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Objective:To observe the lipid-lowering effect of atorvastatin on patients with acute cerebral infarction with different ATP-binding cassette subfamily B member 1(ABCB1) genotypes, and thus to provide clinical research evidence for individual application of atorvastatin in patients with acute cerebral infarction.Methods:From March 2021 to December 2021, 131 patients with acute cerebral infarction admitted to the Department of Neurology of Xuchang Central Hospital were included. The ABCB1 G2677T gene polymorphism rs2032582 of patients was detected by fluorescence staining in situ hybridization.Based on the detection results, patients were divided into GG group, GT group and TT group.All patients were given atorvastatin (20 mg/d) for lipid-lowering treatment.The levels of low density lipoprotein cholesterol(HDL-C), high density lipoprotein cholesterol(HDL-C), total cholesterol(TC)and triglyceride(TG) in serum of patients in the three groups before and 2 months after treatment were recorded and analyzed.The adverse drug reactions in the three groups were recorded. When the serum LDL-C level was less than 1.8 mmol/L, it was considered that the lipid-lowering treatment was effective.The binary Logistic regression analysis was used to explore the influencing factors of atorvastatin lipid lowering therapy.The software of SPSS 25.0 was used for statistical analysis.Results:There were 50 (38.17%), 49 (37.40%) and 32 (24.43%) patients in GG group, GT group and TT group, respectively. The serum TC levels of patients in GG group, GT group and TT group after treatment were (3.47±0.70) mmol/L, (3.59±1.09) mmol/L and (3.48±1.02) mmol/L, respectively, which were lower than those before treatment ((4.27± 0.99) mmol/L, (4.02±0.98) mmol/L and (4.03±1.31) mmol/L), all of which were statistically significant ( t=7.652, 3.092, 5.593, all P<0.01). The serum LDL-C levels in GG group, GT group and TT group after treatment were (1.89±0.53) mmol/L, (2.07±0.92) mmol/L and (1.96±0.79) mmol/L, respectively, which were lower than those before treatment ((2.87±0.92) mmol/L, (2.56±0.89) mmol/L and (2.55±1.11) mmol/L) ( t=9.896, 4.055, 5.980, all P<0.001). The differences of serum LDL-C level before and after treatment in GG group, GT group and TT group were (-0.97±0.69) mmol/L, (-0.50±0.86) mmol/L and (-0.59±0.56) mmol/L, respectively. The difference of serum LDL-C level before and after treatment in the three groups was statistically significant ( F=5.614, P=0.005). The difference of TC, TG and HDL-C before and after treatment was not statistically significant( F=2.783, 0.490, 1.677, all P>0.05). The binary Logistic regression analysis showed that ABCB1 G2677T gene type and staying up late were independent influencing factors for atorvastatin lipid-lowering therapy. The probability of effective lipid-lowering in GT patients with ABCB1 G2677T gene was 27.9% of that in GG patients ( OR=0.279, 95% CI: 0.110-0.709, P=0.007), and the probability of TT type patients was 33.8% of GG type patients ( OR=0.338, 95% CI: 0.121-0.943, P=0.038). The probability of effective lipid-lowering in patients who had the habit of staying up late was 26.4% of the patients who did not stay up late ( OR=0.264, 95% CI: 0.118-0.591, P=0.001). There was no significant difference in the total incidence of adverse drug reactions among the three groups( χ2=0.868, P=0.648). Conclusion:The lipid-lowering effect in patients with GG type of ABCB1 G2677T is better than that of GT type and TT type when atorvastatin is used to treat patients with acute cerebral infarction.
