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PlayNews: International Atherosclerosis Society consensus statement on severe familial hypercholesterolaemia

News: International Atherosclerosis Society consensus statement on severe familial hypercholesterolaemia

In this new statement, the International Atherosclerosis Society (IAS) has placed phenotype at the heart of management strategies for familial hypercholesterolaemia (FH, inherited high cholesterol). Commenting, lead author Dr. Raul Santos (University of São Paulo Medical School Hospital and Preventive Medicine Centre and Cardiology Program,…

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PCSK9 Inhibitors for Treatment of High Cholesterol levels: Effectiveness and Value

PCSK9 Inhibitors for Treatment of High Cholesterol levels: Effectiveness and Value

Ciaran Kohli-Lynch, working with Professor Andrew Briggs, University of Glasgow, UK critically appraises the findings and implications of the Institute for Clinical and Economic Review (ICER) report regarding the value of PCSK9 inhibitors in high cardiovascular risk patients. A summary of the report was published as:…

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Lipoprotein-associated PCSK9: Physiological implications?

Lipoprotein-associated PCSK9: Physiological implications?

Professor Sergio Fazio, The Knight Cardiovascular Institute of OHSU, Portland, USA overviews the physiological implications of lipoprotein-associated PCSK9.  Studies show that only 40% of total plasma PCSK9 associates with LDL. This raises a key question: Does lipoprotein-bound PCSK9 more accurately reflect PCSK9 activity?

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Legacy effects: Does early intensive LDL lowering treatment modify the atherosclerotic process?

Legacy effects: Does early intensive LDL lowering treatment modify the atherosclerotic process?

Professor Packard, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK discusses follow-up data from major statin trials and considers the potential mechanism for the legacy effect seen in some trials, such as WOSCOPS. These findings raise a key question: Would phased…

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PCSK9 inhibitors: What is the value of addressing unmet clinical needs in LDL management?

PCSK9 inhibitors: What is the value of addressing unmet clinical needs in LDL management?

No doubt the PCSK9 monoclonal antibodies are effective in lowering LDL cholesterol across the spectrum of high cardiovascular risk patients. Moreover, data from a recent meta-analysis looking at clinical outcomes with these novel treatments suggested a 50% reduction in all-cause mortality and myocardial infarction (1)….

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Study questions utility of measuring PCSK9 in ACS setting

Study questions utility of measuring PCSK9 in ACS setting

High PCSK9 levels at angiography were not predictive of 1-year mortality in patients with acute coronary syndrome (ACS), but did predict failure to attain LDL cholesterol goal at 1 year follow-up, independent of lipid-modifying therapy or baseline LDL cholesterol levels. This study measured PCSK9 levels…

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Need to manage lipoprotein(a), blood pressure and renal insufficiency in familial hypercholesterolaemia

Need to manage lipoprotein(a), blood pressure and renal insufficiency in familial hypercholesterolaemia

This study makes the case for identifying and managing elevated lipoprotein(a), high blood pressure, and renal insufficiency, to reduce the risk of premature coronary artery disease (CAD) in patients with familial hypercholesterolaemia (FH, inherited high cholesterol). Elevated lipoprotein(a) [Lp(a)] is already recognised as causal for…

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Stroke risk in heterozygous FH

Stroke risk in heterozygous FH

Are individuals with heterozygous familial hypercholesterolaemia (FH, inherited high cholesterol) at higher risk of stroke? And if so, does statin treatment ameliorate this risk? Results from this meta-analysis suggest this may be the case. Heterozygous FH is undoubtedly associated with an increased risk of premature…

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ATVB Council statement on nonstatin LDL therapy

ATVB Council statement on nonstatin LDL therapy

This timely statement, led by Professor Robert Hegele, Robarts Research Institute, Western University, London, Ontario, Canada, considers the place of nonstatin therapy, including PCSK9 inhibitors, in the prevention of cardiovascular disease (CVD). Evidence conclusively establishes LDL cholesterol as causal for atherosclerosis and CVD. Statins are…

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A global call to arms for FH­

A global call to arms for FH­

Over 40 experts from around the world have joined forces to for urgent action on familial hypercholesterolaemia. The European Atherosclerosis Society (EAS) FH Studies Collaboration (FHSC), led by Professor Kausik Ray, Imperial College London, UK, aims to address a number of challenges in FH. There…

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Universal screening for FH in children

Universal screening for FH in children

A report from Slovenia makes the case for universal screening for familial hypercholesterolaemia (FH, inherited high cholesterol) incorporating both family history and genetic data. Total cholesterol (TC) was measured in all children at age 5 years as part of the Slovenia national universal screening for…

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PCSK9 inhibition and glucose homeostasis: new reassurance from human genetics

PCSK9 inhibition and glucose homeostasis: new reassurance from human genetics

INSERM, UMR1087-CNRS UMR6291 & Université de Nantes, Faculté de Médecine, l’Institut du Thorax, and Department of Endocrinology, University Hospital of Nantes, Nantes, France The role of PCSK9 in glucose homeostasis is a critical issue, especially for the PCSK9 inhibitors (1), which are likely to be…

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LDL cholesterol lowering, PCSK9 and neurocognitive effects?

LDL cholesterol lowering, PCSK9 and neurocognitive effects?

The possibility of neurocognitive effects with low-density lipoprotein (LDL) cholesterol lowering has been much debated. A new study (1) raises this issue again, suggesting increased risk of memory loss during the 30 days following the start of treatment, when comparing statin users and nonusers of…

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PlayMaking premature CHD history

Making premature CHD history

Dr Samuel Gidding discusses how treating children with FH early can make premature CHD history

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PlayHow to identify children with FH

How to identify children with FH

Dr Samuel Gidding discusses how to identify children with FH

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PlaySafety of lowering LDL-C

Safety of lowering LDL-C

Dr Albert Wiegman discusses the safety of lowering LDL C in FH children

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PlayEAS Consensus Panel on Paediatric FH

EAS Consensus Panel on Paediatric FH

Dr Raul Santos discusses the EAS Consensus Panel statement on FH in children – Spanish Dr Raul Santos discusses the EAS Consensus Panel statement on FH in children – Portuguese

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Statin Associated Muscle Symptoms – a role for PCSK9 inhibitors? Professor Erik Stroes, Academic Medical Center, Amsterdam, the Netherlands comments

Statin Associated Muscle Symptoms – a role for PCSK9 inhibitors? Professor Erik Stroes, Academic Medical Center, Amsterdam, the Netherlands comments

The latest European Atherosclerosis Society Consensus Panel focused on statin associated muscle symptoms (SAMS),1 which at present accounts for up to 40% of referrals to specialised lipid clinics. The veracity of SAMS has been questioned given the apparent discrepancy between findings from clinical trials and…

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Statins and muscle symptoms: New EAS Consensus Panel statement

Statins and muscle symptoms: New EAS Consensus Panel statement

The European Atherosclerosis Society (EAS) Consensus Panel has published new guidance on the diagnosis, assessment and treatment of statin-associated muscle symptoms (SAMS). Unique to this statement is an overview of current understanding of the pathophysiology of statin myopathy. Without doubt, statins are the therapeutic cornerstone…

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Lifetime exposure and primordial prevention

Lifetime exposure and primordial prevention

Atherosclerosis is a slow onset insidious disease. It is asymptomatic until its manifestations cause significant morbidity and mortality. There is no cheap easy way to detect it. As a result disease management strategies rely on epidemiologically-based risk calculators to identify individuals likely to have significant…

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