Prevention of Cardiovasular Diseases
|
|
- Camron Clark
- 6 years ago
- Views:
Transcription
1 Role and Significance of In-Vitro-Diagnostics in the Healthcare Systems of the Future Prevention of Cardiovasular Diseases Michael Walter Charité University Medicine, Berlin & Unfallkrankenhaus Berlin
2 Prevention of Cardiovasular Diseases: Significance 2004 Diabetes mellitus Myocardial Infarction 2010 (Prognose) Colon Cancer Breast Cancer Prostate Cancer Cervical Cancer ,6 7, Incidence / year (x1000), Germany Percentage Obesity 2040 (Prognose) 50% % 0% 10% 20% 30% 40% 50% 60% Felix Burda Foundation
3 Prevention of Cardiovasular Diseases: General Principles Primary prevention: asymptomatic individuals Population-based strategy: educating a healthy life style in the general population High-risk patient strategy: identification and treatment of high risk patients Secondary prevention: symptomatic patients with established disease Treatment and counseling to prevent a progression of disease
4 Prevention of Cardiovasular Diseases: High-Risk Patient Strategy Step 1: a prospective study Measurement Time Event Y/N Framingham function Sheffield Tables Canadian Tables PROCAM Risk Score UKPDS Risk Engine SCORE Risk Charts Step 2: a mathematical model (Cox-/Weibull-/Neural Network-Algorithm..)
5 PROCAM-Study: Ranking of Risk Factors R 1. Age LDL cholesterol Smoking HDL cholesterol Systolic blood pressure Diabetes/Glucose 120mg/dl Family history of MI Triglycerides PROCAM = Prospective CArdiovascular Münster Study Assmann G, et al. Circulation, 105: ; 2002
6 High-risk Patient Strategy: PROCAM-Study Age Triglycerides (mg/dl) < >199 4 LDL-Cholesterol (mg/dl) < > HDL-Cholesterol (mg/dl) < >54 0 Sy Blood pressure (mm Hg) < >=160 8 Diabetes mellitus MI Family History Smoking No Yes 6 4 8
7 High-Risk Patient Strategy: PROCAM-Study Myocardial Infarctions (per 1000) in 10 years PROCAM Score >65 MI risk in 10 years (%) < Prevalence (%) Assmann G, et al. Circulation, 105: ; 2002
8 High-risk Patient Strategy: Challenges Only 50% of the risk of atherosclerosis can be explained by the established risk factors. Current knowledge is incompletely implemented.
9 PROCAM: Continuum of Patients at Risk for MI < 10% Risk of myocardial infarction 10-20% > 20% 22.3% 27.7% 50.0% MI risk in 10 years 33.9% 12.8% 3.2% proportion of all MI 58.2% 28.5% 13.4% No. of MI s/ year in Germany 18,000 8,700 4,100 Prevalence Age years 241 fatal and nonfatal myocardial infarctions in 2,207 men
10 PROCAM: Continuum of Patients at Risk for MI > 20% 1.5% MI risk in 10 years 37.5% proportion of all MI 17.6% No. of MI s/year in Germany 1, % 5.3% 17.3% 26.1% 1,800 < 10% Risk of myocardial infarction 93.2% 2.1% 56.4% 4,000 Prevalence Age years 165 fatal and nonfatal myocardial infarctions in 4,945 men
11 The Competition : High-Risk versus Population Approach Aggressive pharmacological treatment in individuals with a 10-year event risk of >20% would reduce major cardiovascular disease (CVD) by 34%. A 10% population-wide reduction in long-term mean blood cholesterol and blood pressure could reduce major cardiovascular disease by 45%. Emberson et al. Eur Heart J. 2004;25:
12 Options To Improve Risk Prediction I A better understanding of the process of atherosclerosis. A better understanding of the interaction of risk factors. Identification of new risk factors/indicators and methods. Decades Decades. Minutes Circulation. 2001;104:365.
