Author Interviews, Heart Disease, JAMA, Lipids / 03.07.2024

MedicalResearch.com Interview with: Evan A Stein MD PhD FACC COO/CSO LIB Therapeutics Cincinnati. OH USA 45227 MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) remains the main cause of morbidity and mortality worldwide and is increasing in rapidly industrializing countries and is projected to cause more than >20 million deaths annually over the next 15 years. Low-density lipoprotein cholesterol (LDL-C) is well established as a major, easily modifiable, risk factor for CVD. Reductions with statins and, more recently, PCSK9 inhibitors, all agents which directly or indirectly upregulate the LDL receptor and enhance LDL-C clearance, have demonstrated CVD event reductions in cardiovascular outcome trials. Extensive data from these trials, provide a rough estimate that every 40 mg/dL reduction in LDL-C will reduce the risk of major CV cardiovascular events by 22% to 24%. Furthermore, trials with PCSK9 inhibitors added to statins which achieve substantial additional LDL-C reduction show and CVD event reduction remains linear to very low LDL-C levels without signals of adverse events. Based on this body of evidence, recent revisions to national and international guidelines, now advocate for greater LDL-C reductions and lower LDL-C treatment goals, for patients not achieving these goals on statins alone. The current consensus target goal for LDL-C in patients with CVD, or who are at very-high risk for of CVD, is now less than <55 mg/dL, and <70 mg/dL for those at high risk. This global trial of over 900 patients with CVD, or at very or high risk for CVD, on maximally tolerated statins assessed the 52-week efficacy and safety of monthly lerodalcibep. (more…)
Author Interviews, JAMA, Lipids, Pediatrics, USPSTF / 26.07.2023

MedicalResearch.com Interview with: Li Li, M.D., Ph.D., M.P.H Walter M. Seward Professor Chair of Family Medicine Director of population health University of Virginia School of Medicine Editor-in-chief of The BMJ Family Medicine Dr. Li joined the U.S. Preventive Services Task Force in January 2021 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Task Force reviewed the latest available evidence to evaluate whether screening all children and adolescents who are 20 years old or younger for high cholesterol improves their heart health into adulthood. At this time, there is not enough evidence to determine whether or not screening all kids is beneficial, so we are calling for additional research on the effectiveness of screening and treatment of high cholesterol in kids and teens. (more…)
Author Interviews, Hip Fractures, Lipids / 20.01.2023

MedicalResearch.com Interview with: Dr Monira Hussain Senior Research Fellow & ECF Clinical Research Australian Fellow Public Health and Preventive Medicine Monash University Melbourne VIC MedicalResearch.com: What is the background for this study? Response:  25% of males and 44% of females aged 60 years or over experience minimal trauma fractures. Minimal trauma fractures are a clinical outcome of osteoporosis and may occur following little or no trauma i.e. fractures following a fall from standing height or less. Minimal trauma fractures are silent, people may not notice that they are at high risk of the disease until a bone is broken. I was aware of previous studies reporting that high-density lipoprotein cholesterol (HDL-C) was elevated in patients with osteoporosis. Two animal studies showing that HDL-C reduces bone mineral density by reducing osteoblast number and function provide a plausible explanation for why high HDL-C may increase the risk of fractures. Our study, the ASPirin in Reducing Events in the Elderly (ASPREE), and the ASPREE fracture substudy provide unique data that could determine whether these findings might apply to fracture risk in healthy older adults. The study collected data including HDL-C levels and fractures from more than 16,000 community-dwelling older adults. These participants were followed-up for a median of 4 years. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lipids / 16.11.2021

MedicalResearch.com Interview with: Nicholas A. Marston, MD, MPH Thrombolysis in Myocardial Infarction (TIMI) Study Group Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: There has been recent debate about how much of lipid-associated cardiovascular risk is from LDL cholesterol versus triglycerides. However, genetic studies suggest that apolipoprotein B is actually the primary driver of atherosclerotic risk. Since there is exactly one apoB lipoprotein on each lipid particle (LDL, IDL, VLDL), its measurement is a surrgate for the total number of apoB-containing lipoproteins. So in this study, we asked the question: Do common measures of cholesterol concentration, triglyceride concentration, or their ratio carry predictive value for cardiovascular risk beyond the number of apo-B containing lipoproteins? (more…)
Author Interviews, Lipids, Prostate Cancer / 03.06.2021