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@#Patients undergoing coronary artery bypass grafting (CABG) belong to the very high-risk group of atherosclerotic cardiovascular disease. Although CABG gets advantages in relieving symptoms and improving long-term outcomes, a significant risk of cardiovascular adverse events after surgery still exists and standardized secondary prevention is needed. Lipid management plays a critical role as a secondary preventive strategy in CABG. However, lipid management of CABG patients in real clinical setting is inadequate, including lack of standardized lipid-lowering strategy, low goal attainment rate, as well as poor long-term medication adherence. In recent years, a series of clinical trials have provided a lot of groundbreaking new evidence for lipid management in patients with cardiovascular diseases which offers new strategies together with objectives of lipid-lowering and comprehensive management for patients undergoing CABG. This article reviews the strategy and research progress of lipid management after CABG, aiming to provide objective reference for clinical treatment.
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Background: Stroke is one of the major global health problems. Stroke is the most common clinical manifestation of cerebrovascular disease of which more than 99% are due to arterial involvement and less than 1% due to venous involvement in the form of Cerebral Venous Thrombosis (CVT). Among arterial causes 85% are due to infarction and 15% due to haemorrhage.1,2 There is difference in serum lipid levels in subtypes of strokes to guide lipid-lowering therapy which can reduce incidence of stroke and stroke related mortality by adapting primary and secondary preventive measures.3,4 Authors have endeavoured to correlate severity of lipid derangement and stroke.Methods: In this study 64 consecutive eligible ischaemic stroke cases and 64 eligible hemorrhagic stroke cases would be included. Cases of strokes will be divided into ischaemic and hemorrhagic as per clinical features and with help of brain imaging by CT scan and MRI at the time of admission and 8 hour fasting lipid profile was collected from all cases. All this information will be filled in preformed format.Results: Serum lipid profile of two categories of stroke showed raised serum total cholesterol in 39.1% patients of ischaemic stroke in contrast to 18.8% patients with haemorrhagic stroke (p=0.019).Stroke patients showed raised in LDL cholesterol in 29.7% patients of ischaemic stroke in contrast to 9.4% patients with haemorrhagic stroke, (p=0.007).Conclusions: Based on the finding of our study we conclude that ischemic stroke patient had higher lipid derangement as compare to haemorrhagic stroke in terms of raise total cholesterol, LDL cholesterol and decrease HDL cholesterol.
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Atherosclerotic cardiovascular disease is one of the leading causes of death and disability worldwide.Dyslipidemia mainly with elevated LDL-C is closely related to atherosclerotic cardiovascular disease.Statins are the most effective drugs for lowering LDL-C and play an important role in the prevention and treatment of atherosclerotic cardiovascular disease.However,a considerable number of patients receiving statin therapy can not tolerate its adverse reactions or their low-density lipoprotein can not meet the standard,and the cardiovascular risk remains high.The clinical application of new lipid-lowering drugs such as ezetimibe,PCSK9 inhibitors and cholesterol ester transfer protein(CETP) inhibitors has marked the post-statin era of lipid-lowering therapy.
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background: Hyperlipidaemia is a significant risk factor for cardiovascular disease. However, adherence to lipidlowering therapy is often unsatisfactory due to a combination of patient factors, therapy, socio-economic and health system-related factors. Aims: to identify the prevalence of adherence to lipidlowering therapy, the factors contributing to non-adherence and knowledge regarding hyperlipidaemia and its’ treatment among Malaysian patients with hyperlipidemia. Methods: A quantitative study using a cross-sectional survey was carried out in an urban primary care clinic in August 2015. Patients on lipid-lowering therapy for ≥ 1 year aged ≥ 18 years were selected using simple random sampling. consenting patients answered a selfadministered questionnaire (in Malay/English) which included socio-demographic profile, hyperlipidaemia profile, adherence to lipid-lowering therapy (using the Morisky Medication Adherence scale-8; score ≥ 6 taken as adherent), reasons leading to non-adherence, knowledge regarding hyperlipidaemia and its’ treatment, and use of non-allopathic medicine. results: the response rate was 90.7%. the prevalence of adherence to lipid-lowering therapy was 82.4%. “the most common reasons for non-adherence was being worried about side effect of lipid-lowering agent (71.4%), followed by the need to take too many drugs in a day (61.4%) and negative influences by friends, relative and mass media (60%)”. Factors associated with non-adherence include male gender, on longer duration of therapy, less frequency of follow-up, less number of follow-up clinics, taking medication at night/random timing and having lower knowledge scores. conclusion: Overall the prevalence of adherence was high in patients with hyperlipidaemia. Interventions to boost adherence should target those who were identified as non-adherent.