13 A Low HDL Cholesterol as Coronary Risk Factor Risk per 1,000 in 10 years high global risk low global risk mg/dl mmol/l 0,65 0,78 0,91 1,03 1,16 1,29 1,42 1,55 1,68 PROCAM-Study HDL cholesterol
14 Defective Reverse Cholesterol Transport in Familial HDL Deficiency (Tangier Disease) Reverser Cholesterintransport HDL CE X ABCA1 HO X Galle SR-B1 ABCG5/8 CE ER GOLGI HDL ABCG1 Hepatozyt Periphere Zelle Rust et al. Nature Genetics 1998;20:96, Nature Genetics 1999;22:352 Walter et al. Arterioscler Thromb Vasc Biol. 1995;15:1975
15 Synergistic Effect of LDL- and HDL- Cholesterol Incidence of coronary events per 1000 in 10 years HDL-C (mg/dl) LDL-C (mg/dl) PROCAM-Study
16 GRIPS: Synergistic Effect of LDL-Cholesterol MI-10-year risk [%] (40-60 year-old persons) Myocardial Infarctions (per 1000) in 10 years Familial MI history plus smoking Familial MI history Smoking Glucose intolerance Hypertension No other risk factor Secondary Prevention LDL-Cholesterol (mg/dl) GRIPS, Göttingen Risk, Incidence and Prevalence Study Cremer et al. Atherosclerosis Mar 21;129:
17 Algorithms are Superior to Individual Risk Factors Sensitivity (%) Specificity (%) R Voss et al.int J Epidemiol. 2002;31: PROCAM Neural Networks (90.2%*) PROCAM Algorithm Cox (82.7%*) PROCAM Algorithm Weibull (82.4%*) Age (74.3%*) Body Mass Index (57.5%*) Men (PROCAM-Study)
18 Options To Improve Risk Prediction II Lifestyle Pharmaka MSCT MRT PET Algorithms Neural Network Lp(a) CRP Homocysteine Phytosterols Metabolic syndrome Genes of clinical relevance
19 Risk Prediction: Genotype + Phenotype SNP s Neural Network AA BB AB HYPERT.TAB FAM AP DIAB.MELLI SMOKER URIC.AC DIAST.BP B.GLUCOSE BMI SYST.BP LDL HDL LNTG TG AGE 0 ( 0-1 ) 1 ( 0-1 ) 0 ( 0-1 ) 0 ( 0-3 ) 1 ( 0-1 ) 70 ( ) 82 ( ) 98 ( ) 254 ( ) 108 ( ) 178 ( ) 44 ( ) 4.96 ( ) 142 ( ) 46 ( ) input layer b bias b hidden layer psp: 0.68 act: 0.66 psp: act: 0 psp: 2.89 act: 0.95 psp: act: 0.01 true: 0 pred.prob.: pred.class: 0 (th: 0.2 ) psp: -2 2 act: 0.1 output layer nnet.obj nodes: 15,4,1 weights: 84 decay: 0.15 skip: T entropy: T softmax: F censored: F R Voss et al., unpublished
20 Phytosterols as Cardiovascular Risk Factors* before treatment *Kannenberg F et al. Nutr Metab Cardiovasc Dis. 2006;16: after treatment
21 Telomere Length as a Biomarker of Aging Telomere repeat, (TTAGGG)n Cell Divisions Cell divisions plus Stress Telomere Length Age (healthy blood donors) Walter M et al., unpublished,
22 High Cardiovascular Risk in a Subgroup of Patients with Abdominal Obesity.
23 High-risk patient strategy: Challenges Only 50% of the risk of atherosclerosis can be explained by the established risk factors. Current knowledge is incompletely implemented.
24 LDL-Cholesterol: The Lower the Better Statin Placebo 4S MI Risk (%) S LIPID LIPID CARE CARE HPS HPS TNT (10 mg of atorvastatin) TNT (80 mg of atorvastatin) LDL Cholesterol (mg/dl)
25 Treatment Targets (LDL < 100 mg/dl) are Reached in a Minority of High Risk Patients! Reality Only 43,8% of the hospital patients and 32,2% of medical practice patients reach the LDL-cholesterol target <100 mg/dl. However: 95,8% of the hospital physicians and 94,4% of the physicians in private practice feel that their patients are treated according to current guidelines. Feeling Gitt AK, Eur J Cardiovasc Prev.Rehab. 2009;16: (2-L-Cardio Registry)
26 Deadly Myocardial Infarctions in Germany (2001) Deaths Male : Women ~1 : ~2 : Statistisches Jahrbuch >75 Alter (Jahre)
27 Summary Cardiovascular risk prevention includes population-wide and high risk strategies and is only partially implemented. The current risk scores do not provide reliable cardiovascular risk estimates in young patients, in patients with intermediate risk and in certain subgroups of patients (metabolic syndrome). Only the combination of novel in vitro diagnostics (the identification of new risk indicators), the use of intelligent mathematical models, a better understanding of the interrelationships among risk factors and other methods (imaging etc.) can significantly improve risk prediction.
Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden
Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Cardiovascular Disease Prevention (CVD) Three Strategies for CVD
More informationCVD Risk Assessment. Michal Vrablík Charles University, Prague Czech Republic
CVD Risk Assessment Michal Vrablík Charles University, Prague Czech Republic What is Risk? A cumulative probability of an event, usually expressed as percentage e.g.: 5 CV events in 00 pts = 5% risk This
More informationThe inhibition of CETP: From simply raising HDL-c to promoting cholesterol efflux and lowering of atherogenic lipoproteins Prof Dr J Wouter Jukema
The inhibition of CETP: From simply raising HDL-c to promoting cholesterol efflux and lowering of atherogenic lipoproteins Prof Dr J Wouter Jukema Dept Cardiology, Leiden University Medical Center, Leiden,
More informationDyslipidemia in women: Who should be treated and how?
