Your SlideShare is downloading. ×
ACTUALIZACIÓN EN LÍPIDOS Y ARTERIOSCLEROSIS 2011. LLUIS MASANA. XIV JORNADA DE LA XARXA CATALANA DE LÍPIDS i ARTERIOSCLEROSI
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

ACTUALIZACIÓN EN LÍPIDOS Y ARTERIOSCLEROSIS 2011. LLUIS MASANA. XIV JORNADA DE LA XARXA CATALANA DE LÍPIDS i ARTERIOSCLEROSI

832
views

Published on

PONENCIA ACTUALIZACIÓN EN LÍPIDOS Y ARTERIOSCLEROSIS UPDATE 2011, REALIZADA POR EL DOCTOR LLUIS MASANA DURANTE LA XIV JORNADA DE LA XARXA CATALANA DE LÍPIDS i ARTERIOSCLEROSI

PONENCIA ACTUALIZACIÓN EN LÍPIDOS Y ARTERIOSCLEROSIS UPDATE 2011, REALIZADA POR EL DOCTOR LLUIS MASANA DURANTE LA XIV JORNADA DE LA XARXA CATALANA DE LÍPIDS i ARTERIOSCLEROSI

Published in: Health & Medicine

1 Comment
1 Like
Statistics
Notes
  • THIS PPT IS GOOD!
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
No Downloads
Views
Total Views
832
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
7
Comments
1
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. XIV JORNADA DE LA XARXA CATALANA DE LÍPIDS i ARTERIOSCLEROSI ACTUALITZACIÓN EN LÍPIDOS Y ARTERIOSCLEROSIS UPDATE 2011 LLUÍS MASANA HOSPITAL UNIVERSITARI SANT JOAN UNIVERSITAT ROVIRA & VIRGILI CIBERDEM-IISPV REUS
  • 2. Búsqueda PubMed“Atherosclerosis AND Lipoprotein” Limits: 1 year English or Spanish+ búsqueda específica en NEJM, Circulation, Diabetes Estudios básicos y clínicos pero de interés clínico Estudios en humanos Selección totalment sesgada por las preferencias del “speaker”Total 1269 artículos; Primera selección 84 pdf; Incluidos 44
  • 3. CÉLULAS, MOLÉCULAS, LÍPIDOS Y ARTERIOSCLEROSIS
  • 4. The Human Plasma LipidomeN Engl J Med 2011;365:1812-23.
  • 5. Autophagy Regulates Cholesterol Efflux from Macrophage Foam Cells via Lysosomal Acid LipaseCell Metabolism 2011, 13: 655-667
  • 6. Metabolism: Let them eat fatNature:477:166–167; 2011
  • 7. MicroRNA Modulation of Cholesterol HomeostasisArterioscler Thromb Vasc Biol. 2011;31:2378-2382
  • 8. MicroRNAs are Transported in Plasma and Delivered to Recipient Cells by High-Density LipoproteinsNat Cell Biol. 2011 April ; 13(4): 423–433. doi:10.1038/ncb2210.
  • 9. MicroRNAs are Transported in Plasma and Delivered to Recipient Cells by High-Density LipoproteinsNat Cell Biol. 2011 April ; 13(4): 423–433. doi:10.1038/ncb2210.
  • 10. OxLDL up-regulates microRNA-29b, leading to epigenetic modifications ofMMP-2/MMP-9 genes: a novel mechanism for cardiovascular diseases FASEB J. 25, 1718–1728 (2011)
  • 11. GUÍAS CLÍNICAS Y CONSENSOS
  • 12. Assessment and Treatment of Cardiovascular Risk in Prediabetes: Impaired Glucose Tolerance and Impaired Fasting Glucose Because prediabetes and diabetes are CV risk equivalents,the goals for LDL-C level should be similar in both groups: LDL-C 70 mg/dL in patients with prediabetes/diabetes with known CVD or without CVD but with 1 additional major CV risk factor; and LDL-C 100 mg/dL in patients with prediabetes/diabetes without CVD and without any major CV risk factor. The TZDs—especially at low doses and in combination with metformin— represent a rational choice to ameliorate insulin resistance, prevent the progression of IGT/IFG to type 2 diabetes, and possibly to reduce the high incidence of CV events in individuals with prediabetes and type 2 diabetesAm J Cardiol 2011;108[suppl]:3B–24B
  • 13. FÁRMACOS, PAUTAS TERAPÉUTICAS Y ENSAYOS CLÍNICOS
  • 14. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trialThe Lancet, 2011; 377, 2153-2154
  • 15. Safety of Anacetrapib in Patients with or at High Risk for Coronary Heart DiseaseN Engl J Med Nov 2010
  • 16. Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non- invasive multimodality imaging (dal-PLAQUE): a randomised clinical trialLancet 2011;378: 1547-59
  • 17. Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non- invasive multimodality imaging (dal-PLAQUE): a randomised clinical trialLancet 2011;378: 1547-59
  • 18. dal-VESSEL FMD: Observed change from baseline. No adverse effect of dalcetrapib 2.00 Placebo (n=234) 1.75 Dalcetrapib 600 mg (232) Change from baseline in % FMD 1.50 1.25 1.00 0.75 0.50 0.25 0.00 -0.25 -0.50 0 12 36 Week Data presented as least squares mean (SE) absolute change from baseline in %FMD at weeks 12 and 36Lüscher et al. ESC 2011.23
