Clinical updates in management of cardiovascular risk Using data from large randomized clinical trials and from various cohorts, risk and treatment effects in individual patients can be predicted. Now even lifetime risk and lifetime treatment benefit can be predicted in terms of vascular disease-free life years gained.
DPP-4 inhibition with sitagliptin for 24 months decreased the intima-media thickness of the internal carotid artery in type 2 diabetic patients without established CVD.
Clinical updates in management of cardiovascular risk For lowering LDL-c, statins play a major role in both primary and secondary CV prevention in all patients. There is room for improvement with respect to choosing the right dosing regimen.
Clinical updates in management of cardiovascular risk CV risk factors that drive arterial disease in early life have a major impact on future CV risk. Communication about early lifestyle intervention to the public should be a major focus to reduce CV risk in later years.
Healthy food intake was associated with having no coronary artery calcium, and in combination with higher cardiorespiratory fitness, it was also associated with lower CAC levels.
Patients with hypertension with low platelet counts and high total homocysteine levels, which may promote platelet adherence, had the highest risk of first stroke, and this risk was reduced with folic acid treatment.
In a large community-based database, in patients with peripheral artery disease, statin therapy was associated with a significant reduction of amputations and mortality compared with no statin use.
In a double-blind pilot study, a single lean vegan-donor fecal microbiota transplantation in obese male patients with metabolic syndrome did not alter markers of arterial wall inflammation.
Mendelian randomization study suggests that lowering LDL affects large artery atherosclerosis, but not small artery occlusion or cardioembolic stroke, while increasing HDL may benefit small artery disease.
In young asymptomatic individuals with family history of premature ASCVD, elevated Lp(a) is related to higher CAC score, resulting in the identification of individuals with subclinical atherosclerosis.
Evolocumab significantly changes lipoprotein particle number and size, irrespective of concordance with LDL-c at baseline or disease status.
Prof. John Kastelein describes 3 major disturbances in lipoprotein metabolism contributing to CV risk. Novel therapies are being developed to address residual risk after LDL-c eradication.