Dyslipidemia in women: Who should be treated and how? Lale Tokgozoglu, MD, FACC, FESC Professor of Cardiology Hacettepe University Faculty of Medicine Ankara, Turkey. Cause of Death in Women: European
More informationJohn J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam
Latest Insights from the JUPITER Study John J.P. Kastelein MD PhD Professor of Medicine Dept. of Vascular Medicine Academic Medial Center / University of Amsterdam Inflammation, hscrp, and Vascular Prevention
More informationJUPITER NEJM Poll. Panel Discussion: Literature that Should Have an Impact on our Practice: The JUPITER Study
Panel Discussion: Literature that Should Have an Impact on our Practice: The Study Kaiser COAST 11 th Annual Conference Maui, August 2009 Robert Blumberg, MD, FACC Ralph Brindis, MD, MPH, FACC Primary
More informationReview of guidelines for management of dyslipidemia in diabetic patients
2012 international Conference on Diabetes and metabolism (ICDM) Review of guidelines for management of dyslipidemia in diabetic patients Nan Hee Kim, MD, PhD Department of Internal Medicine, Korea University
More informationCardiovascular risk assessment in the metabolic syndrome: results from the Prospective Cardiovascular Munster (PROCAM) Study
(28) 32, S11 S16 & 28 Nature Publishing Group All rights reserved 37-6/8 $3. www.nature.com/ijo ORIGINAL ARTICLE Cardiovascular risk assessment in the metabolic syndrome: results from the Prospective Cardiovascular
More informationThe JUPITER trial: What does it tell us? Alice Y.Y. Cheng, MD, FRCPC January 24, 2009
The JUPITER trial: What does it tell us? Alice Y.Y. Cheng, MD, FRCPC January 24, 2009 Learning Objectives 1. Understand the role of statin therapy in the primary and secondary prevention of stroke 2. Explain
More informationIschemic Heart and Cerebrovascular Disease. Harold E. Lebovitz, MD, FACE Kathmandu November 2010
Ischemic Heart and Cerebrovascular Disease Harold E. Lebovitz, MD, FACE Kathmandu November 2010 Relationships Between Diabetes and Ischemic Heart Disease Risk of Cardiovascular Disease in Different Categories
More information1. Which one of the following patients does not need to be screened for hyperlipidemia:
Questions: 1. Which one of the following patients does not need to be screened for hyperlipidemia: a) Diabetes mellitus b) Hypertension c) Family history of premature coronary disease (first degree relatives:
More informationLipid Management: Beyond LDL
Lipid Management: Beyond LDL Lisa R. Tannock MD Division of Endocrinology and Molecular Medicine University of Kentucky Overview Discuss the concept of residual risk Review current evidence-based medicine
More informationAndrew Cohen, MD and Neil S. Skolnik, MD INTRODUCTION
2 Hyperlipidemia Andrew Cohen, MD and Neil S. Skolnik, MD CONTENTS INTRODUCTION RISK CATEGORIES AND TARGET LDL-CHOLESTEROL TREATMENT OF LDL-CHOLESTEROL SPECIAL CONSIDERATIONS OLDER AND YOUNGER ADULTS ADDITIONAL
More informationClasses of recommendations
Classes of recommendations Levels of evidence Quality of evidence used in GRADE Percentage of the decrease in deaths from coronary heart disease attributed to treatments and risk factor changes in different
More informationCase Presentation. Rafael Bitzur The Bert W Strassburger Lipid Center Sheba Medical Center Tel Hashomer
Case Presentation Rafael Bitzur The Bert W Strassburger Lipid Center Sheba Medical Center Tel Hashomer Case Presentation 50 YO man NSTEMI treated with PCI 1 month ago Medical History: Obesity: BMI 32,
More informationHow would you manage Ms. Gold
How would you manage Ms. Gold 32 yo Asian woman with dyslipidemia Current medications: Simvastatin 20mg QD Most recent lipid profile: TC = 246, TG = 100, LDL = 176, HDL = 50 What about Mr. Williams? 56
More information2013 Cholesterol Guidelines. Anna Broz MSN, RN, CNP, AACC Adult Certified Nurse Practitioner North Ohio Heart, Inc.
