Low-density lipoprotein-lowering strategies: target versus maximalist versus population percentile.

Abstract:

PURPOSE OF REVIEW:Maximalist low-density lipoprotein (LDL)-lowering strategies such as lowering LDL as much as possible or, alternatively, using the most potent LDL-lowering regimens have become increasingly popular. Almost all attention has focused on the potential advantages of these approaches with little focus on their potential disadvantages. Moreover, it is increasingly assumed that the lower and lower is better and better approach is supported by unassailable evidence. RECENT FINDINGS:This article will examine how strongly the findings of the statin clinical trials actually support the maximalist strategy. We will also introduce a new approach, the population percentile strategy, which is based on the fact that the amount of cholesterol in LDL can differ substantially. When cholesterol-depleted LDL particles are present, LDL cholesterol (LDL-C) underestimates apolipoprotein B (apoB) and LDL particle number. Statins lower LDL-C and nonhigh-density lipoprotein cholesterol (non-HDL-C) more than they lower apoB and LDL particle number. This means that, even if LDL-C, non-HDL-C and apoB are equal markers of on-treatment risk, apoB is a better marker of the adequacy of LDL-lowering therapy. SUMMARY:Our analysis indicates that the LDL-lowering regimen should be tailored to the individual using a population percentile strategy to ensure the greatest number of patients receive the greatest overall benefit. With this approach, apoB is the best marker of the adequacy of LDL-lowering therapy.

journal_name

Curr Opin Cardiol

authors

Sniderman AD,De Graaf J,Couture P

doi

10.1097/HCO.0b013e328353fed5

subject

Has Abstract

pub_date

2012-07-01 00:00:00

pages

405-11

issue

4

eissn

0268-4705

issn

1531-7080

journal_volume

27

pub_type

杂志文章,评审
  • The intrinsic cardiac nervous system and atrial fibrillation.

    abstract:PURPOSE OF REVIEW:Radiofrequency ablation techniques to cure cardiac arrhythmias have focused on destroying myocardial tissue involved in abnormal excitation or conduction. This review will address recent basic and clinical studies which suggest that targeting autonomic nerves and ganglia on the large vessels and the h...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000198980.40390.e4

    authors: Scherlag BJ,Po S

    更新日期:2006-01-01 00:00:00

  • A customized genetic approach to the number one killer: coronary artery disease.

    abstract:PURPOSE OF REVIEW:To review the evidence supporting genetic predisposition to coronary artery disease (CAD). Secondly, to elucidate the barriers precluding the identification of genes responsible for CAD. Thirdly, to indicate the new technology now available to overcome these barriers and summarize current progress. R...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32830e6b4e

    authors: Roberts R

    更新日期:2008-11-01 00:00:00

  • Genetic basis of arrhythmogenic cardiomyopathy.

    abstract:PURPOSE OF REVIEW:To date 16 genes have been associated with arrhythmogenic cardiomyopathy (ACM). Mutations in these genes can lead to a broad spectrum of phenotypic expression ranging from disease affecting predominantly the right or left ventricle, to biventricular subtypes. Understanding the genetic causes of ACM is...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000509

    authors: Karmouch J,Protonotarios A,Syrris P

    更新日期:2018-05-01 00:00:00

  • Echocardiography in pulmonary hypertension.

    abstract:PURPOSE OF REVIEW:Pulmonary hypertension is a progressive disease of the pulmonary vasculature characterized by increased vascular resistance and pressure overload of the right ventricle. This review aims to describe the diagnostic and prognostic role of echocardiography in pulmonary hypertension with particular consid...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000217

    authors: Bossone E,Ferrara F,Grünig E

    更新日期:2015-11-01 00:00:00

  • Coarctation of the aorta: evaluation and management.

    abstract:PURPOSE OF REVIEW:Coarctation of the aorta is the discrete narrowing of the proximal descending aorta and is the sixth most common lesion in congenital heart disease. Repair of the coarctation can relieve the obstruction, but recurrent coarctation and future aneurysm formation can occur, and a heightened risk of vascul...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328330cc22

    authors: Tanous D,Benson LN,Horlick EM

    更新日期:2009-11-01 00:00:00

  • Long-term results of coronary artery bypass grafting.