MedicalResearch.com Interview with: Michelle Hill, PhD Head, Precision & Systems Biomedicine Group QIMR Berghofer Medical Research Institute MedicalResearch.com: What is the background for this study? Response: The role of cholesterol and cholesterol lowering drug therapy in prostate cancer has been previously investigated with mixed results. Our previous laboratory studies indicate that high cholesterol diet accelerates the spreading of advanced prostate cancer. We also observed a change of the cellular location of cholesterol, from the cell periphery (plasma membrane) to inside the cell. This study investigates the how the change in cholesterol location promotes prostate cancer spread. (more…)
Alzheimer's - Dementia, Author Interviews, Lipids, Mental Health Research, Microbiome / 18.11.2020

MedicalResearch.com Interview with: Moira Marizzoni, PhD Researcher, Fatebenefratelli Center in Brescia  MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease is the most common cause of dementia. Still incurable, it directly affects nearly one million people in Europe, and indirectly millions of family members as well as society as a whole. The gut microbiota could play a role in brain diseases including Alzheimer’s disease. Some gut bacteria components or products can reach the brain via the blood and might promote brain amyloidosis (one of the main pathological features in Alzheimer’s disease).   MedicalResearch.com: What are the main findings?  Response: This study evaluated a cohort of 89 people between 65 and 85 years of age composed of subjects suffering from Alzheimer’s disease or other neurodegenerative diseases causing similar memory problems, and of subjects with no memory problems. The study revealed that elevated levels of microbiota-products with known pro-inflammatory properties (i.e. lipopolysaccharides and the short chain fatty acids acetate and valerate) were associated with greater cerebral amyloid pathology while elevated levels of those with anti-inflammatory properties (i.e. the short chain fatty acid butyrate) were associated with lower amyloid pathology. (more…)
Aging, Author Interviews, Geriatrics, Heart Disease, Lancet, Lipids / 11.11.2020

MedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark  MedicalResearch.com: What is the background for this study? Response: Previous studies have yielded mixed results regarding the association between elevated cholesterol levels and increased risk of atherosclerotic cardiovascular disease in individuals above age 70 years; with some studies showing no association and others only minimal association. However, these previous studies were based on cohorts recruiting individuals decades ago where life-expectancy were shorter and where treatment of comorbidities were very different from today (more…)
Author Interviews, COVID -19 Coronavirus, Lipids, Statins, UCSD / 26.09.2020

MedicalResearch.com Interview with: Lori B. Daniels, MD, MAS, FACC, FAHA Professor of Medicine Director, Cardiovascular Intensive Care Unit UCSD Division of Cardiovascular Medicine Sulpizio Cardiovascular Center La Jolla, CA 92037-7411  MedicalResearch.com: What is the background for this study? Response: The purpose of our study was to investigate whether there is an association between the use of statin medications and COVID-19 morbidity and mortality among patients hospitalized for COVID-19. Our study investigated all patients hospitalized for treatment of COVID at a major US academic medical center during the study period. We studied patients who were hospitalized with COVID-19, and compared those who had been taking statins for at least 30 days prior to admission, with those not on statins.  (more…)
Author Interviews, Heart Disease, Lipids, PAD, Women's Heart Health / 27.08.2020

MedicalResearch.com Interview with: First Author: Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author Dr. Virani Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center, Houston, TX Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX @virani_md MedicalResearch.com: What is the background for this study? What are the main findings? What do you think accounts for the gender differences? Response: We know that women with ischemic heart disease (IHD) have lower prescription rates for statin and high-intensity statin therapy. In this study, we assessed whether the same trends hold true for women with other forms of atherosclerotic cardiovascular disease (ASCVD) i.e. women with peripheral artery disease (PAD) or ischemic cerebrovascular disease (ICVD). Maximally tolerated statin therapy is a Class-I indication in patients with clinical ASCVD which includes PAD and ICVD. We also assessed statin adherence among men and women with PAD and ICVD. Lastly, we performed exploratory analyses to assess whether statin therapy, statin intensity, and statin adherence in women with PAD and ICVD were associated with cardiovascular outcomes and/or mortality.  (more…)
Author Interviews, Lipids, Regeneron / 26.08.2020

