism This Nerdy Book This Great Book T-shirts Categories (3) (4) (6) (45) (28) (6) (16) (190) (5) (20) (52) (88) (2) (1) (2) (1) (677) (4) (14) (2) (37) (4) (9) (3) (11) (6) (3) (16) (13) (1) (6) (8) (6) (6) (3) (13) (2) (2) (27) (1) (2) (6) (1) (7) (8) (3) (1) (4) (12) (1) (3) (20) (2) (13) (1) (20) (15) (4) (1) (20) (1) (1 (...) ) (2) (1) (5) (1) (10) (1) (2) (1) (1) (6) (4) (3) (2) (52) (3) (18) (10) (1) June 30th, 2014 by Ben Goldacre in | Sorry to be absent, I’ve about a zillion big things shortly coming to fruition, at which point expect a deluge. Everyone is having kittens about statins and the BMJ at the moment. Here’s what I wrote as a rabid response on the latest BMJ editorial about it, and a disco soundtrack to keep your attention focused: Statins are a mess: we need better data, and shared decision making I have
evaluating long-term clinical benefits and harms are needed to better inform clinical decisionmaking, patient choice, and clinical practice guidelines. Final publication URL Additional data URL Indexing Status Subject indexing assigned by CRD MeSH Cardiovascular Diseases; Drug Therapy, Combination; Humans; Hydroxymethylglutaryl-CoAReductaseInhibitors Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence AHRQ (...) Combination therapy versus intensification of statin monotherapy: an update Combination therapy versus intensification of statin monotherapy: an update Combination therapy versus intensification of statin monotherapy: an update Monroe AK, Gudzune KA, Sharma R, Chelladurai Y, Ranasinghe PD, Ansari MT, Robinson KA Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made
Higher potency statins and the risk of new diabetes: multicentre, observational study of administrative databases. To evaluate the incremental increase in new onset diabetes from higher potency statins compared with lower potency statins when used for secondary prevention.Eight population based cohort studies and a meta-analysis.Six Canadian provinces and two international databases from the UK and US.136,966 patients aged ≥ 40 years newly treated with statins between 1 January 1997 and 31 (...) March 2011.Within each cohort of patients newly prescribed a statin after hospitalisation for a major cardiovascular event or procedure, we performed as-treated, nested case-control analyses to compare diabetes incidence in users of higher potency statins with incidence in users of lower potency statins. Rate ratios of new diabetes events were estimated using conditional logistic regression on different lengths of exposure to higher potency versus lower potency statins; adjustment for confounding
Statin Strikeout. 24835850 2014 06 10 2018 12 02 1533-4406 370 23 2014 Jun 05 The New England journal of medicine N. Engl. J. Med. Statin strikeout. 2240-1 10.1056/NEJMe1405032 Drazen Jeffrey M JM From the Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York (A.C.G.). Gelijns Annetine C AC eng Editorial Comment 2014 05 18 United States N Engl J Med 0255562 0028-4793 0 Fluorobenzenes 0 Hydroxymethylglutaryl-CoAReductaseInhibitors 0 Pyrimidines 0 (...) Sulfonamides 83MVU38M7Q Rosuvastatin Calcium AGG2FN16EV Simvastatin AIM IM N Engl J Med. 2014 Jun 5;370(23):2201-10 24836125 N Engl J Med. 2014 Jun 5;370(23):2191-200 24835849 Female Fluorobenzenes therapeutic use Humans Hydroxymethylglutaryl-CoAReductaseInhibitors therapeutic use Male Pulmonary Disease, Chronic Obstructive drug therapy Pyrimidines therapeutic use Respiratory Distress Syndrome, Adult drug therapy Rosuvastatin Calcium Sepsis complications Simvastatin therapeutic use Sulfonamides
being associated with a reduction in cardiovascular events. Older studies were able to compare active lipid lowering versus placebo. Contemporary studies compared different statins and end- treatment LDL in the setting of gradually improving background care (such as ACE inhibitors, angiotensin receptor blockers, antiplatelet agents, beta-blockers, etc.). Supporters of a more aggressive strategy have been not been disappointed with the results. We have also been able to appreciate the importance (...) New Cholesterol Guidelines: How Safe Are High-Potency Statins? New Cholesterol Guidelines: How Safe Are High-Potency Statins? – Clinical Correlations Search New Cholesterol Guidelines: How Safe Are High-Potency Statins? May 14, 2014 9 min read By Molly Anderson Peer Reviewed Managing hyperlipidemia is a mainstay of cardiovascular risk reduction. The 2013 ACC/AHA guidelines no longer target specific low-density lipoprotein (LDL)-cholesterol levels, . Adoption of the new guidelines would