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Diabetic retinopathy (DR) is one of the major microvascular complications of diabetes,it is the most common cause of preventable blindness in diabetic adults in developed countries.Dyslipidemia,a systemic disease,is one of the most important risk factors for cardiovascular disease.Patients with diabetes are susceptibly suffering from dyslipidemia.Many studies have shown that dyslipidemia can accelerate the progression of DR and aggravate the condition of DR,making the treatment of DR more difficult.The study on the mechanism of dyslipidemia aggravating DR provides a new way to treat and prevent DR by improving dyslipidemia.Current researches have shown that dyslipidemia may accelerate the progression of DR by exacerbating mitochondrial damage,insulin resistance,inflammatory response,and PKC/AGE pathway.Studies on lipid-lowering drugs,such as statins and fibrates and other lipid-lowering measures have shown that lipid-lowering is positive in the treatment of DR.This review summarizes the research progress of DR with dyslipidemia from the clinical features,potential mechanism and the effect of lipidlowering measures on DR.
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Objective To observe influence of atorvastatin combining with berberine on blood cholesterol level and carotid atherosclerotic plaques in patients with acute artery atherosclerosis cerebral infarction disease. Methods Fif-ty-five cases of acute cerebral infarction patients were randomized into 3 groups: group A (n=28), group B (n=11) and group C (n=16). Group A, B or C received atorvastatin 20 mg (qn), atorvastatin 40 mg (qn) or atorvastatin 20 mg (qn) +berberine 0.4 g (tid), respectively. All groups were then followed up for 3 months. The total cholesterol(TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C),high-density lipoprotein-cholesterol(HDL-C and the changes of carotid atherosclerotic plaques including total plaque area (TPA), crouse score,carotid intima-media thickness (IMT) and the stability of carotid plaques as well as the serum levels of creatinine(Scr), alanine aminotransferase(ALT), aspartate aminotransferase(AST), were compared among three groups. Results After 3 months, the TC, TG and LDL-C were de-creased in all three groups. There were statistically significant differences in the TC and LDL-C among these three groups (P=0.011,P=0.033) after treatment. The compliance rate of group C (75.0%) was significantly higher than group A ( 32.1% ) and group B (45.5%) in LDL-C (P=0.026). Both berberine combining with atorvastatin and atorvastatin monotherapy(20mg could significantly reduce crouse score. Conclusions Berberine can significantly enhance the benefi-cial effects of atorvastatin on LDL-C and the crouse score in patients with acute artery atherosclerosis cerebral infarction patients.
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BACKGROUND: In order to evaluate the factors of compliance with a lipid lowering therapy, a prospective observational study of patients with hypercholesterolemia using rosuvastatin was carried out. METHODS: A total of 2,607 patients who were newly prescribed rosuvastatin were enrolled from 32 family physicians in Korea from March 2009 to December 2009. Of them, 301 patients were excluded due to incomplete data or follow-up compliance data. The patients were regularly observed to ascertain the compliance associated with rosuvastatin at intervals of 12 and 24 weeks. We collected risk factors for the compliance using a structured questionnaire. The criteria for evaluating compliance are to measure clinic attendance, to assess the continuity of therapy, and to calculate the percentage of doses taken. RESULTS: Among a total of 2,306 patients, the degree of compliance was 54.1%. According to logistic regression analysis, the factors for compliance with the lipid lowering drug included old age (odds ratio [OR], 2.68; 95% confidence interval [CI], 2.09 to 3.45), frequent exercise (OR, 1.76; 95% CI, 1.43 to 2.18), previous statin therapy (OR, 4.02; 95% CI, 3.22 to 5.01), hypertension (OR, 1.80; 95% CI, 1.48 to 2.19), diabetes mellitus (OR, 2.20; 95% CI, 1.69 to 2.87), concomitant medication (OR, 2.28; 95% CI, 1.88 to 2.77), and high coronary heart disease (CHD) risk category (OR, 1.82; 95% CI, 1.39 to 2.38). The compliance decreased with high low density lipoprotein cholesterol levels (OR, 0.20; 95% CI, 0.16 to 0.26). CONCLUSION: The compliance of patients using rosuvastatin was 54.1% in primary care. The factors related to higher compliance were old age, regular exercise, previous statin therapy, concomitant medication, presence of hypertension or diabetes, and higher CHD risk level.