MedicalResearch.com Interview with: Professor F. J. Raal, FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand  MedicalResearch.com: What is the background for this study? Response: The objective of this randomized phase 3 study was to evaluate the efficacy and safety of evinacumab in adult patients with homozygous familial hypercholesterolemia (HoFH), a condition that remains very difficult to treat. The primary endpoint was reduction of low-density lipoprotein cholesterol (LDL-C) from baseline with evinacumab compared to placebo at 24 weeks.  MedicalResearch.com: Would you briefly explain what is meant by homozygous familial hypercholesterolemia? How many individuals may be affected by this disorder? Response: HoFH, or homozygous familial hypercholesterolemia, is the most serious and more rare form of familial hypercholesterolemia (FH).  It is estimated that as many as 1 in 300,000 people worldwide and approximately 1,300 people in the U.S. are affected by HoFH. A person who has HoFH has inherited two FH genes, one from each parent. They therefore have LDL-C levels that are elevated 4-fold or greater from birth and are at high risk for premature atherosclerotic disease and cardiac events which can occur in childhood. While current treatment guidelines recommend early and intensive LDL-C lowering, people with HoFH tend to be less responsive (or unresponsive) to standard lipid-lowering therapies, including high-intensity statins and PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors and often require lipid apheresis. (more…)
Author Interviews, Heart Disease, JAMA, Lipids / 21.08.2020

MedicalResearch.com Interview with: First Author Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX MedicalResearch.com: What is the background for this study? Response: The incidence of atherosclerotic cardiovascular disease among young patients has been on the rise. These patients with premature and extremely premature atherosclerotic cardiovascular disease experience similar rates of mortality compared to older adults. Additionally, these young patients have a greater accrued rate of life-time morbidity. Therefore, secondary prevention measures such as use of guideline concordant statin therapy and aspirin therapy are paramount in this population.  (more…)
Author Interviews, Heart Disease, JAMA, Lipids, Metabolic Syndrome, UCSF / 12.08.2020

MedicalResearch.com Interview with: Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC Professor of Medicine, UCSF School of Medicine, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: This paper describes the findings form the FOURIER study, a very large study evaluating the efficacy of evolocumab, a PCSK9 inhibitor in patients with metabolic syndrome and preexisting atherosclerotic cardiovascular disease (ASCVD) who were already being treated with statins. In this largest study of its kind of 27,000 patients we found that 60% of patients with ASCVD had metabolic syndrome. We also found that the presence of metabolic syndrome identified a higher risk of future cardiac & coronary events in these patients despite them receiving maximum tolerated doses of statin. Furthermore, study treatment with evolocumab was efficacious in reducing the increased risk during the median follow up of nearly 3 years . Unlike treatment with statins there was no risk of new-onset diabetes with evolocumab, which was generally well tolerated. What was interesting thatpatients without metabolic syndrome had much less benefit with PCSK9 inhibition. These findings suggest that the presence of metabolic syndrome can help the clinicians identify the ASCVD patients who are most likely to benefit from treatment with PCSK9 inhibitors. This will be of great help for the cost containment of therapeutic strategy as PCSK9 inhibitors as a class are still quite expensive drugs. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, JAMA, Lipids / 14.07.2020

MedicalResearch.com Interview with: Manja Koch, Ph.D., Research Associate Department of Nutrition Harvard T.H. Chan School of Public Health Majken K. Jensen, Ph.D. Adjunct Professor of Nutrition Harvard T.H. Chan School of Public Health & Professor in the Department of Public Health University of Copenhagen, Copenhagen, Denmark     MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and other dementias are highly prevalent conditions. According to the Alzheimer’s Association, 50 million people are currently living with Alzheimer’s disease or other dementias worldwide. Lower apolipoprotein E in plasma is a risk factor for dementia, but the underlying biological mechanisms are not fully understood. Thus, we investigated the role of apolipoprotein E overall and in lipoproteins with distinct metabolic functions in relation to cognitive function and dementia risk.. (more…)
Author Interviews, Brigham & Women's - Harvard, Geriatrics, Lipids / 08.07.2020