2013 Cholesterol Guidelines Anna Broz MSN, RN, CNP, AACC Adult Certified Nurse Practitioner North Ohio Heart, Inc. Disclosures Speaker Gilead Sciences NHLBI Charge to the Expert Panel Evaluate higher quality
More informationThe TNT Trial Is It Time to Shift Our Goals in Clinical
The TNT Trial Is It Time to Shift Our Goals in Clinical Angioplasty Summit Luncheon Symposium Korea Assoc Prof David Colquhoun 29 April 2005 University of Queensland, Wesley Hospital, Brisbane, Australia
More informationInflammation and and Heart Heart Disease in Women Inflammation and Heart Disease
Inflammation and Heart Disease in Women Inflammation and Heart Disease What is the link between een inflammation and atherosclerotic disease? What is the role of biomarkers in predicting cardiovascular
More informationDyslipidaemia. Is there any new information? Dr. A.R.M. Saifuddin Ekram
Dyslipidaemia Is there any new information? Dr. A.R.M. Saifuddin Ekram PhD,FACP,FCPS(Medicine) Professor(c.c.) & Head Department of Medicine Rajshahi Medical College Rajshahi-6000 New features of ATP III
More informationAgreement of Swiss-Adapted International and European Guidelines for the Assessment of Global Vascular Risk and for Lipid Lowering Interventions
DOI 10.1007/s10557-009-6162-y Agreement of Swiss-Adapted International and European Guidelines for the Assessment of Global Vascular Risk and for Lipid Lowering Interventions Michel Romanens & Franz Ackermann
More informationThe Diabetes Link to Heart Disease
The Diabetes Link to Heart Disease Anthony Abe DeSantis, MD September 18, 2015 University of WA Division of Metabolism, Endocrinology and Nutrition Oswald Toosweet Case #1 68 yo M with T2DM Diagnosed DM
More informationAn update on lipidology and cardiovascular risk management. Lipids, Metabolism & Vascular Risk Section - Royal Society of Medicine
An update on lipidology and cardiovascular risk management Lipids, Metabolism & Vascular Risk Section - Royal Society of Medicine National and international lipid modification guidelines: A critical appraisal
More information2013 ACC/AHA Guidelines on the Assessment of Atherosclerotic Cardiovascular Risk: Overview and Commentary
2013 ACC/AHA Guidelines on the Assessment of Atherosclerotic Cardiovascular Risk: Overview and Commentary The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease Becky McKibben, MPH; Seth
More informationCVD Prevention, Who to Consider
Continuing Professional Development 3rd annual McGill CME Cruise September 20 27, 2015 CVD Prevention, Who to Consider Dr. Guy Tremblay Excellence in Health Care and Lifelong Learning Global CV risk assessment..
More information2013 Cholesterol Guidelines. Anna Broz MSN, RN, CNP, AACC Cer=fied Adult Nurse Prac==oner North Ohio Heart, Inc.
2013 Cholesterol Guidelines Anna Broz MSN, RN, CNP, AACC Cer=fied Adult Nurse Prac==oner North Ohio Heart, Inc. Disclosures Speaker Gilead Sciences NHLBI Charge to the Expert Panel Evaluate higher quality
More informationLipid Management 2013 Statin Benefit Groups
Clinical Integration Steering Committee Clinical Integration Chronic Disease Management Work Group Lipid Management 2013 Statin Benefit Groups Approved by Board Chair Signature Name (Please Print) Date
More informationDyslipidemia in the light of Current Guidelines - Do we change our Practice?
Dyslipidemia in the light of Current Guidelines - Do we change our Practice? Dato Dr. David Chew Soon Ping Senior Consultant Cardiologist Institut Jantung Negara Atherosclerotic Cardiovascular Disease
More informationSoo LIM, MD, PHD Internal Medicine Seoul National University Bundang Hospital
Soo LIM, MD, PHD Internal Medicine Seoul National University Bundang Hospital 1. Importance of Lowering LDL-Cholesterol in Diabetes Patients & Lipid Guidelines Prevalence of dyslipidemia in Korea Prevalence
More informationJAMA. 2011;305(24): Nora A. Kalagi, MSc
JAMA. 2011;305(24):2556-2564 By Nora A. Kalagi, MSc Cardiovascular disease (CVD) is the number one cause of mortality and morbidity world wide Reducing high blood cholesterol which is a risk factor for
More informationPlacebo-Controlled Statin Trials MANAGEMENT OF HIGH BLOOD CHOLESTEROL MANAGEMENT OF HIGH BLOOD CHOLESTEROL: IMPLICATIONS OF THE NEW GUIDELINES
MANAGEMENT OF HIGH BLOOD CHOLESTEROL: IMPLICATIONS OF THE NEW GUIDELINES Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest
More informationWhen Statins Aren t Enough: Appropriate Therapies for High-Risk Patients with Diabetes
When Statins Aren t Enough: Appropriate Therapies for High-Risk Patients with Diabetes Kim K. Birtcher, MS, PharmD, AACC, FNLA, CLS, BCPS (AQ-Cardiology), CDE Clinical Professor University of Houston College
More informationDiabetes Mellitus: A Cardiovascular Disease
Diabetes Mellitus: A Cardiovascular Disease Nestoras Mathioudakis, M.D. Assistant Professor of Medicine Division of Endocrinology, Diabetes, & Metabolism September 30, 2013 1 The ABCs of cardiovascular
More informationCase Study: Chris Arden. Peripheral Arterial Disease
Case Study: Chris Arden Peripheral Arterial Disease Patient Presentation Diane is a 65-year-old retired school teacher She complains of left calf pain when walking 50 metres; the pain goes away after she
More informationASSeSSing the risk of fatal cardiovascular disease
ASSeSSing the risk of fatal cardiovascular disease «Systematic Cerebrovascular and coronary Risk Evaluation» think total vascular risk Assess the risk Set the targets Act to get to goal revised; aupril
More informationLow HDL-levels: leave it or treat it?
