Clinical cardiology
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Clinical cardiology · Oct 2014
Randomized Controlled Trial Multicenter StudyEfficacy and safety of alirocumab as add-on therapy in high-cardiovascular-risk patients with hypercholesterolemia not adequately controlled with atorvastatin (20 or 40 mg) or rosuvastatin (10 or 20 mg): design and rationale of the ODYSSEY OPTIONS Studies.
The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20-40 mg/d) or rosuvastatin (10-20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20-40 mg) or rosuvastatin (10-20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). ⋯ The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level.
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Clinical cardiology · Sep 2014
Impact of clinical and therapeutic factors on incident cardiovascular and cerebrovascular events in a population-based cohort of HIV-infected and non-HIV-infected adults.
Cardiovascular and cerebrovascular (CVD) events/diseases are a common cause of non-acquired immunodeficiency syndrome (AIDS)-related mortality in the aging human immunodeficiency virus (HIV)-infected population. The incidence rate and clinical correlates of CVD in people living with HIV/AIDS compared to the general population warrants further investigation. ⋯ After adjusting for traditional risk factors and sociodemographic differences, there is higher risk of incident cardiovascular events among HIV-infected individuals exposed to combined antiretroviral medications compared to the general population.
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Clinical cardiology · Sep 2014
Controlled Clinical TrialRosuvastatin reduces ischemia-reperfusion injury in patients with acute coronary syndrome treated with percutaneous coronary intervention.
Statins reduce the incidence of cardiovascular events after percutaneous coronary intervention (PCI), but no clinical studies have investigated the role of statins in ischemia-reperfusion injury after PCI. ⋯ Rosuvastatin before PCI reduced ischemia-reperfusion injury in patients with acute coronary syndrome, which suggests the importance of application of rosuvastatin before PCI for early intervention.
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Clinical cardiology · Aug 2014
Does low vitamin D amplify the association of COPD with total and cardiovascular disease mortality?
Chronic obstructive pulmonary disease (COPD) has been shown to be associated with lower levels of vitamin D, and the latter has been associated with total and cardiovascular disease (CVD) mortality. ⋯ Lower levels of vitamin D may be associated with further increases in total and CVD mortality associated with COPD; however, age and cardiovascular risk factors appear to explain much of this association.
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Clinical cardiology · Aug 2014
Hyperglycemia in patients referred for cardiac catheterization is associated with preexisting diabetes rather than a stress-related phenomenon: a prospective cross-sectional study.
An increased serum glucose level in patients with acute coronary syndrome (ACS) is associated with adverse clinical outcome. This hyperglycemia has been attributed, at least in part, to acute stress reaction. Our objective was to determine whether hyperglycemia is a stress-related phenomenon or whether it represents a more sustained and possibly significant background dysglycemia. ⋯ Hyperglycemia in patients undergoing cardiac catheterization is a strong predictor of adverse outcome. It is mainly related to background dysglycemia and to a lesser extent to the acute stress accompanying ACS.