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Statins are cholesterol lowering medications that have been proven to prevent heart attacks, strokes and death in middle-aged adults. Current guidelines for cholesterol lowering therapy are uncertain as to treatment for older adults due to a lack of available data, even though older adults are at the highest risk of heart disease and death. (more…)
Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Heart Disease, JACC, Lipids / 23.05.2020

MedicalResearch.com Interview with: Robert P. Giugliano, MD, SM Senior Investigator, TIMI Study Group Cardiovascular Medicine Brigham and Women's Hospital Professor of Medicine Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? Response: Some prior studies had suggested that lipid lowering therapies were associated with impaired cognition.  We sought to explore this question in a prospectively designed substudy of the large FOURIER randomized, double-blind clinical trial utilizing patient self-surveys administered the end of the study to determine whether patients themselves noticed any changes in cognition over the duration of the trial. The survey tool was a shortened version of the Everyday Cognition Questionnaire (see attached) that asks patients 23 questions that assess memory and executive function (including subdomains of planning, organization, and divided attention). The questions are in the format of "Compared to the beginning of the study, has there been any change in .....", and are graded as 1=better/no change, 2=questionable/occasionally worse, 3=consistently a little worse, 4=consistently much worse. (more…)
Author Interviews, Heart Disease, Lipids / 02.04.2020

MedicalResearch.com Interview with: Nathan D. Wong, PhD, FACC, FAHA, FNLA Professor and Director Heart Disease Prevention Program Division of Cardiology, University of California, Irvine MedicalResearch.com: What is the background for this study? Response: Many higher risk persons, despite guideline-recommended therapy such as statins, still suffer from cardiovascular disease events. There are few therapies available to reduce this persistent risk. The REDUCE-IT trial led by Brigham and Women’s Hospital in Boston researchers originally published in November of 2018 was landmark in showing for the first time a highly purified, stable, prescription fish oil product, icosapent ethyl (an EPA only compound marketed as Vascepa®) if given to high risk persons with either cardiovascular disease or diabetes and two or more risk factors who were on statin therapy and had elevated triglyceride levels, achieved an unprecedented 25 percent reduction in the risk of time to first cardiovascular disease events. Given that many persons often experience multiple cardiovascular events, a follow-up analysis showed that TOTAL cardiovascular events were reduced by 30 percent.  (more…)
Author Interviews, Heart Disease, Lipids / 01.04.2020

MedicalResearch.com Interview with: Professor F. J. Raal, FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand MedicalResearch.com: What is the background for this study? How does Evinacumab differ from the three drugs used in triple therapy for this severe form of hypercholesterolemia? Response:      Despite available lipid lowering therapies, the vast majority of patients with homozygous familial hypercholesterolemia are unable to achieve desirable LDL-cholesterol levels and remain at high risk for premature atherosclerotic cardiovascular disease. Unlike statins and PCSK9-inhibitors which act mainly by upregulating LDL receptor activity on the cell surface, evinacumab, a monoclonal antibody inhibitor of ANGPTL3, acts independent of the LDL receptor. (more…)
Author Interviews, Lipids, NEJM, Neurological Disorders, Stroke / 18.11.2019

MedicalResearch.com Interview with: Pierre Amarenco, MD Professor and Chairman Paris University, Paris, France INSERM Department of Neurology and Stroke Centre Bichat Hospital Paris, France MedicalResearch.com: What is the background for this study? Response: The rationale of the Treat Stroke to target trial was that after we published the SPARCL trial in 2006 (atorvastatin 80 mg/day vs placebo in patients with stroke) which showed a 16% relative risk reduction of recurrent stroke, we performed several pre specified and post hoc analyses, showing that in SPARCL patients randomized with "atherosclerotic disease" the risk reduction for the primary endpoint was much higher (33%), and in in patients achieving a LDL cholesterol of less than 70 mg/dL as compared to those achieving a LDL cholesterol 100 mg/dL or higher, the risk reduction was 28%. Therefore to confirm this findings, we designed the TST trial, which was an investigator initiated trial funded by the french ministry of health,  and enrolled patients with an ischemic stroke due to atherosclerotic stenosis and randomized them to either a target LDL cholesterol of less than 70 mg/dL or a target LDL cholesterol of 90 to 110 mg/dL. To achieve these goals, the investigators could use any statin available on the market, and titrate the dosage of the statin to get to the assigned target. They could also use ezetimibe on top of statin therapy if a high dosage of statin was not sufficient to get to the target level assigned by randomization. (more…)
AHA Journals, Author Interviews, Heart Disease, Lipids / 17.09.2019

