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European consensus in questions about atherogenic dyslipidemia and combination of statine and obrate


Authors: M. Vráblík
Authors place of work: Centrum preventivní kardiologie, III. interní klinika 1. LF UK a VFN v Praze
Published in the journal: Kardiol Rev Int Med 2016, 18(1): 61-66
Category: Cardiology Review

Summary

Atherogenic dyslipidemia (AD), characterized by increased triglycerides in the context of the reduction in HDL-cholesterol (HDL-c), has been in the center of our attention for quite some time. Epidemiological trends, new knowledge about the importance of AD as well as the possibilities of its management led to the formulation of a consensus of European experts on this issue. AD regularly accompanies conditions associated with insulin resistance. Non-HDL-cholesterol and apolipoprotein B concentrations appear to be suitable markers of cardiovascular risk in patients with AD and, also, therapeutic targets. The question of remnant lipoproteins and their role in determining cardiovascular risk, especially in patients with AD, has gained special attention. Treatment is based on a rigorous diet and lifestyle modification. Pharmacological therapy is based on statins. In patients with hypertriglyceridemia and persistent unsatisfactory control of non-HDL-C a combination with fenofibrate should be considered. In this situation this combination further reduces the risk of macrovascular and microvascular complications.

Keywords:
consensus –  atherogenic dyslipidemia –  non-HDL cholesterol –  remnant lipoproteins –  statins –  fenofibrate


Zdroje

1. Češka R. Cholesterol a ateroskleróza, léčba dyslipidémií. Praha: Triton 2005.

2. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome –  new worldwide definition. Lancet 2005; 366: 1059– 1062.

3. Grundy SM, Cleeman JI, Merz CN et al. Coordinating Committee of the National Cholesterol Education Program. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Arterioscler Thromb Vasc Biol 2004; 24: 149– 161.

4. Lusis AJ, Mar R, Pajukanta P. Genetics of atherosclerosis. Annu Rev Genomics Hum Genet 2004; 5: 189– 218.

5. Soška V. Léčba dyslipidemie u diabetiků. Interní Med 2007; 4: 163– 166.

6. Adiels M, Olofsson SO, Taskinen MR et al. Overproduction of very low-density lipoproteins is the hallmark of the dyslipidemia in the metabolic syndrome. Atheroscler Thromb Vasc Biol 2008; 28: 1225– 1236. doi: 10.1161/ ATVBAHA.107.160192.

7. Hsieh J, Hayashi AA, Webb J et al. Postprandial dyslipidemia in insulin resistence: Mechanisms and role of intestinal insulin sensitivity. Atheroscler Suppl 2008; 9: 7– 13. doi:10.1016/ j.atherosclerosissup.2008.05.011.

8. Rivellese AA, De Natale C, Di Marino L et al. Exogenous and endogenous postprandial lipid abnormalities in type 2 diabetic patiens with optimal blood glucose control and optimal fasting triglyceride levels. J Clin Endocrinol Metab 2004; 89: 2153– 2159.

9. Catapano AL, Reiner Z, De Backer G et al. ESC/ EAS Guidelines for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 2011; 217: 3– 46.

10. Di Angelantonio E, Sarwar N, Perry P et al. The Emerging Risk Factors Collaboration. Major lipids, apolipoproteins, and risk of vascular disease. JAMA 2009; 302: 1993– 2000. doi: 10.1001/ jama.2009.1619.

11. Perk J, Backer GD, Gohlke H et al. European Guide­lines on cardiovascular disease prevention in clinical practice (version 2012). The fifth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol 2012;19: 585– 667. doi: 10.1177/ 2047487312450228.

12. Wuelffelé MG, Kooy A, de Zeeuw D et al. The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review. J Intern Med 2004; 256: 1– 14.

13. Eleftheriadou I, Grigoropoulou P, Katsilambros Net al. Effect of medications used for the management of diabetes and obesity on postprandial lipid metabolism. Curr Diab Rev 2008; 4: 340– 356.

14. Kearney PM, Blackwell L, Collins R et al. Cholesterol treatment trialists. Efficacy of cholesterol-lowering therapy in 18 686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008, 371: 117– 125. doi: 10.1016/ S0140-6736(08)60104-X.

15. Armitage J, Bowman L, Wallendszus K et al. Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) Collaborative Group. Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12,064 survivors of myocardial infarction: a double-blind randomised trial. Lancet 2010; 376: 1658– 1669.

16. Bruckert E, Hayem G, Dejager S et al. Mild to moderate muscular symp­toms with high-dosage statin therapy in hyperlipidemic patients-the PRIMO study. Cardiovasc Drugs Ther 2005; 19: 403– 414.

17. Rajpathak SN, Kumbhani DJ, Crandall J et al. Statin therapy and risk of developing type 2 diabetes: a meta-analysis. Diabetes Care 2009; 32: 1924– 1929. doi: 10.2337/ dc09-0738.

18. Preiss D, Sattar N. Statins and the risk of new-onset diabetes: a review of recent evidence. Curr Opin Lipido 2011; 22: 460– 466. doi: 10.1097/ MOL.0b013e32834b4994.

19. Baigent C, Landray MJ, Reith C et al. SHARP Investigators. 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 trial. Lancet 2011; 377: 2181– 2192. doi: 10.1016/ S0140-6736(11)60739-3.

20. Takase H, Dohi Y, Okado T et al. Effects of ezetimibe on visceral fat in the metabolic syndrome: a randomised controlled study. Eur J Clin Invest 2012; 42: 1287– 1294. doi: 10.1111/ eci.12000.

21. Handelsman Y. Role of bile acid sequestrants in the treatment of type 2 diabetes. Diab Care 2011; 34 (Suppl 2): S244– S250. doi: 10.2337/ dc11-s237.

22. Ginsberg HN, Elam MB, Lovato LC et al. ACCORD Study Group. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med 2010; 362: 1563– 1574. doi: 10.1056/ NEJMoa1001282.

23. Wright AD, Dodson PM. Medical management of diabetic retinopathy: fenofibrate and ACCORD Eye studies. Eye (Lond) 2011; 25: 843– 849. doi: 10.1038/ eye.2011.62.

24. Davidson MH, Ballantyne CM, Kerzner B et al. Efficacy and safety of ezetimibe coadministered with statins: randomised, placebo-controlled, blinded experience in 2382 patients with primary hypercholesterolemia. Int J Clin Pract 2004; 58: 746– 755.

Štítky
Paediatric cardiology Internal medicine Cardiac surgery Cardiology

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