    abstract::The treatment of ischemic heart disease by coronary artery bypass grafting remains under intense scrutiny. A better understanding of the long-term outcome for particular patient subgroups will allow a more appropriate choice to be made among the options of coronary artery bypass grafting, angioplasty, or continued med...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199611000-00003

    authors: Kanagasabay RR,Parker DJ

    更新日期:1996-11-01 00:00:00

  • Statins for primary prevention of cardiovascular disease: the benefits outweigh the risks.

    abstract:PURPOSE OF REVIEW:Statins significantly reduce cardiovascular morbidity and mortality in patients with and without coronary heart disease. Recently, much debate has focused on use of statins for primary prevention following a class-wide safety label change by the US Food and Drug Administration amidst concerns of worse...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e32836429e6

    authors: Minder CM,Blumenthal RS,Blaha MJ

    更新日期:2013-09-01 00:00:00

  • Unravelling the benefit against the risk of long-term dual antiplatelet therapy.

    abstract:PURPOSE OF REVIEW:To evaluate whether long-term antiplatelet therapy may be effective and well tolerated. RECENT FINDINGS:Five important studies assessed the efficacy and safety of clopidogrel therapy in different settings. However, the problems concerning the duration of therapy are based substantially on the Clopido...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000409964.20588.8c

    authors: Bolognese L,Angiolillo DJ

    更新日期:2011-12-01 00:00:00

  • Primary tumors of the heart.

    abstract:PURPOSE OF REVIEW:Primary cardiac tumors are a rare disease, which may have severe clinical consequences. Malignant tumors may be misdiagnosed as mixomas, with improper treatment. The aim of this review is to report how to make a differential diagnosis using old and modern tools, the latest trends in tumor classificati...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000335

    authors: Lestuzzi C

    更新日期:2016-11-01 00:00:00

  • Optimal revascularization strategies for multivessel coronary artery disease.

    abstract:PURPOSE OF REVIEW:The aim of this article is to review the current status of optimal revascularization strategies in patients presenting with multivessel coronary artery disease. RECENT FINDINGS:Coronary artery bypass surgery is the gold standard for patients with multivessel disease. Recent developments in the interv...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000245738.40088.70

    authors: Daemen J,Serruys PW

    更新日期:2006-11-01 00:00:00

  • Physical activity and fitness for the prevention of hypertension.

    abstract:PURPOSE OF REVIEW:The aim of this review is to evaluate the most recent literature about the role of physical activity, exercise, and fitness in hypertension prevention. RECENT FINDINGS:Strong evidence indicates that performing moderate-to-vigorous physical activity, particularly aerobic exercise, and improving cardio...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000526

    authors: Bakker EA,Sui X,Brellenthin AG,Lee DC

    更新日期:2018-07-01 00:00:00

  • Global patterns of health care for acute coronary syndromes.

    abstract:PURPOSE OF REVIEW:Despite similar guidelines, remarkable global differences exist in the management of acute coronary syndromes. This review describes recent insights in global patterns of patient baseline characteristics, treatment strategies, medication use, and outcome in acute coronary syndromes. RECENT FINDINGS:R...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000142063.30214.d2

    authors: Sinnaeve PR,Van de Werf FJ

    更新日期:2004-11-01 00:00:00

  • Unusual forms of ischemic heart disease.

    abstract::Unusual forms and causes of ischemic heart disease include angina pectoris in the presence of normal coronary arteries (syndrome X), congenital coronary abnormalities, vasculitic disorders, and graft atherosclerosis after cardiac transplantation. There is now evidence that endothelial dysfunction of coronary resistanc...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:

    authors: Drexler H,Schroeder JS

    更新日期:1994-07-01 00:00:00

  • Pacing delivered rate and rhythm control for atrial fibrillation.