MedicalResearch.com Interview with: Samuel S. Gidding, MD FH Foundation Pasadena, CA MedicalResearch.com: What is the background for this study? Response: Patients with familial hypercholesterolemia are at high risk for atherosclerotic heart disease but little is known about intensification of treatment and event rates in lipid specialty care in the United States. We examined data on 1900 patients, enrolled in the CASCADE FH Registry,sponsored by the Familial Hypercholesterolemia Foundation, to determine if cholesterol lowering therapy increased to improve getting patients to a lower LDL cholesterol and to look at incident cardiac events in tow groups, those with prior heart disease and those without. (more…)
Author Interviews, BMJ, Diabetes, Lipids, Omega-3 Fatty Acids / 23.08.2019

MedicalResearch.com Interview with: Lee Hooper PhD, RD Reader in Research Synthesis, Nutrition & Hydration Norwich Medical School University of East Anglia England, UK MedicalResearch.com: What is the background for this study? Response: The World Health Organization asked us to carry out a set of studies (systematic reviews of randomised controlled trials) assessing health effects of omega-3 and omega-6, which are polyunsaturated fats. This is because the WHO are planning to update their dietary guidance on fats in the near future. Worries about effects of long chain omega-3 on control of diabetes have long existed, and some experimental studies have suggested that omega-3 supplementation and diets high in PUFA and omega-3 raise fasting glucose. Pollutants such as methylmercury and polychlorinated biphenyl levels exceeding recommended thresholds are rarer now, but have been reported in seafoods and fish oil supplements; elevated mercury levels interrupt insulin signalling, raising fasting glucose, in mouse models. Body concentrations of organic pollutants are correlated with prevalence of diabetes in the US, but other cross sectional studies have suggested either no association with or benefits of eating fish on glycaemic control. Systematic reviews of observational studies have suggested both positive and negative associations with glucose metabolism, but strong evidence shows that omega-3 supplements reduce raised triglycerides and have little or no effect on body weight. Theories suggest that omega-3 and omega-6 fats compete in some metabolic pathways so that the omega-3/omega-6 ratio is more important than absolute intakes of either.  (more…)
AHA Journals, Author Interviews, Lipids, Omega-3 Fatty Acids / 22.08.2019

MedicalResearch.com Interview with: Ann Skulas-Ray, PhD. Assistant Professor, Department of Nutritional Sciences University of Arizona MedicalResearch.com: What is the background for this study? Response: The prior guidance from the AHA regarding omega-3 fatty acids and high triglycerides was published in 2002, prior to the availability of prescription omega-3 concentrates and results from many of the clinical studies we were able to review. Our advisory was able to address questions such as dose and concomitant use of statin therapy. Another unique feature of our advisory is that we evaluated studies of the effects of omega-3 fatty acids in people with triglycerides (TG)  > or = 500 mg/dL and 200-499 mg/dL separately, so we were able to see patterns relating to dose of omega-3 fatty acids and baseline triglyceride values. We came to separate conclusions for populations above and below TG of 500 mg/dL and concluded that 4 g/d was most effective. In contrast, the 2002 guidance recommended 2-4 g/d EPA + DHA under a physician's care for high triglycerides.  (more…)
Author Interviews, Geriatrics, Heart Disease, Lipids / 18.07.2019