Cardiology Update 2011 Davos, 14 02 2011 Low HDL-levels: leave it or treat it? Experts: J.P. Kastelein, Amsterdam and U. Landmesser, Zurich Cases: C. Besler, Zurich and I. Sudano, Zurich Mr H.B., 1960
More informationSUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL A Meta-analysis of LDL-C, non-hdl-c, and apob as markers of cardiovascular risk. Slide # Contents 2 Table A1. List of candidate reports 8 Table A2. List of covariates/model adjustments
More informationFasting or non fasting?
Vascular harmony Robert Chilton Professor of Medicine University of Texas Health Science Center Director of Cardiac Catheterization labs Director of clinical proteomics Which is best to measure Lower continues
More informationPlacebo-Controlled Statin Trials EXPLAINING THE DECREASE IN DEATHS FROM CHD! PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN EXPLAINING THE DECREASE IN
PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest EXPLAINING THE DECREASE
More information(n=6279). Continuous variables are reported as mean with 95% confidence interval and T1 T2 T3. Number of subjects
Table 1. Distribution of baseline characteristics across tertiles of OPG adjusted for age and sex (n=6279). Continuous variables are reported as mean with 95% confidence interval and categorical values
More informationManaging Dyslipidemia in Disclosures. Learning Objectives 03/05/2018. Speaker Disclosures
Managing Dyslipidemia in 2018 Glen J. Pearson, BSc, BScPhm, PharmD, FCSHP, FCCS Professor of Medicine (Cardiology) Co-Director, Cardiac Transplant Clinic; Associate Chair, Health Research Ethics Boards;
More informationCLINICAL OUTCOME Vs SURROGATE MARKER
CLINICAL OUTCOME Vs SURROGATE MARKER Statin Real Experience Dr. Mostafa Sherif Senior Medical Manager Pfizer Egypt & Sudan Objective Difference between Clinical outcome and surrogate marker Proper Clinical
More informationPREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN
PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest EXPLAINING THE DECREASE
More informationCardiovascular Risk Assessment and Management Making a Difference
Cardiovascular Risk Assessment and Management Making a Difference Norman Sharpe March 2014 Numbers and age-standardised mortality rates from all causes, by sex, 1950 2010 Death rates halved Life expectancy
More informationCurrent Cholesterol Guidelines and Treatment of Residual Risk COPYRIGHT. J. Peter Oettgen, MD
Current Cholesterol Guidelines and Treatment of Residual Risk J. Peter Oettgen, MD Associate Professor of Medicine Harvard Medical School Director, Preventive Cardiology Beth Israel Deaconess Medical Center
More informationCanakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS)
Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS) Stable CAD (post MI) On Statin, ACE/ARB, BB, ASA Persistent Elevation of hscrp (> 2 mg/l) N = 10,061 39 Countries April 2011 - June 2017
More informationThere are many ways to lower triglycerides in humans: Which are the most relevant for pancreatitis and for CV risk?
There are many ways to lower triglycerides in humans: Which are the most relevant for pancreatitis and for CV risk? Michael Davidson M.D. FACC, Diplomate of the American Board of Lipidology Professor,
More informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Cholesterol Treatment Trialists Collaboration.