    abstract:PURPOSE OF REVIEW:Device therapy for atrial fibrillation remains contentious despite the recognized benefit of atrial pacing in sinus node dysfunction. There are various new specialized pacing algorithms that aim to provide rhythm or rate control in atrial fibrillation. We review the various options for device therapy ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000210302.56736.60

    authors: Redfearn DP,Yee R

    更新日期:2006-03-01 00:00:00

  • Myocardial contrast echocardiography in acute coronary syndromes.

    abstract::Myocardial contrast echocardiography (MCE) is an emerging technique in which microbubble contrast agents are visualized in the coronary microvasculature. MCE is an ideal modality for the noninvasive evaluation of acute coronary syndromes because it provides portable, simultaneous assessment of regional wall motion and...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200209000-00003

    authors: Ward RP,Lang RM

    更新日期:2002-09-01 00:00:00

  • Will left-ventricular assist device therapy replace heart transplantation in the foreseeable future?

    abstract:PURPOSE OF REVIEW:Implantation of circulatory assist devices as a permanent alternative to heart transplantation, so-called Destination Therapy, has become a promising new option for treatment of patients with advanced heart failure who are not candidates for heart transplantation. RECENT FINDINGS:The landmark REMATCH...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/01.hco.0000153949.42189.03

    authors: Lietz K,Miller LW

    更新日期:2005-03-01 00:00:00

  • Stress testing for the evaluation of patients with mitral regurgitation.

    abstract:PURPOSE OF REVIEW:The emerging role of stress and particularly exercise echocardiography in mitral regurgitation has been recently emphasized. In fact, the evaluation of mitral regurgitation only under resting conditions might underestimate the full impact of the lesion and its clinical effects. RECENT FINDINGS:Exerci...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283565c3b

    authors: Lancellotti P,Magne J

    更新日期:2012-09-01 00:00:00

  • Mitral valve surgery for rheumatic heart disease: replace, repair, retrain?

    abstract:PURPOSE OF REVIEW:Rheumatic heart disease (RHD) affects over 30 million people worldwide. Substantial variation exists in the surgical treatment of patients with RHD. Here, we aim to review the surgical techniques to treat RHD with a focus on rheumatic mitral valve (MV) repair. We introduce novel educational paradigms ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章

    doi:10.1097/HCO.0000000000000826

    authors: Vervoort D,Ouzounian M,Yanagawa B

    更新日期:2020-12-24 00:00:00

  • Are statins diabetogenic?

    abstract:PURPOSE OF REVIEW:Statins are widely utilized for low-density lipoprotein lowering and for prevention of atherosclerotic cardiovascular disease. Although these drugs have a good safety record, increased risk of developing diabetes during extended use has recently garnered attention. Here we review clinical trial eviden...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e3283470359

    authors: Sampson UK,Linton MF,Fazio S

    更新日期:2011-07-01 00:00:00

  • Update about atrial fibrillation genetics.

    abstract:PURPOSE OF REVIEW:Atrial fibrillation is an important cause of morbidity in the aging population. The mechanisms responsible for the triggering and maintenance of the chaotic atrial rhythm are still poorly understood. In this review, we will focus on the genetic aspects of atrial fibrillation, to understand causality, ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章

    doi:10.1097/HCO.0000000000000387

    authors: Pérez-Serra A,Campuzano O,Brugada R

    更新日期:2017-05-01 00:00:00

  • Preventive cardiology.

    abstract::Over the past year, significant new advances have been made in preventive cardiology. New trials of lipid lowering, estrogen therapy, and hypertension control have added to our understanding of the pathophysiology and prevention of coronary atherosclerosis. This review highlights these new trials and provides insight ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199909000-00006

    authors: Foody JA

    更新日期:1999-09-01 00:00:00

  • Genetic risk stratification in cardiac arrhythmias.

    abstract:PURPOSE OF REVIEW:The current article provides a concise summary of the possibilities and limitations of genotype-based risk stratification of cardiac arrhythmias. We will outline the most important findings of the recent years in the light of their chronological and conceptual development. RECENT FINDINGS:Genotype-ph...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000506

    authors: Napolitano C,Mazzanti A,Priori SG

    更新日期:2018-05-01 00:00:00

  • Update on digoxin and other oral positive inotropic agents for chronic heart failure.