  • 19. AIM-HIGH STUDY-FDA Statement on the AIM-HIGH Trial[05-26-2011]The U.S. Food and Drug Administration (FDA) will conduct a comprehensive review of the results from the clinical trial called the Atherothrombosis Intervention in MetabolicSyndrome with Low HDL/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) once they are available. The AIM-HIGH trial studied whether raising high-densitylipoprotein (HDL) or "good" cholesterol levels in patients who have a history of cardiovascular disease and well-controlled low-density lipoprotein (LDL) or "bad" cholesterollevels could lower the rate of major adverse cardiovascular events (MACE). In AIM-HIGH, MACE was defined as cardiovascular death, non-fatal heart attack, ischemic stroke,hospitalizations for acute coronary syndrome in which there is insufficient blood flow to the heart, or revascularization procedures to improve blood flow in the arteries of theheart and brain.In this trial, all study participants were given standard therapy with simvastatin 40 mg per day, and then randomly assigned to receive either extended-release niacin 1500-2000mg per day or placebo. In the first year of the trial, the simvastatin dose could be adjusted, or a second LDL cholesterol-lowering drug, ezetimibe 10 mg, could be added, toachieve the target LDL-cholesterol goal of 40-80 mg/dL.The trial was started in September 2005, but was stopped early due to the lack of incremental benefit on cardiovascular risk reduction in the extended-release niacin plussimvastatin treatment group over simvastatin alone. In addition, a small, unexplained, increase in the rate of ischemic stroke was noted in the simvastatin plus extended-releaseniacin group compared to the simvastatin alone group (28 strokes [1.6%] vs. 12 strokes [0.7%], respectively). Nine of the ischemic strokes in the simvastatin plus extended-release niacin group occurred in participants who had stopped taking their niacin for at least 2 months and up to 4 years before their stroke. Therefore, it is unclear what role, ifany, niacin contributed to this imbalance in ischemic stroke.At this time, FDA has made no new conclusions or recommendations regarding the use of extended-release niacin alone or in combination with simvastatin or other statins.The Agency will conduct a comprehensive review of the AIM-HIGH trial data as soon as they become available to determine their impact on the approved indications forextended-release niacin.High-dose niacin is a prescription drug that is used along with diet and exercise to manage cholesterol and fat (triglyceride) levels in the blood. It is also indicated as amonotherapy to lower the risk of heart attacks in patients who have had a heart attack and have high cholesterol. High-dose niacin is available as an extended-release tabletunder the brand-name Niaspan, and is also available in combination with simvastatin under the brand-name Simcor, and in combination with lovastatin under the brand-nameAdvicor.Healthcare professionals should consider the available clinical information on high-dose extended-release niacin and statin drugs when deciding what cholesterol-loweringmedication to prescribe.Patients should not stop taking their current medications without talking to their healthcare professional.The Agency will update the public with any new recommendations or conclusions when its review of the AIM-HIGH trial data is complete.The AIM-HIGH trial was funded by the National Heart, Lung, and Blood Institute (NHLBI). To view the NHLBIs press release, please visit NIH stops clinical trial on combinationcholesterol treatment1.-Related Information•Simvastatin (marketed as Zocor) Information2•NIH stops clinical trial on combination cholesterol treatment3NIH Press Release - 5/26/2011
  • 20. Weighing the Benefits of High-Dose Simvastatin against the Risk of Myopathy10.1056/nejmp1106689 2 nejm.org