More informationCardiovascular Complications of Diabetes
VBWG Cardiovascular Complications of Diabetes Nicola Abate, M.D., F.N.L.A. Professor and Chief Division of Endocrinology and Metabolism The University of Texas Medical Branch Galveston, Texas Coronary
More information4/7/ The stats on heart disease. + Deaths & Age-Adjusted Death Rates for
+ Update on Lipid Management Stacey Gardiner, MD Assistant Professor Division of Cardiovascular Medicine Medical College of Wisconsin + The stats on heart disease Over the past 10 years for which statistics
More informationLipoprotein Particle Profile
Lipoprotein Particle Profile 50% of people at risk for HEART DISEASE are not identified by routine testing. Why is LPP Testing The Most Comprehensive Risk Assessment? u Provides much more accurate cardiovascular
More informationGuidelines on cardiovascular risk assessment and management
European Heart Journal Supplements (2005) 7 (Supplement L), L5 L10 doi:10.1093/eurheartj/sui079 Guidelines on cardiovascular risk assessment and management David A. Wood 1,2 * 1 Cardiovascular Medicine
More informationUnmet needs in the diagnosis and treatment of dyslipidemia in the primary care setting in Germany
Unmet needs in the diagnosis and treatment of dyslipidemia in the primary care setting in Germany S. Böhler a,, H. Scharnagl b, F. Freisinger b, T. Stojakovic b, H. Glaesmer a, J. Klotsche a, L. Pieper
More informationProtecting the heart and kidney: implications from the SHARP trial
Cardiology Update, Davos, 2013: Satellite Symposium Protecting the heart and kidney: implications from the SHARP trial Colin Baigent Professor of Epidemiology CTSU, University of Oxford S1 First CTT cycle:
More informationFelix Vallotton Ball (1899) LDL-C management in Asian diabetes: moderate vs. high intensity statin --- a lesson from EMPATHY study
Felix Vallotton Ball (1899) LDL-C management in Asian diabetes: moderate vs. high intensity statin --- a lesson from EMPATHY study Conflict of interest disclosure None Committee of Scientific Affairs Committee
More informationEugene Barrett M.D., Ph.D. University of Virginia 6/18/2007. Diagnosis and what is it Glucose Tolerance Categories FPG
Diabetes Mellitus: Update 7 What is the unifying basis of this vascular disease? Eugene J. Barrett, MD, PhD Professor of Internal Medicine and Pediatrics Director, Diabetes Center and GCRC Health System
More informationMarshall Tulloch-Reid, MD, MPhil, DSc, FACE Epidemiology Research Unit Tropical Medicine Research Institute The University of the West Indies, Mona,
Marshall Tulloch-Reid, MD, MPhil, DSc, FACE Epidemiology Research Unit Tropical Medicine Research Institute The University of the West Indies, Mona, Jamaica At the end of this presentation the participant
More informationControversies in Preventative Cardiology
Controversies in Preventative Cardiology Francisco Lopez-Jimenez, M.D., M.Sc, FACC, FAHA Professor of Medicine, Mayo Medical School Chair, Division of Preventive Cardiology Co-Director, Artificial Intelligence
More informationThe Clinical Unmet need in the patient with Diabetes and ACS
The Clinical Unmet need in the patient with Diabetes and ACS Professor Kausik Ray (UK) BSc(hons), MBChB, MD, MPhil, FRCP (lon), FRCP (ed), FACC, FESC, FAHA Diabetes is a global public health challenge
More informationA: Epidemiology update. Evidence that LDL-C and CRP identify different high-risk groups
A: Epidemiology update Evidence that LDL-C and CRP identify different high-risk groups Women (n = 27,939; mean age 54.7 years) who were free of symptomatic cardiovascular (CV) disease at baseline were
More informationTreatment of Cardiovascular Risk Factors. Kevin M Hayes D.O. F.A.C.C. First Coast Heart and Vascular Center
Treatment of Cardiovascular Risk Factors Kevin M Hayes D.O. F.A.C.C. First Coast Heart and Vascular Center Disclosures: None Objectives What do risk factors tell us What to check and when Does treatment
More informationThe Metabolic Syndrome: Is It A Valid Concept? YES
The Metabolic Syndrome: Is It A Valid Concept? YES Congress on Diabetes and Cardiometabolic Health Boston, MA April 23, 2013 Edward S Horton, MD Joslin Diabetes Center Harvard Medical School Boston, MA
More informationHyperlipidemia: Lowering the Bar on the Lipid Limbo. Community Faculty Development Symposium March 13, 2004 Hugh Huizenga MD, MPH
Mark slides Hyperlipidemia: Lowering the Bar on the Lipid Limbo Community Faculty Development Symposium March 13, 2004 Hugh Huizenga MD, MPH Hyperlipidemia is a common problem Nearly 50% of men in the
More informationTotal risk management of Cardiovascular diseases Nobuhiro Yamada
Nobuhiro Yamada The worldwide burden of cardiovascular diseases (WHO) To prevent cardiovascular diseases Beyond LDL Multiple risk factors With common molecular basis The Current Burden of CVD CVD is responsible
More informationStatin therapy in patients with Mild to Moderate Coronary Stenosis by 64-slice Multidetector Coronary Computed Tomography
Statin therapy in patients with Mild to Moderate Coronary Stenosis by 64-slice Multidetector Coronary Computed Tomography Hyo Eun Park 1, Eun-Ju Chun 2, Sang-Il Choi 2, Soyeon Ahn 2, Hyung-Kwan Kim 3,
More informationHow to Reduce Residual Risk in Primary Prevention
How to Reduce Residual Risk in Primary Prevention Helene Glassberg, MD Assistant Professor of Medicine Section of Cardiology Hospital of the University of Pennsylvania Philadelphia, PA USA Patients with
More informationBehind LDL: The Metabolism of ApoB, the Essential Apolipoprotein in LDL and VLDL
Behind LDL: The Metabolism of ApoB, the Essential Apolipoprotein in LDL and VLDL Sung-Joon Lee, PhD Division of Food Science Institute of Biomedical Science and Safety Korea University Composition of Lipoproteins:
More informationEnvironmental. Vascular / Tissue. Metabolics
Global Risk Reduction--WINS Picking Mom and Dad-2016 Environmental Vascular / Tissue Metabolics Stop smoking-1b Physical activity-1b Weight control-1b Chelation therapy-3c Influenza vaccination-1b Blood
More informationIl rischio residuo nella persona con diabete: come individuarlo e come trattarlo?
