1,721,128 research outputs found
PCSK9 Inhibition could be Effective for Acute Myocardial Infarction.
No full textIn this review, we explore the role of PCSK9 and the inhibition of PCSK9 in patients after acute myocardial infarction (MI). Despite the implementation of evidencebased therapies to improve outcomes, one-year mortality remains at 12-15%, and there is still a need to further reduce complications related to MI. Mechanistic and epidemiologic studies have suggested that the naturally occurring PCSK9 protein increases coronary plaque vulnerability through several pathways, including pro-inflammatory LDL-C oxidation and direct modification of plaque composition. PCSK9 inhibitors are a class of drugs with proven efficacy in patients with recent MI. The latest guidelines recommend the use of PCSK9 inhibitors in patients with recent MI early in the process of care to reduce LDL-C values and associated morbidity. The use of PCSK9 inhibition could be beneficial for mortality reduction after an acute MI and should be tested in an appropriately powered randomized controlled trial
Inhibiteurs de la PCSK9 : un nouveau traitement pour l’hypercholestérolémie
No full textThe proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors appear to represent an important development in the management of hypercholesterolemia. US Food and Drug Administration and European Medicines Agency approved alirocumab and evolocumab, injected drugs administered subcutaneously every 2 or 4 weeks, for patients with hypercholesterolemia, such as those who not reached the cholesterol targets or those with intolerance to statin, especially in secondary prevention or familial hypercholesterolemia. This decision is based on several clinical trials suggesting that these drugs have a powerful effect on levels of LDL-cholesterol with an acceptable safety compared to placebo. Large clinical studies are currently performed to assess the impact of PCSK9 inhibitors on major adverse cardiovascular events in secondary prevention.Le traitement de l’hypercholestérolémie entre dans une nouvelle phase de développement avec la mise sur le marché prochaine des inhibiteurs de la proprotéine convertase subtilisine/kexine de type 9 (PCSK9). La Food and Drug Administration (FDA) et l’Agence européenne des médicaments (EMA) ont approuvé récemment l’alirocumab et l’évolocumab, des anticorps monoclonaux injectables par voie sous-cutanée toutes les deux ou quatre semaines contre la PCSK9, pour le traitement de l’hypercholestérolémie chez les patients avec une intolérance ou une réponse insuffisance aux statines, surtout en prévention secondaire ou en cas d’hypercholestérolémie familiale. Cette décision est basée sur plusieurs essais cliniques montrant que les inhibiteurs de la PCSK9 baissent le LDL-cholestérol comparés au placebo, alors que les études sont en cours pour évaluer l’impact sur les événements cardiovasculaires
Recommandations de prise en charge des dyslipidemies en 2016 en Suisse.
No full textDiscordance between American guidelines and the "Swiss medical Board" position regarding treatment of dyslipidemia raised many questions. While benefits of statins are clear in secondary prevention, care should be individualised according to PROCAM cardiovascular risk score adapted to Switzerland in primary prevention. Lifestyle modification should be the first line therapy and a drug therapy is an option in high or intermediate risk, but not anymore in low cardiovascular risk. Familial dyslipidemia, often identified only after first cardiovascular event, should not be missed, as particular care is needed and riskscores cannot be used in this situation. Statins adverse effects remain a challenge in daily clinical practice.La discordance entre les recommandations américaines et la prise de position restrictive du « Swiss Medical Board » sur la prise en charge des dyslipidémies a soulevé de nombreuses questions. Alors que le bénéfice des statines est clair en prévention secondaire, il faut individualiser l’approche selon le score de risque cardiovasculaire de PROCAM, adapté à la Suisse en prévention primaire. Les modifications du style de vie sont prioritaires et un traitement médicamenteux est une option lors de risque élevé ou intermédiaire mais n’est plus recommandé lors de risque faible. Il ne faut pas manquer les dyslipidémies familiales, souvent identifiées qu’après le premier événement cardiovasculaire et nécessitant une prise en charge particulière, les scores de risque n’étant pas fiables dans ces maladies. Les effets indésirables des statines restent un défi au quotidien
Evidence and controversies regarding the screening for subclinical hypothyroidism in patients with cardiovascular disease.
No full textInclisiran in primary prevention: reality or fiction?
Full text linkThis editorial refers to ‘Effect of inclisiran on lipids in primary prevention: the ORION-11 trial’, by K.K. Ray et al., https://doi.org/10.1093/eurheartj/ehac615</a
[Highlights from the 2015 ESC NSTE-ACS Guidelines].
No full textThe 2015 non-ST-segment elevation acute coronary syndromes guidelines of the European Society of Cardiology have been published 4 years after the previous edition. A new algorithm was presented for the diagnosis of acute myocardial infarction based on the measurement of high-sensitivity cardiac troponin levels at presentation and at 1 hour, including a guidance on the duration of cardiac rhythm monitoring. New recommendations address the management of antiplatelet therapy regarding duration of dual antiplatelet therapy, in patients requiring long-term anticoagulation or undergoing urgent coronary artery bypass surgery as well as of acute bleeding events related to antithrombotics. The guidelines give a clear recommendation in favor of the radial access over the femoral one for coronary angiography and percutaneous revascularization
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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