Lipid lowering drugs and risk of vascular events in older patients

Although elderly patients are at higher risk of cardiovascular events, the majority cardiovascular trials exclude these patients.  Accordingly, little is known about the use of lipid lowering medications for prevention of cardiovascular events in elderly populations. This prospective cohort study evaluated the association between use of statins or fibrates for prevention of vascular events among […]

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Why is Atherosclerotic Cardiovascular Disease Risk Overestimated by the ACC/AHA Pooled Cohort Equation?

The 2013 ACC/AHA Cholesterol Guidelines expand the recommendations for statin use to populations previously felt to be at lower risk. Central to risk-estimation in these guidelines is a new equation for determination of atherosclerotic cardiovascular disease (ASCVD) risk. However, this risk model has been criticized overestimating ASCVD risk in validation studies of the model.  Using […]

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Differences in Statin Eligible Patients across Guidelines

Recent ACC/AHA guidelines recommend consideration of statin therapy among patients with a 7.5% 10-year risk of atherosclerotic cardiovascular disease (CVD).  In this study, the authors examined implications of these new guidelines as compared with previous European Society of Cardiology (ESC) and Adult Treatment Panel III (ATP III) guidelines in a Dutch population-based prospective cohort of […]

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Validation of the Pooled Cohort Risk Equations from Recent ACC/AHA Guidelines

Recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the assessment of cardiovascular risk recommend a new 10-year atherosclerotic cardiovascular disease (CVD) risk prediction tool called the Pooled Cohort risk equation. This new predictive model developed from cohorts of patients that were largely studied prior to the year 2000.  In light of the declining […]

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Statins inhibit thrombosis

Hypercholesterolemia is one of the primary risk factors for atherosclerotic coronary disease. Statins have revolutionised lipid management with their proven ability to reduce circulating cholesterol levels and have even demonstrated regression of coronary plaques. Interestingly, statins have also been shown to have anti-inflammatory and anti-thrombotic activities, with several studies having shown statin therapy to be […]

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High-dose statin therapy linked to diabetes

Three recent trials comparing intensive- to moderate-dose statin therapy have suggested an increased risk of incident diabetes in patients treated with high-dose statin regimens.  To investigate this phenomenon further, the authors conducted a collaborative meta-anlysis of published and unpublished data from five statin trials, all of which were randomise controlled end-point trials that compared intensive-dose […]

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Ezetimibe and Cancer: What is the risk?

The recent Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) Trial showed that the combined treatment had no impact on the progression of aortic stenosis – but an excess of incident cancers was identified in the simvastatin-ezetimibe group when compared to placebo (105 vs 70, p=0.01). Deaths from cancer were also more frequent in the simvastatin-ezetimibe […]

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SEARCHing For A Genetic Cause of Statin Myopathy

The incidence of myopathy secondary to statin use is approximately 1 in 10,000 patients/year on standard doses, but increases with higher doses or concurrent prescription of drugs such as cyclosporine that can inhibit statin metabolism.  Identification of genetic factors that influence an individual’s susceptibility to these complications would improve patient management by identifying those who […]

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