    abstract::The benefit of digoxin in chronic heart failure has been debated fervently for decades. In the 1970s, the use of digoxin was challenged due to the high incidences of digitalis toxicity and the lack of data on the effects of digoxin in patients with chronic heart failure. In the 1980s, interest in digoxin was renewed a...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199705000-00004

    authors: Reddy S,Benatar D,Gheorghiade M

    更新日期:1997-05-01 00:00:00

  • Thrombolytic therapy in acute pulmonary embolism.

    abstract:PURPOSE OF REVIEW:The goal of this review is to offer an overview of the use of thrombolytic therapy in acute pulmonary embolism. Clinicians including internists, surgeons, pulmonologists, and other specialists continue to face decisions regarding massive and submassive acute pulmonary embolism in their daily routines....

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328358308c

    authors: Tapson VF

    更新日期:2012-11-01 00:00:00

  • Evaluation of pulmonary hypertension in heart transplant candidates.

    abstract::Assessment of the pulmonary circulation and right ventricular function is a cornerstone in the evaluation of the patient as a potential heart transplant recipient. The importance of pulmonary hypertension is linked to outcomes in the posttransplant period. Preoperative pulmonary vascular resistance is an independent r...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200303000-00012

    authors: Natale ME,Piña IL

    更新日期:2003-03-01 00:00:00

  • Recent trends in infective endocarditis: influence of case definitions.

    abstract:PURPOSE OF REVIEW:Infective endocarditis continues to pose major challenges in diagnosis and management despite advances in understanding the epidemiology, microbiology, and pathology of the disease. The purpose of this article is to provide a review of diagnosis, microbiology, and treatment of infective endocarditis, ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200403000-00012

    authors: Devlin RK,Andrews MM,von Reyn CF

    更新日期:2004-03-01 00:00:00

  • The role of antiplatelet therapy in the secondary prevention of coronary artery disease.

    abstract:PURPOSE OF REVIEW:In this study, we review the evidence for both long-standing and newer oral antiplatelet agents as secondary prevention in coronary artery disease, and give our opinion on where each agent's treatment role lies. RECENT FINDINGS:Platelets play a pathological role in acute coronary syndromes and are th...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0b013e328338f7b5

    authors: Behan MW,Chew DP,Aylward PE

    更新日期:2010-07-01 00:00:00

  • Pediatric cardiac electrophysiology.

    abstract::Over the past year, many advances have been made in the management of cardiac arrhythmias in the pediatric patient. It has become evident that the new surgical procedures for congenital cardiac disease can result in arrhythmia-associated morbidity and mortality. New pharmacologic agents such as adenosine have been s...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-199102000-00016

    authors: Kaminer SJ,Gelband H

    更新日期:1991-02-01 00:00:00

  • Therapy for primary cardiac tumors: is there a role for heart transplantation?

    abstract::Primary cardiac tumors are rare clinical entities. Benign tumors are often amenable to surgical excision, whereas malignant tumors are seldom resectable. The literature has reported that 28 patients have undergone orthotopic heart transplantation for inoperable primary cardiac tumors. The results of these transplants ...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/00001573-200003000-00010

    authors: Gowdamarajan A,Michler RE

    更新日期:2000-03-01 00:00:00

  • Imaging and heart failure: myocardial strain.

    abstract:PURPOSE OF REVIEW:To summarize literature on the application of myocardial strain in patients with heart failure published since 2018. RECENT FINDINGS:Left ventricular (LV) and right ventricular strain provides important prognostic information in patients with acute and chronic heart failure and new insights in diseas...

    journal_title:Current opinion in cardiology

    pub_type: 杂志文章,评审

    doi:10.1097/HCO.0000000000000653

    authors: Edvardsen T,Klaeboe LG

    更新日期:2019-09-01 00:00:00