Il rischio residuo nella persona con diabete: come individuarlo e come trattarlo? Alberto Zambon University of Padova - Italy DISCLOSURE - CONFLICT OF INTEREST Prof. A. Zambon reports having received grants,
More informationEffective Interventions in the Clinical Setting: Engaging and Empowering Patients. Michael J. Bloch, M.D. Doina Kulick, M.D.
Effective Interventions in the Clinical Setting: Engaging and Empowering Patients Michael J. Bloch, M.D. Doina Kulick, M.D. UNIVERSITY OF NEVADA SCHOOL of MEDICINE Sept. 8, 2011 Reality check: What could
More informationThe Latest Generation of Clinical
The Latest Generation of Clinical Guidelines: HTN and HLD Dave Brackett Clinical Guideline Purpose Uniform approach Awareness of key details Diagnosis Treatment Monitoring Evidence based approach Inform
More informationPlacebo-Controlled Statin Trials Prevention Of CVD in Women"
MANAGEMENT OF HIGH BLOOD CHOLESTEROL: IMPLICATIONS OF THE NEW GUIDELINES Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest
More informationFamilial hypercholesterolaemia
Familial hypercholesterolaemia Jaimini Cegla MRCP FRCPath PhD Consultant in Chemical Pathology and Metabolic Medicine Hammersmith Hospital Lipid Clinic 20 April 2017 An unrecognised, potentially fatal,
More informationDoes High-Intensity Pitavastatin Therapy Further Improve Clinical Outcomes?
Late Breaking Clinical Trial Session at AHA 2017 Does High-Intensity Pitavastatin Therapy Further Improve Clinical Outcomes? The REAL-CAD Study in 13,054 Patients With Stable Coronary Artery Disease Takeshi
More informationPreventing Cardiovascular Disease With Lipid Management: Matching Therapy to Risk
PREVENTING CARDIOVASCULAR DISEASE WITH LIPID MANAGEMENT : MATCHING TREATMENT TO RISK Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict
More informationWhat have We Learned in Dyslipidemia Management Since the Publication of the 2013 ACC/AHA Guideline?
What have We Learned in Dyslipidemia Management Since the Publication of the 2013 ACC/AHA Guideline? Salim S. Virani, MD, PhD, FACC, FAHA Associate Professor, Section of Cardiovascular Research Baylor
More informationMOHAMMED R. ESSOP DIVISION OF CARDIOLOGY CH-BARAGWANATH HOSPITAL
MOHAMMED R. ESSOP DIVISION OF CARDIOLOGY CH-BARAGWANATH HOSPITAL DEFINITION OF A SCREENING TEST TESTING FOR A DISEASE OR CONDITION IN ASYMPTOMATIC PERSONS TO IDENTIFY THE CONDITION BEFORE IT MANIFESTS
More informationGUIDELINES FOR DYSLIPIDEMIA MANAGEMENT AND EDUCATION THROUGH NOVA SCOTIA DIABETES CENTRES
GUIDELINES FOR DYSLIPIDEMIA MANAGEMENT AND EDUCATION THROUGH NOVA SCOTIA DIABETES CENTRES Prepared by DCPNS Action Committee Dr. Lynne Harrigan Brenda Cook Peggy Dunbar Bev Harpell with the assistance
More informationPreclinical Detection of CAD: Is it worth the effort? Michael H. Crawford, MD
Preclinical Detection of CAD: Is it worth the effort? Michael H. Crawford, MD 1 Preclinical? No symptoms No physical findings No diagnostic ECG findings No chest X-ray X findings No diagnostic events 2
More informationKnow Your Number Aggregate Report Single Analysis Compared to National Averages
Know Your Number Aggregate Report Single Analysis Compared to National s Client: Study Population: 2242 Population: 3,000 Date Range: 04/20/07-08/08/07 Version of Report: V6.2 Page 2 Study Population Demographics
More informationAntihypertensive Trial Design ALLHAT
1 U.S. Department of Health and Human Services Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic National Institutes
More informationHIGH LDL CHOLESTEROL IS NOT AN INDEPENDENT RISK FACTOR FOR HEART ATTACKS AND STROKES
HIGH LDL CHOLESTEROL IS NOT AN INDEPENDENT RISK FACTOR FOR HEART ATTACKS AND STROKES A study published in the British Medical Journal shows that not only is high LDL cholesterol not a risk factor for all-caused
More informationThe target blood pressure in patients with diabetes is <130 mm Hg
Controversies in hypertension, About Diabetes diabetes and and metabolic Cardiovascular syndrome Risk ESC annual congress August 29, 2011 The target blood pressure in patients with diabetes is
More informationAccelerated atherosclerosis begins years prior to the diagnosis of diabetes
Joslin Diabetes Forum 211: Optimizing Care for the Practicing Clinician Risk for atherosclerosis is 2 4 times greater in patients with diabetes CVD accounts for 65% of diabetic mortality >5% of patients
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE QUALITY AND OUTCOMES FRAMEWORK (QOF) INDICATOR DEVELOPMENT PROGRAMME Briefing paper QOF indicator area: Primary prevention of CVD Potential output:
More informationLDL cholesterol and cardiovascular outcomes?
