Articles related to CARDIOVASCULAR DISEASE (CVD)

Clinicians are directed to the American College of Cardiology/American Heart Association pooled cohort equation, which takes into account age, gender, blood pressure, lipids, diabetes mellitus, and tobacco use but not family history. The USPSTF now advises against starting aspirin therapy in individuals 60 and older since there is no net benefit and the risk of damage may outweigh the benefit. The USPSTF guidelines are based on evidence from 13 trials, which show that aspirin has a slight advantage for select adults aged 40 to 59, but no net benefit (with the potential for harm) for patients aged 60 and older.

The study was conducted while GLP-1 RAs and SGLT-2 inhibitors were still considered second-line therapies; however, in a 2022 Consensus Report, the American Diabetes Association and the European Association for the Study of Diabetes recommended these medications as first-line therapy for people with type 2 diabetes who have or are at high risk of certain complications such as heart failure, CKD, and atherosclerotic cardiovascular disease (ASCVD). Are the medications’ price tag keeping people away?

In a study of nearly 100,000 individuals aged 30 to 95 without any prior evidence of CVD, decline in peak metabolic equivalent of task score (METS) of greater than 1.0 was inversely proportionate to changes in mortality risk. METS were determined using symptom-limited exercise treadmill tests.

Bempedoic acid is currently approved for two patient subgroups. This 3-year, double-blind, randomized, placebo-controlled trial examined cholesterol-lowering and CV protective effects in a broader population of approximately 14,000 patients with elevated cholesterol who were unable or unwilling to take statins. The drug was 21% more effective than placebo at reducing LDL in this trial. There was a small but significant reduction in primary events of CV-related death, MI, stroke, or coronary revascularization.

Researchers used retinal imaging to examine the eyes of 200 people with age-related macular degeneration (AMD) to see who had subretinal drusenoid deposits (SDDs). Patients were asked to fill out a questionnaire about their family history of cardiovascular disease. There were 97 SDDs and 103 drusen only among the 200 patients. 47 of the 200 patients had severe heart disease, and 40 of the 47 (86%) had SDDs. In comparison, 57 (43%) of the 153 AMD patients who did not have these severe diseases had SDDs. According to the researchers, AMD patients who had these severe cardiovascular diseases and strokes were nine times more likely to have SDDs than those who did not.

Versus placebo, pemafibrate yielded a more than 25% greater reduction in triglycerides, VLDL, remnant cholesterol, and apolipoprotein C-III in patients with type 2 diabetes. However, there was no reduction versus placebo in MI, ischemic stroke, need for coronary revascularization, or CV death.