Mayo Clinic proceedings
-
Mayo Clinic proceedings · Sep 2024
ReviewReview of Recent Literature and Updates in Nonstatin Cholesterol Management.
The guidelines for cholesterol management have been updated over the years from treat-to-target using any drug class to emphasis on statins without treatment targets to a hybrid of the 2 approaches. The most recent guideline updates include newer nonstatin lipid-lowering therapies (LLTs), low-density lipoprotein cholesterol (LDL-C) reduction goals, and LDL-C thresholds considering secondary prevention and cardiovascular risk. Although statins have been the mainstay of LLT for years, newer pharmacological agents such as proprotein convertase subtilisin-kexin type 9 inhibitor(s) (PCSK9i) monoclonal antibodies, small interfering RNA PCSK9i, and bempedoic acid to optimize LDL-C levels may be underutilized in clinical practice. ⋯ Cost may be a barrier to initiating these agents for patients who are underinsured or uninsured. Clinicians should reference the most up-to-date guidance for LLT for primary and secondary prevention of ASCVD. Additionally, clinicians must diligently continue to optimize statin and nonstatin LLT to improve cardiovascular health outcomes.
-
Mayo Clinic proceedings · Sep 2024
Genetic Risk and Coronary Artery Calcium in Personalizing Antihypertensive Treatment: A Pooled Cohort Analysis.
To assess the role of the systolic blood pressure polygenic risk score (SBP-PRS) in antihypertensive treatment initiation and its comparative efficacy with coronary artery calcium (CAC) scores. ⋯ Including genetic information in risk estimation of individuals with elevated BP/low-risk stage 1 hypertension has modest value in the initiation of antihypertensive therapy. Genetic risk and CAC both have efficacy in personalizing antihypertensive therapy.
-
Mayo Clinic proceedings · Sep 2024
Observational StudyImpact of Serum Creatinine- and Cystatin C-Based Sarcopenia Index on Renal Outcomes in Non-Dialysis-Dependent Chronic Kidney Disease Patients: Results From the KNOW-CKD Study.
To evaluate the impact of the serum creatinine- and cystatin C-based new sarcopenia index (SI) on renal outcomes in non-dialysis-dependent patients with chronic kidney disease (CKD). ⋯ The new SI is an independent predictor of renal outcomes. A low SI is associated with poor renal outcome.
-
Mayo Clinic proceedings · Sep 2024
Case ReportsTotal Laryngeal Transplant in the Setting of Active Laryngeal Malignancy.
Laryngeal transplant (LT) is a promising option to restore quality of life in patients with severe laryngeal dysfunction or a laryngectomy. These patients may be tracheostomy tube dependent or gastrostomy tube dependent and may lose their ability to verbally communicate. ⋯ Laryngeal transplant has the potential to restore all of these important laryngeal functions. Herein, we report the first known documented LT performed in the setting of laryngeal chondrosarcoma.
-
Mayo Clinic proceedings · Sep 2024
Observational StudyPredicting Primary Care Physician Burnout From Electronic Health Record Use Measures.
To evaluate the ability of routinely collected electronic health record (EHR) use measures to predict clinical work units at increased risk of burnout and potentially most in need of targeted interventions. ⋯ In a sample of primary care physicians, routinely collected EHR use measures demonstrated limited ability to predict individual burnout and moderate ability to identify high-risk clinics.