MedicalResearch.com Interview with: Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: Elderly patients represent the largest group of those hospitalized for an acute coronary syndrome, and age is an important marker of increased risk. The risk of death and recurrent cardiovascular events is greatest among the elderly. High intensity lipid lowering by statins has been shown to reduce the incidence of recurrent cardiovascular events after an acute coronary syndrome in general, but there remains limited data on efficacy and safety of that treatment in the elderly, and guidelines do not routinely advocate higher intensity treatment for patients older than 75 years. In practice, older age has been associated with a lower likelihood of being prescribed intensive lipid lowering therapy. IMPROVE-IT evaluated the effect of higher-intensity lipid lowering with ezetimibe combined with simvastatin compared with simvastatin-placebo among patients after ACS, and observed that ezetimibe added to statin therapy incrementally lowered LDL-cholesterol level and improved CV outcomes. IMPROVE-IT enrolled patients with no upper age limit, which gave us the opportunity to examine the effect of age on outcome on the benefit of more intensive lipid lowering with ezetimibe combined with simvastatin vs. simvastatin monotherapy. (more…)
Author Interviews, Heart Disease, Lipids / 18.07.2019

MedicalResearch.com Interview with: Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary  Co-authors: Guanmin Chen, PhD, MD, MPH, Megan S. Farris, MSc, Tara Cowling, MA, MSc, Stephen M. Colgan, PhD, Pin Xiang, PharmD, Louisa Pericleous, PhD, Raina M. Rogoza, MSc, Ming-Hui Tai, MSc, PhD, and Todd Anderson, MD  MedicalResearch.com: What are the main findings? Response:
  • Atherosclerotic cardiovascular disease (ASCVD) remains a significant cause of morbidity and mortality in Canada (and worldwide). Despite the established benefits of treatment with statins, most Canadians fail to achieve dyslipidemia targets (a risk factor for ASCVD).
  • The objective of this study was to examine current treatment patterns of lipid-lowering therapies for the management of low-density lipoprotein cholesterol (LDL-C) in patients with ASCVD.
  • This was a retrospective cohort study conducted using province-wide administrative health data from Alberta, Canada. Datasets used included health services, pharmaceutical, and laboratory data, in addition to the Alberta population registry. The study population consisted of individuals aged 18 years or older diagnosed with ASCVD between 2011-2015, based on International Classification of Diseases (ICD) codes. The cohort was then restricted to individuals with an initial (index) LDL-C measurement after ASCVD diagnosis and at least one year of pre-index data and one year of follow-up data.
(more…)
Amgen, Author Interviews, Cost of Health Care, JAMA, Lipids, UCLA / 24.06.2019

MedicalResearch.com Interview with: Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA  MedicalResearch.com: What is the background for this study? Response: Last year, Amgen made the PCSK-9 inhibitor evolocumab available at a reduced list price of $5,850 per year This 60% reduction was aimed at improving patient access by lowering patient copays, especially for Medicare beneficiaries. Additionally, the treatment landscape for PCSK9 inhibitors was further defined in 2018 when the American College of Cardiology/American Heart Association Multisociety Clinical Guideline on the Management of Blood Cholesterol recommended PCSK9 inhibitors for, among other patient populations, patients with very high-risk (VHR) ASCVD whose low-density lipoprotein cholesterol levels remain at 70 mg/dL or more  despite a heart-healthy lifestyle and treatment with standard background therapy. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Lipids / 28.05.2019

MedicalResearch.com Interview with: Samia Mora, MD, MHS Associate Physician, Brigham and Women's Hospital Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Preventive Medicine Boston, MA 02115  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Lipid testing plays a major role in cardiovascular disease (CVD) risk screening, prediction, and treatment. In the past decade, several pivotal studies (including the Women’s Health Study, the Copenhagen City Heart Study, and the Copenhagen General Population Study) compared populations of individuals who had fasting lipid testing with populations of individuals who had nonfasting lipid testing, and found that non-fasting lipids were at least as good as fasting lipids in cardiovascular risk screening and predicting CVD risk. To date, however, no study has examined the cardiovascular predictive value of lipids measured on the same individuals who had both fasting and nonfasting lipid testing. This is important because individual-level variability in fasting versus nonfasting lipids may not be captured when looking at population-level risk associations, and evidence from randomized studies is lacking. Furthermore, it is unclear whether substituting nonfasting lipids would misclassify cardiovascular risk for individuals who may be eligible for statin therapy. (more…)