  • 21. The relationship of vitamin D deficiency to statin myopathy abstract Objective: Our goal was to examine the interaction between vitamin D and statins and the possible role of vitamin D deficiency in statin myopathy. Background: The vitamin D receptor is present in skeletal muscle and vitamin D deficiency can cause myopathy. Statins (3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors) are generally well tolerated, but have been associated with a spectrum of skeletal muscle complaints, ranging from myalgia and asymptomatic mild elevations of creatine kinase (CK) to rhabdomyolysis. There has been recent interest in the possible interaction between statin myopathy and vitaminDdeficiency.Weperformed a systematic medical literature review to examine this possible relationship. Methods: We identified English language articles relating statins, vitamin D and statin myopathy via a PubMed search through July 2010. Articles pertinent to the topic were reviewed in detail. Results/conclusions: Our review suggests that some but not all statins increase 25(OH) D levels. Two crosssectional studies have associated vitamin D deficiency with statin- associated myalgias, and suggested that that increasing vitamin D levels can reverse the myalgia. Nevertheless, given the quality and paucity of studies examining this possibility, additional studies are needed to examine the potential role of vitamin D deficiency in statin myopathy. It is presently premature to recommend vitamin D supplementation as treatment for statin associated muscle complaints in the absence of low vitamin D levels although such supplementation could be tried in patients with deficient or reduced vitamin D levels.Atherosclerosis 215 (2011) 23–29
  • 22. Colesevelam HCl Added to Background Metformin Therapy in Patients With Type 2 Diabetes Mellitus: A Pooled Analysis From Three Clinical StudiesEndocr Pract 2011 AACE.DOI:10.4158/EP11218.OR
  • 23. ASPECTOS EPIDEMIOLÓGICOS DEL RIESGO CARDIOVASCULAR
  • 24. Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death The Emerging Risk Factors Collaboration*N Engl J Med 2011;364:829-41.
  • 25. Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death The Emerging Risk Factors Collaboration*N Engl J Med 2011;364:829-41.
  • 26. Adolescent BMI Trajectory and Risk of Diabetes versus Coronary DiseaseN Engl J Med 2011;364:1315-25.
  • 27. Trends in the Risk for CHD Among Adults With Diagnosed Diabetes in the U.S. Findings from the National Health and Nutrition Examination Survey, 1999–2008DIABETES CARE, VOLUME 34, JUNE 2011
  • 28. Changes in atherosclerotic plaques induced by inhalation of diesel exhaustAtherosclerosis 216 (2011) 299–306
  • 29. Traffic Air Pollution and Oxidized LDLPLoS ONE 6(1): e16200. doi:10.1371/journal.pone.0016200
  • 30. MARCADORES DE RIESGO CARDIOVASCULAR
  • 31. Decreased circulating lipoprotein-associated phospholipase A2 levels areassociated with coronary plaque regression in patients with ACSAtherosclerosis xxx (2011) xxx– xxx
  • 32. Lipoprotein-associated phospholipase A2 testing usefulness among patients with symptomatic intracranial atherosclerotic diseaseAndreu Massot et al. Atherosclerosis 218 (2011) 181– 187
  • 33. Predictive value of remnant lipoprotein for cardiovascular events in patients with coronary artery disease after achievement of LDL-cholesterol goalsAtherosclerosis 218 (2011) 163– 167
  • 34. IMAGEN , FUNCIÓN VASCULAR Y ATEROSCLEROSIS SUBCLÍNICA
  • 35. Predictors of Coronary Heart Disease Events Among Asymptomatic Persons With Low Low-Density Lipoprotein Cholesterol MESA (Multi-Ethnic Study of Atherosclerosis)J Am Coll Cardiol 2011;58:364–74
  • 36. Predictors of Coronary Heart Disease Events Among Asymptomatic Persons With Low Low-Density Lipoprotein Cholesterol MESA (Multi-Ethnic Study of Atherosclerosis)J Am Coll Cardiol 2011;58:364–74
  • 37. Aortic Pulse Wave Velocity Is Associated With Measures of Subclinical Target Organ DamageJACC:CARDIOVASCULARIMAGING,VOL.4,NO.7,2011
  • 38. Carotid-Wall Intima–Media Thickness and Cardiovascular Eventsn engl j med 365;3 nejm.org july 21, 2011
  • 39. Evaluation of subclinical atherosclerosis by computed tomography coronary angiography and its association with risk factors in familial hypercholesterolemiaAtherosclerosis 213 (2010) 486–491
  • 40. HDL
  • 41. Cholesterol Efflux Capacity, High-Density Lipoprotein Function, and Atherosclerosisn engl j med 364;2 nejm.org january 13, 2011 133
  • 42. Cholesterol Efflux Capacity, High-Density Lipoprotein Function, and Atherosclerosisn engl j med 364;2 nejm.org january 13, 2011 133

×