Overcoming patient reluctance to statin intolerance DOI Open Access
Basant E. Katamesh,

Alicia Mickow,

Linda Huang

et al.

Kardiologia Polska, Journal Year: 2024, Volume and Issue: 82(5), P. 485 - 491

Published: May 8, 2024

Statin therapy is a cornerstone in the management of dyslipidemia, both primary and secondary prevention cardiovascular events. Despite strong guidelines supporting statin use, concerns regarding side effects, particularly musculoskeletal symptoms, contribute to intolerance patient reluctance. While reported 5% 30% patients, its true prevalence may be overestimated due influence nocebo effect. Factors associated with higher incidence include older age, female sex, comorbidities such as diabetes chronic kidney disease, concurrent use medications antiarrhythmic agents or calcium channel blockers. Clinical characterization requires thorough evaluation exclusion alternative causes symptoms. Strategies address reassessing risk, engaging shared decision-making, rechallenge after appropriate washout periods, dosage titration for tolerability, consideration therapies when low-density lipoprotein goals cannot achieved statins. This review provides an overview spectrum intolerance, clinical assessment, systematic approach caring intolerance.

Language: Английский

2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines DOI Creative Commons
Salim S. Virani, L. Kristin Newby, Suzanne V. Arnold

et al.

Circulation, Journal Year: 2023, Volume and Issue: 148(9)

Published: July 20, 2023

AIM: The “2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease” provides an update to and consolidates new evidence since “2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Diagnosis Stable Ischemic Heart corresponding “2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update Disease.” METHODS: A comprehensive literature search was conducted from September 2021 May 2022. Clinical studies, systematic reviews meta-analyses, other on human participants were identified that published in English MEDLINE (through PubMed), EMBASE, Cochrane Library, Agency Healthcare Research Quality, selected databases relevant this guideline. STRUCTURE: This guideline evidenced-based patient-centered approach management patients with chronic coronary disease, considering social determinants health incorporating principles shared decision-making team-based care. Relevant topics include general approaches treatment decisions, guideline-directed therapy reduce symptoms future cardiovascular events, pertaining revascularization recommendations special populations, patient follow-up monitoring, gaps, areas need research. Where applicable, based availability cost-effectiveness data, cost–value are also provided clinicians. Many previously guidelines have been updated evidence, created when supported by data.

Language: Английский

Citations

587

2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease DOI Creative Commons
Salim S. Virani, L. Kristin Newby, Suzanne V. Arnold

et al.

Journal of the American College of Cardiology, Journal Year: 2023, Volume and Issue: 82(9), P. 833 - 955

Published: July 20, 2023

Language: Английский

Citations

217

10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2024 DOI Open Access
Nuha A. ElSayed, Grazia Aleppo, Raveendhara R. Bannuru

et al.

Diabetes Care, Journal Year: 2023, Volume and Issue: 47(Supplement_1), P. S179 - S218

Published: Dec. 11, 2023

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating Standards annually, or more frequently as warranted. For a detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.

Language: Английский

Citations

178

Understanding the molecular mechanisms of statin pleiotropic effects DOI Open Access
Charles German, James K. Liao

Archives of Toxicology, Journal Year: 2023, Volume and Issue: 97(6), P. 1529 - 1545

Published: April 21, 2023

Language: Английский

Citations

64

An “Inclisiran First” Strategy vs Usual Care in Patients With Atherosclerotic Cardiovascular Disease DOI Creative Commons

Michael Koren,

Fátima Rodríguez, Cara East

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(20), P. 1939 - 1952

Published: April 7, 2024

Most patients with atherosclerotic cardiovascular disease (ASCVD) fail to achieve guideline-directed low-density lipoprotein cholesterol (LDL-C) goals. Twice-yearly inclisiran lowers LDL-C by ∼50% when added statins. To evaluate the effectiveness of an "inclisiran first" implementation strategy (adding immediately upon failure reach <70 mg/dL despite receiving maximally tolerated statins) versus representative usual care in US ASCVD. VICTORION-INITIATE, a prospective, pragmatically designed trial, randomized 1:1 (284 mg at Days 0, 90, and 270) plus (lipid management treating physician's discretion) alone. Primary endpoints were percentage change from baseline statin discontinuation rates. We 450 (30.9% female, 12.4% Black, 15.3% Hispanic); mean 97.4 mg/dL. The led significantly greater reductions Day 330 (60.0% vs 7.0%; p<0.001). Statin rates (6.0%) noninferior (16.7%). More achieved goals (<70 mg/dL: 81.8% 22.2%; <55 71.6% 8.9%; Treatment-emergent adverse event (TEAE) serious TEAE compared similarly between treatment strategies (62.8% 53.7% 11.5% 13.4%, respectively). Injection-site TEAEs causing withdrawal occurred more commonly than (10.3% 0.0%, 2.6% 0.5%, An lowering without discouraging use or raising new safety concerns.

