Mayo Clinic proceedings
-
Mayo Clinic proceedings · Nov 2013
ReviewLipoprotein(a), cardiovascular disease, and contemporary management.
Elevated lipoprotein(a) (Lp[a]) is a causal genetic risk factor for cardiovascular disease. To determine if current evidence supports both screening and treatment for elevated Lp(a) in high-risk patients, an English-language search of PubMed and MEDLINE was conducted. In population studies, there is a continuous association between Lp(a) concentrations and cardiovascular risk, with synergistic effects when low-density lipoprotein (LDL) is also elevated. ⋯ If, after these interventions, the patient has progressive coronary heart disease (CHD) or LDL-C levels of 160-200 mg/dL or higher, LDL apheresis should be contemplated. Although Lp(a) is a major causal risk factor for CHD, no currently available controlled studies have suggested that lowering it through either pharmacotherapy or LDL apheresis specifically and significantly reduces coronary risk. Further research is needed to (1) optimize management in order to reduce CHD risk associated with elevated Lp(a) and (2) determine what other intermediate- or high-risk groups might benefit from Lp(a) screening.
-
Mayo Clinic proceedings · Nov 2013
Review Meta AnalysisStatins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects.
To evaluate the effect of statins on short-term cognitive function and the long-term incidence of dementia. ⋯ In patients without baseline cognitive dysfunction, short-term data are most compatible with no adverse effect of statins on cognition, and long-term data may support a beneficial role for statins in the prevention of dementia.
-
Mayo Clinic proceedings · Nov 2013
Review Meta AnalysisStatins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects.
To evaluate the effect of statins on short-term cognitive function and the long-term incidence of dementia. ⋯ In patients without baseline cognitive dysfunction, short-term data are most compatible with no adverse effect of statins on cognition, and long-term data may support a beneficial role for statins in the prevention of dementia.