Article Archive
Highlights Report: 2014 FH Global Summit
The FH Global Summit offers a unique opportunity for all players in the healthcare arena, academia, government and patient advocacy groups, to act together to catalyse progress in FH care. Sooner not later: Children are the driver for improving FH care Top of the agenda…
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Unmet clinical needs in cholesterol lowering
Recent decades has seen marked improvement in reducing rates of heart disease and stroke (cardiovascular disease), particularly in developed nations.1 High levels of low-density lipoprotein cholesterol (LDL-C), or ‘bad cholesterol’ are considered a major risk factor for cardiovascular disease. International guidelines state that reduction of…
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Alirocumab and Lp(a): Pooled analysis of Phase II trials
Alirocumab 150 mg every 2 weeks reduced Lp(a) by 30% compared with placebo, based on a pooled analysis of 3 phase II trials in patients treated with background lipid-lowering treatment.1 These findings were consistent with a pooled analysis of evolocumab phase II trials,2 suggesting a…
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Evidence for the effects of PCSK9 beyond the liver
Evidence for the effects of PCSK9 beyond the liver was discussed by Professor Bertrand Cariou, INSERM UMR1087, l’Institut du Thorax, Nantes, France. A seminal paper showed that PCSK9 exerts hypocholesterolaemic effects via action in both the liver and intestine; in the latter case, PCSK9 modulates…
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Reducing the burden of Disease and Death from Familial Hypercholesterolemia: A Call to Action
Familial hypercholesterolemia (FH) is a genetic disease characterized by substantial elevations of low-density lipoprotein cholesterol, unrelated to diet or lifestyle. Untreated FH patients have 20 times the risk of developing coronary artery disease, compared to the general population. Estimates indicate that as many as 1…
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IMPROVE-IT: will it prove anything?
Professor Anthony S. Wierzbicki, London UK Comments on the IMPROVE-IT debate Cardiovascular disease (CVD) guidelines are emphasising the use of clinical outcome data on major vascular events (American Heart Association/American College of Cardiology)1 or hard CVD events alone (UK NICE)2 . They have begun to…
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Low PCSK9 levels in CKD patients on haemodialysis
Serum PCSK9 levels are decreased in patients with chronic kidney disease (CKD) undergoing haemodialysis, thereby implying that PCSK9 plays a similar important role in regulating low-density lipoprotein cholesterol (LDL-C) levels in these patients, as in the general population. Abujrad H, Mayne J, Ruzicka M, Cousins…
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What does PCSK9 monoclonal antibody therapy offer to reduce residual CV risk?
Anthony S. Wierzbicki DM, DPhil, FRCPath Consultant, Department of Metabolic Medicine/Chemical Pathology Guy’s & St Thomas’ Hospitals St Thomas’ Hospital, London UK E-mail: [email protected] Cardiovascular disease (CVD) remains the greatest cause of world morbidity and mortality. Rates of CVD have decreased in parallel with reductions…
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ODYSSEY trials at ESC Congress Hotline
ESC Congress 2014: Lipids Hotline: ODYSSEY TRIALS Prof Alberto Zambon, University of Padua, Italy discusses the four ODYSSEY trials with the PCSK9 inhibitor alirocumab presented at ESC Congress Hotline Sunday. Addition of a new investigational agent – Alirocumab – to high doses of statins result…
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The role of PCSK9 inhibitors in FH
Monoclonal antibodies targeting PCSK9 have been shown to reduce low density lipoprotein cholesterol (LDL-C) by 30-40% in patients with familial hypercholesterolaemia (FH) who still have LDL receptors. Studies also show that the investigational drug, evolocumab was well tolerated, Dr Dirk Blom said.
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Take home messages from ACC2014
Results of studies presented in 2014, show that PCSK9 inhibitors: 1) very effectively reduce low density lipoprotein cholesterol (LDL-C); and 2) show consistently predictable safety profiles. The positive results of short-term studies are now being reported in longer terms and larger clinical studies, Dr Evan…
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Updates from the literature
Norsworthy PJ, Vandrovcova J, Thomas ER, Campbell A, Kerr SM, Biggs J, Game L, Soutar AK, Smith BH, Dominiczak AF, Porteous DJ, Morris AD, Scotland G, Aitman TJ: Targeted genetic testing for familial hypercholesterolaemia using next generation sequencing: a population-based study. BMC.Med.Genet. 2014, 15:70. Abstract:…
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Dyslipidaemia management
2021: Lipid Measurements in the Management of Cardiovascular Diseases: NLA Scientific Statement https://www.lipid.org/sites/default/files/files/JACL%201734(3).pdf 2021: Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults. https://pubmed.ncbi.nlm.nih.gov/33781847/ 2021: Lipid-lowering and anti-thrombotic therapy in patients with peripheral arterial disease—European Atherosclerosis Society/European…
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Why we need new approaches
Undoubtedly, LDL cholesterol is the priority target for intervention to reduce the risk of cardiovascular disease (CVD), as reaffirmed by the recent ACC/AHA guidelines for cholesterol management.1 Statins are at the cornerstone of lipid-modifying therapy. However, as recommended targets for LDL cholesterol have fallen as…
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Do we need to re-consider cholesterol treatment in primary prevention?
High cholesterol is a major risk factor for atherosclerosis and coronary heart disease (CHD). However, many individuals with only mild to moderately elevated high cholesterol do not meet guideline criteria for treatment with statins. This poses a key question: Does prolonged exposure to only mild…
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Is there a need for a unified definition for FH?
2014 FH Global Summit: 13-14 October, New York, USA: FH is clearly underdiagnosed and undertreated in the majority of countries.1 Given this status quo, would the development of a unified global definition of FH offer advantages for detection, management and health policy? In the FH…
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Do the PCSK9 inhibitors have pleiotropic effects?
Experimental studies show that significant reductions in low density lipoprotein cholesterol (LDL-C) will significantly reduce inflammation which is important in Atherosclerosis (narrowing of the arteries) says Professor Erik Stroes.
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Lp(a) and FH
Certain conditions, notably familial hypercholesterolaemia (FH), are associated with increased Lp(a) levels. The mechanism of this is so far undefined and may not directly involve the LDL receptor pathway. Holmes DT, Schick BA, Humphries KH, Frohlich J. Lipoprotein(a) is an independent risk factor for cardiovascular…
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Lp(a) and CV risk
In epidemiological studies, levels of Lp(a) >125 nmol/L (~50 mg/dL), the 80th percentile for most populations, showed a consistent and independent positive association with CVD risk.1,2 Additionally, a large Mendelian randomisation study showed that a genetically determined doubling of Lp(a) was associated with a 22%…
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About Lp(a)
Lipoprotein(a) [Lp(a)] is an LDL-like plasma lipoprotein rich in cholesterol. Lp(a) differs from LDL as it contains an additional protein, apolipoprotein(a) [apo(a)], which is attached via a single disulphide bond. Apo(a) itself comprises a series of loop structures called kringles, named after a Danish pastry….
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