Language: Английский

Citations

35

10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 DOI

Nuha A. ElSayed,

Rozalina G. McCoy, Grazia Aleppo

et al.

Diabetes Care, Journal Year: 2024, Volume and Issue: 48(Supplement_1), P. S207 - S238

Published: Dec. 9, 2024

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating Standards annually, or more frequently as warranted. For a detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.

Language: Английский

Citations

28

Potential Benefits and Risks Associated with the Use of Statins DOI Creative Commons

Nisha Khatiwada,

Zhongkui Hong

Pharmaceutics, Journal Year: 2024, Volume and Issue: 16(2), P. 214 - 214

Published: Feb. 1, 2024

HMG-CoA reductase inhibitors, commonly known as statins, are the primary treatment choice for cardiovascular diseases, which stand leading global cause of mortality. Statins also offer various pleiotropic effects, including improved endothelial function, anti-inflammatory properties, reduced oxidative stress, anti-thrombotic and stabilization atherosclerotic plaques. However, usage statins can be accompanied by a range adverse such development type 2 diabetes mellitus, muscular symptoms, liver toxicity, kidney cataracts, hemorrhagic strokes, psychiatric complications. These issues referred to statin-associated symptoms (SAS) relatively infrequent in clinical trials, making it challenging attribute them statin use definitively. Therefore, these lead significant problems, necessitating dose adjustments or discontinuation therapy. This review aims provide comprehensive overview mechanism action, potential advantages, associated risks utilization settings.

Language: Английский

Citations

25

2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines DOI

Sunil V. Rao,

Michelle L. O’Donoghue, Marc Ruel

et al.

Circulation, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

Aim: The “2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes” incorporates new evidence since “2013 ACCF/AHA ST-Elevation Myocardial Infarction” and corresponding “2014 AHA/ACC Non–ST-Elevation “2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Intervention Infarction.” “2021 Artery Revascularization” retire replace, respectively, “2016 ACC/AHA Duration Dual Antiplatelet Therapy in Disease.” Methods: A comprehensive literature search was conducted from July 2023 to April 2024. Clinical studies, systematic reviews meta-analyses, other human participants were identified that published English MEDLINE (through PubMed), EMBASE, Cochrane Library, Agency Healthcare Research Quality, selected databases relevant this guideline. Structure: Many recommendations previously guidelines have been updated with evidence, created when supported by data.

Language: Английский

Citations

13

2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes DOI
Sunil V. Rao, Michelle L. O’Donoghue, Marc Ruel

et al.

Journal of the American College of Cardiology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

Citations

2

Assessment and management of statin-associated muscle symptoms (SAMS): A clinical perspective from the National Lipid Association DOI Creative Commons
Bruce A. Warden, John R. Guyton,

Adrienne C Kovacs

et al.

Journal of clinical lipidology, Journal Year: 2022, Volume and Issue: 17(1), P. 19 - 39

Published: Sept. 11, 2022

Statin-associated muscle symptoms (SAMS) are the most common form of statin intolerance and associated with increased risk cardiovascular events that manifest from underutilization discontinuation. The reported frequencies SAMS divergent in literature. writing group estimates prevalence SAMS, namely all temporally related to use but without regard causality, be about 10% (range 5% 25%), pharmacological specifically resulting properties statin, 1-2% 0.5% 4%). In clinical practice, likely result a combination nonpharmacological effects, however this does not make any less clinically relevant. Regardless etiology, need addressed accordance patients' preferences experiences. This perspective reviews epidemiology underlying pathophysiology consequences We present patient-centered communication strategies mitigate improve medication adherence outcomes among users. Treatment include 1) optimizing lifestyle interventions, 2) modulating factors may contribute symptoms, 3) tolerability by dose reduction, decreased dosing frequency, or an alternate more favorable pharmacokinetic properties, 4) non-statins, emphasizing those evidence for atherosclerotic either place therapy depending on patient's circumstances. focus is sustainable lipoprotein goal achievement, which important reduction.

Language: Английский

Citations

63