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Humans , Cholesterol , Cholesterol, LDL , Compliance , Coronary Disease , Diabetes Mellitus , Fluorobenzenes , Follow-Up Studies , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypercholesterolemia , Hypertension , Korea , Lipoproteins , Logistic Models , Physicians, Family , Primary Health Care , Prospective Studies , Pyrimidines , Risk Factors , Sulfonamides , Rosuvastatin Calcium , Surveys and QuestionnairesABSTRACT
Cardiovascular high risk population should receive intensive lipid-lowering therapy to reduce low density lipoprotein-cholesterol(LDL-C) below(2.6 mmol/L) or(1.8 mmol/L).This therapy can stop or regress atherosclerotic lesion,prevent and treat acute coronary syndrome.Individuals of coronary heart disease or risk equivalents can be benefited from intensive lipid-lowering therapy.
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Objective To investigate the plasma lipid levels,ratio achieving the optimal goals and its possible influencing factors in patients with coronary heart disease,and to elaborate the current status of lipid-lowering therapy.Methods The incipient plasma lipid level and status of therapy from the case history data of the 101 patients with CHD who were followed up after discharge were collected.The data including blood lipid levels and medications were recorded and analyzed.Results (1)60.6%patients with CHD had elevated LDL-C,but actually 80.7% had taken lipid-lowering drugs in hospital.(2)Lipid-lowering therapy was used in 68.3% of patients during the follow-up period.According to NCEP ATP Ⅲ,the ratio achieving the optimal LDL-C goals was 65.3%.(3)The ratio achieving the optimal goals was related to income and smoking(P0.05).(4)None of the patients had apparent elevated alanine aminotransferase(ALT)or creatine kinase(CK).Conclusion The current status of CHD lipid-lowering therapy remains a big gap.The ratio achieving the optimal goals is related to economy status and life style(smoking),and influenced by the physician quality of care,patient compliance,drug efficacy and cost–benefit.Long-term lipid-lowering therapy is safe when the drug use and dosage are appropriate.
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Objective To determine efficacy and safety of intensive lipid lowering with atorvastatin made in China in coronary artery disease(CAD)patients with high risk factors.Methods We enrolled 104 CAD patients admitted to our hospital with high risk Factors.All patients were randomized to either low dose of atorvastatin group(n=50,10 mg/daily)or large dose of atorvastatin group(n=54,40 mg/daily)for 6 months.Total cholesterol(TC),low den- sity lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),triglycerides(TG),serum glucose,hepatic function,renal function,ereatine kinase(CK)of the patients were measured before treatment and at 1 month,3 months,6 months,respectively.Results After six-month treatment,LDL-C,TC,TG levels were reduced by 38.04%,29.37%,20.74%,respectively in the low dose atorvastatin group compared with baseline; whereas reduced by 49.14%,37.69%,26.98%,respectively in the high dose atorvastatin group as compared with baseline level.As for HDL-C,it was increase of 5.98% in low dose atorvastatin group and 3.48% in high dose atorv- astatin group.Responder rates were 54.00% in low dose of atorvastatin group and 79.24% in large dose of atorvastatin group.Much more patients in the high dose atorvastatin group achieved LDL cholesterol goal compare with low dose ator- vastatin group(P