LDL cholesterol and cardiovascular outcomes? Prof Kausik Ray, BSc (hons), MBChB, FRCP, MD, MPhil (Cantab), FACC, FESC Professor of Cardiovascular Disease Prevention St Georges University of London Honorary
More informationΛΟΙΜΩΞΗ HIV. Ιγνάτιος Οικονομίδης,MD,FESC Β Πανεπιστημιακή Καρδιολογική
ΛΟΙΜΩΞΗ HIV Ιγνάτιος Οικονομίδης,MD,FESC Β Πανεπιστημιακή Καρδιολογική Κλινική, Νοσοκομείο «Αττικόν» Infection Acute Myocardial Infarction p er 100,000 HIV/AIDS discharg es 800 700 600 500 400 300 200
More informationWelcome and Introduction
Welcome and Introduction This presentation will: Define obesity, prediabetes, and diabetes Discuss the diagnoses and management of obesity, prediabetes, and diabetes Explain the early risk factors for
More informationIdentification of subjects at high risk for cardiovascular disease
Master Class in Preventive Cardiology Focus on Diabetes and Cardiovascular Disease Geneva April 14 2011 Identification of subjects at high risk for cardiovascular disease Lars Rydén Karolinska Institutet
More informationInflammation as A Target for Therapy. Focus on Residual Inflammatory Risk
ESC Rome Monday August 29, 2016 Inflammation as A Target for Therapy Focus on Residual Inflammatory Risk Paul M Ridker, MD Eugene Braunwald Professor of Medicine Harvard Medical School Director, Center
More informationCVD risk calculation
CVD risk calculation Cardiovascular disease (CVD) is the most common cause of death in Alberta, accounting for nearly one third (31%) of the overall deaths (1). The majority (90%) of the CVD cases are
More informationKey causes of preventable deaths in New Zealand In a population of 10,000 New Zealanders, every year there will be about:
Preventive care - Chronic Disease Management in primary care: a population perspective Rod Jackson University of Auckland New Zealand (22/11/8) Key causes of preventable deaths in New Zealand In a population
More informationStatistical Fact Sheet Populations
Statistical Fact Sheet Populations At-a-Glance Summary Tables Men and Cardiovascular Diseases Mexican- American Males Diseases and Risk Factors Total Population Total Males White Males Black Males Total
More informationSerum levels of galectin-1, galectin-3, and galectin-9 are associated with large artery atherosclerotic
Supplementary Information The title of the manuscript Serum levels of galectin-1, galectin-3, and galectin-9 are associated with large artery atherosclerotic stroke Xin-Wei He 1, Wei-Ling Li 1, Cai Li
More informationEffects of whole grain intake on weight changes, diabetes, and cardiovascular Disease
Effects of whole grain intake on weight changes, diabetes, and cardiovascular Disease Simin Liu, MD, ScD Professor of Epidemiology and Medicine Director, Center for Global Cardiometabolic Health Brown
More informationMetabolic Syndrome. Shon Meek MD, PhD Mayo Clinic Florida Endocrinology
Metabolic Syndrome Shon Meek MD, PhD Mayo Clinic Florida Endocrinology Disclosure No conflict of interest No financial disclosure Does This Patient Have Metabolic Syndrome? 1. Yes 2. No Does This Patient
More informationSupplementary Online Content
Supplementary Online Content Leibowitz M, Karpati T, Cohen-Stavi CJ, et al. Association between achieved low-density lipoprotein levels and major adverse cardiac events in patients with stable ischemic
More informationSupplementary Online Content
Supplementary Online Content Kavousi M, Leening MJG, Nanchen D, et al. Comparison of application of the ACC/AHA guidelines, Adult Treatment Panel III guidelines, and European Society of Cardiology guidelines
More informationBEST PRACTICE MANAGEMENT: CARDIOVASCULAR RISKS
BEST PRACTICE MANAGEMENT: CARDIOVASCULAR RISKS Neil R Poulter ICCH, Imperial College London BHIVA: October 10th, 2008 Background CVD is the biggest single killer in the world CVD rates are increasing High
More informationConceptual Approach to CAD Risk. Disclosures. Integrating Imaging and Biomarkers for Optimal CVD Risk Assessment and Management 2/10/2014.
Integrating Imaging and Biomarkers for Optimal CVD Risk Assessment and Management None Disclosures Arthur Agatston Conceptual Approach to CAD Risk Devereux Circulation, 1993 1 Age Obesity Family Hx Diabetes
More information