Statins for Secondary Prevention: Clinical Use in Patients With Acute Coronary Syndrome in Wales

Protty, Majd; Lacey, Arron; Hayes, Joanne; Freeman, Phillip

doi:10.2217/fca-2016-0060

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Despite the beneficial effects of statins, a dichotomy exists between intention to prescribe and real prescribing of therapy (44). Less than 40% of CAD statin-treated patients attained their recommended LDL-C and non-HDL-C goals due to irregular use and unscheduled dosage ( 45), with discontinuation rates of 53.7 and 84.3% at one and three-year follow-up, respectively, after ACS (46). Suboptimal statin use is common early after non-ST elevation acute coronary syndrome (NSTE-ACS) due to muscular symptoms, therefore, keep, and enhance use of high-potency statin therapy can improve outcomes (47).…”

Section: Prescription Strategies and Eligibility For Therapymentioning

confidence: 99%

Preventive effects of statin therapy in coronary artery diseases: Current controversy

Kamal¹,

Abdel-Gaber²

2018

Beyer Curr Res Integr Med

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S tatins inhibit hepatic biosynthesis of cholesterol where they prevent mevalonate formation, and inhibit 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) (1-2). Through the last decades, research targets the protective cardiovascular effects of statins (3-4). Statins have desired roles preventing primary and secondary all-cause death and major cardiovascular events of coronary artery disease (CAD) (5). Protecting against atherosclerotic cardiovascular disease, statin therapy is effective with modification of risk factors (6).The favorable pleiotropic effects occur through increasing expression of atheroprotection genes, inhibiting inflammatory markers, protecting endothelium, enhancing plaques stability, inhibiting platelets aggregation, increasing nitric oxide bioavailability, decreasing circulating oxidative stress and inflammatory biomarkers, and inhibiting thrombogenesis (2,7).Variable recommendations of statins in high-risk CAD patients exist. Many guidelines recommend low-density lipoprotein-cholesterol (LDL-C) goal at 70 mg/dl (8-9), but the guideline of American College of Cardiology/ American Heart Association (ACC/AHA) supports high-intensity statins and repeated lipid measures (10).A debate exists about prescribing patterns, eligible patients, high-intensity doses (11-13), combined lipid-lowering therapy, improved outcomes following coronary surgery or intervention (14-15). Therefore, our review of the contemporary literature concerns contemporary status and debates of statin therapy in CAD patients. Our methods of constituting this narrative review include searching MEDLINE with a limit of publication dates between January and December 2017, using search terms of (statins) and (coronary artery disease) which yield 319 trials, of which 104 studies were relevant to the aim of our review. Impact of Statins on BiomarkersThe current research proceeds to investigate the role of statins in repairing, stabilization, and regression of coronary artery lesions, which form a cornerstone in inhibition of cardiac events ( 16). However, the mechanisms rather than lowering LDL-C to produce beneficial cardiovascular pleiotropic effects, remain multifactorial and unclear.

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Section: Prescription Strategies and Eligibility For Therapymentioning

confidence: 99%

Preventive effects of statin therapy in coronary artery diseases: Current controversy

Kamal¹,

Abdel-Gaber²

2018

Beyer Curr Res Integr Med

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“…(11) Healthcare professionals have the mission of conducting the screening for primary risk factors within their designated populations, evaluating the overall risk profile of each individual, and initiating and maintaining interventions targeted at the management of these risk factors. (12) The objective of this study is to appraise the impact of an educational intervention on patients affiliated with the Family Medical Office #18 at the polyclinic in the municipality of Venezuela, with the aim of augmenting their knowledge of the risk factors associated with angina pectoris. An initial assessment of the patients' knowledge will be executed, followed by the implementation of a tailored educational strategy.…”

Section: Introductionmentioning

confidence: 99%

Educational intervention on risk factors that trigger angina pectoris

Lugo Torres

2021

Interdisciplinary Rehabilitation / Rehabilitacion Interdiscipli

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Se realizó una intervención educativa de tipo antes y después, a través de un estudio preexperimental para evaluar la efectividad en la aplicación de un programa de intervención educativa y elevar conocimientos relacionados con los factores de riesgo desencadenantes de la angina de pecho en pacientes del municipio Venezuela, durante el período comprendido entre junio del 2020 y mayo del 2021. Se empleó la prueba estadísticas Mc.Nemar para hallar diferencias significativas entre el nivel de conocimiento antes y después. El universo de estudio estuvo constituido por 242 pacientes adultos jóvenes de ambos sexos, en las edades comprendidas entre 30 y 45 años de edad, que pertenecieron al Consultorio Médico de la Familia # 18, del área de salud del policlínico de Venezuela. Se trabajó con una muestra de 20 pacientes donde se les aplicó un cuestionario para evaluar el nivel de conocimientos antes y después de la intervención. Antes de esta los pacientes presentaban conocimientos inadecuados sobre factores de riesgo desencadenantes de la angina, y luego de esta hubo una modificación significativa en la evaluación final. La intervención fue efectiva porque elevó el nivel de conocimientos sobre el tema.

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“…Simvastatin is a type of cholesterol-lowering agent that also serves an immunomodulatory role through the inhibition of superantigen-mediated T cell activation ( 2 ). It is widely used for the reduction of cardiovascular morbidity and mortality ( 6 , 7 ), and pretreatment with simvastatin has been reported to decrease the apoptosis and necroptosis in cardiac allograft ischemia/reperfusion ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Combined treatment with simvastatin and rapamycin attenuates cardiac allograft rejection through the regulation of T helper 17 and regulatory T cells

et al. 2017

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Allograft rejection is an important issue post cardiac transplantation. In order to investigate the effect of combined treatment with simvastatin and rapamycin on allograft rejection, a cardiac transplantation rat model was employed in the present study. The survival time of rats following cardiac transplantation was recorded, while histopathological alterations were assessed by hematoxylin and eosin staining. The levels of transcription factors were measured by reverse transcription-quantitative polymerase chain reaction. In addition, the levels of CD4+ interleukin (IL)-17+ cells and CD4+ forkhead box P3 (FOXP3)+ cells in the allografts and CD4+ T cells and CD8+ T cells in the spleens were detected by flow cytometry. The results of the current study demonstrated that, following treatment with simvastatin and rapamycin, the survival time of model rats was prolonged, and the histopathological damage was attenuated. Treatment with simvastatin and rapamycin also led to decreased retinoic acid receptor-related orphan receptor γt (RORγt) level, increased FOXP3 level, reduced levels of CD4+IL-17+, CD4+ T and CD8+ T cells, and increased level of CD4+FOXP3+ cells. In conclusion, the current study observed that simvastatin and rapamycin performed a synergistic effect to reduce cardiac transplantation rejection. Thus, combined therapy of simvastatin and rapamycin may be a promising adjuvant therapy to reduce rejection post cardiac transplantation.

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Statins for Secondary Prevention: Clinical Use in Patients With Acute Coronary Syndrome in Wales

Cited by 4 publications

References 7 publications

Preventive effects of statin therapy in coronary artery diseases: Current controversy

Preventive effects of statin therapy in coronary artery diseases: Current controversy

Educational intervention on risk factors that trigger angina pectoris

Combined treatment with simvastatin and rapamycin attenuates cardiac allograft rejection through the regulation of T helper 17 and regulatory T cells

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