ABSTRACT
Background and Objective: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality worldwide, with high-risk patients requiring effective management to reduce their risk of cardiovascular events. Bempedoic acid is a novel therapeutic agent recently approved as an add-on therapy to statins in patients with uncontrolled LDL-c. Bempedoic acid inhibits cholesterol synthesis in the liver, which ultimately reduces the risk of cardiovascular events. Therefore, the present study aims to assess the efficacy and safety of bempedoic acid in patients with uncontrolled LDL-c (Previously on moderate or high-intensity statins) with a high risk of CVD in real-world settings. Methods: This is a multicenter, retrospective, observational study on the data of high-risk-CVD patients collected from Bempedoic Acid on Efficacy and Safety in patients (BEST) Registry. The clinical data of 140 patients who were already on statin therapy and were receiving Bempedoic acid at a dose of 180 mg, along with measurements of the level of LDL-c, HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, serum creatinine was taken into consideration. The primary outcome includes a change in LDL-c level, and secondary outcomes involve a change in the level of HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, and serum creatinine at week 12 and 24. Adverse events were reported at both time points. Results: A total of 140 patients were included in the present study with a mean age of 51.8 ± 9.2 years and had primary confirmed diagnosis of dyslipidemia with uncontrolled LDL-c. The mean levels of LDL-c decreased from the mean baseline value of 142.67 ± 46.49 mg/dL, to 106.78 ±33.92 mg/d; a statistically significant reduction by 23.23% (p < 0.01) at week 12. Similarly, at week 24, the mean LDL-c value reduced to 90.39 ± 38.89 mg/dL. A 33.38 % decrease was observed (p < 0.01). Other parameters such as non-HDL, FPG, PPPG, AST and serum creatinine also showed statistically significant reduction at week 12 and week 24. Conclusion: The present study demonstrates that bempedoic acid is an effective add-on medication in lowering LDL-c levels in high-risk CVD patients with uncontrolled LDL-c.
ABSTRACT
@#Cardiovascular diseases (CVDs) are major disease burdens with high mortality worldwide. Early prediction of cardiovascular events can reduce the incidence of acute myocardial infarction and decrease the mortality rates of patients with CVDs. The pathological mechanisms and multiple factors involved in CVDs are complex; thus, traditional data analysis is insufficient and inefficient to manage multidimensional data for the risk prediction of CVDs and heart attacks, medical image interpretations, therapeutic decision-making, and disease prognosis prediction. Meanwhile, traditional Chinese medicine (TCM) has been widely used for treating CVDs. TCM offers unique theoretical and practical applications in the diagnosis and treatment of CVDs. Big data have been generated to investigate the scientific basis of TCM diagnostic methods. TCM formulae contain multiple herbal items. Elucidating the complicated interactions between the active compounds and network modulations requires advanced data-analysis capability. Recent progress in artificial intelligence (AI) technology has allowed these challenges to be resolved, which significantly facilitates the development of integrative diagnostic and therapeutic strategies for CVDs and the understanding of the therapeutic principles of TCM formulae. Herein, we briefly introduce the basic concept and current progress of AI and machine learning (ML) technology, and summarize the applications of advanced AI and ML for the diagnosis and treatment of CVDs. Furthermore, we review the progress of AI and ML technology for investigating the scientific basis of TCM diagnosis and treatment for CVDs. We expect the application of AI and ML technology to promote synergy between western medicine and TCM, which can then boost the development of integrative medicine for the diagnosis and treatment of CVDs.
ABSTRACT
Non-communicable diseases (NCDs) are defined as diseases of long duration, and are generally slow in progression. NCDs are replacing communicable diseases, maternal and child health as well as malnutrition as the leading cause of death. Non-communicable diseases are the leading cause of death in the world, responsible for 63% deaths worldwide in 2008. NCDs accounts for 53 percent of deaths in India. Based on available evidence cardiovascular diseases (24 percent), chronic respiratory diseases (11 percent), cancer (6 percent) and diabetes (2 percent) are the leading cause of mortality in India. Treatment cost is almost double for NCDs as compared to other conditions and illnesses. Burden of non-communicable diseases and resultants mortality is expected to increase unless massive efforts are made to prevent and control NCDs and their risk factors. India could develop a strategy for reducing out of pocket expenditure. Underlying determinants of NCDs mainly exist in non-health sectors, such as agriculture, urban development, education and trade. Inter-sectoral collaboration is therefore essential to create an enabling environment. Government of India had launched various vertical programmes such as National Cancer Control Programmes, National Tobacco Control Programme, National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) etc. Strong surveillance, monitoring and evaluation system is required for successful implementation of the programmes. Public health facilities should be strengthened for providing services of screening; early diagnosis and treatment within the public health care delivery system. Efforts need to be done on implementing the clinical standards and guidelines developed under the Indian Public Health Standards (IPHS), and integrating NCD training into training curricula of health workforce.