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Saturday, 10 May, 2008


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Editor's Choice
A selection of hand-picked articles

Hot Topic
Cholesterol-Associated Gene Variants Can Predict Cardiovascular Events
21 March 2008
A study appearing in this week's New England Journal of Medicine confirms that a combination of gene variants previously associated with cholesterol levels does reflect patients' cholesterol levels and can signify increased risk of heart attack, stroke or sudden cardiac death. Led by researchers from the Massachusetts General Hospital Cardiology Division, the study's findings are a first step towards the ability to identify individuals who might benefit from earlier use of cholesterol-lowering medications and other measures to combat elevated risk.

Further Reading
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Paper of the Month

BioMed Central

The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects


Robert V Acuff1 , David J Cai2 , Zhi-Ping Dong1 and Doris Bell3
1East Tennessee State University, College of Medicine, Johnson City, TN, USA
2Cognis Corporation, LaGrange, IL, USA
3Cognis Deutschland GmbH & Co. KG, Monheim, Germany
BioMed Central

This study is the first study that confirmed regular use of plant sterol ester capsules is an effective strategy in improving lipid profiles, especially lipoprotein ratios, among hypercholesterolemic subjects in a free-living setting without dietary intervention.

Methods: Sixteen subjects participated in a double-blind, placebo-controlled, sequential study with a 4-week placebo phase followed by a 2-week wash-out period and a 4-week treatment phase. Subjects were instructed to maintain stable diet pattern and physical activities. Blood samples were collected at 7, 21 and 28 days of each phase. The primary measurements were change in plasma total cholesterol (TC), HDL-cholesterol (HDL) and LDL-cholesterol (LDL) between phases and within each phase. The secondary measurements were change in triglycerides, lipoprotein ratios (TC/HDL, LDL/HDL) and C-reactive protein (CRP).

Highlights of the results

The effect of plant sterol ester on LDL – cholesterol

The effect of plant sterol ester on HDL – cholesterol
Results: HDL at week 3 of the treatment was significantly increased by 9% (P < 0.01), but not at week 4 (4%)

In comparison to placebo, LDL-cholesterol was significantly reduced by 7% and 4% (P < 0.05) at both week 3 and week 4.

Total cholesterol was not significantly different from placebo throughout the period.

Highlights of the results

The effect of plant sterol ester on HDL – cholesterol

The effect of plant sterol ester on LDL – cholesterol
TC/HDL and LDL/HDL were significantly reduced by (8%, 8%, 6%, 10%, respectively) (P < 0.01) at both week 3 and week 4.

CRP and triglycerides did not differ either between the two phases or during the treatment phase.

Keeping you up to date with the latest hypercholesterolemia research

The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects

Conclusion: In conclusion, plant sterol ester capsule is effective in improving lipid profiles among hypercholesterolemic subjects in a free-living setting at the minimum dosage recommended by FDA. The significant improved lipid profiles were reached after three weeks of administration. To achieve better lipid lowering results, higher dosages and combination with diets low in saturated fat and cholesterol are recommended.



Controversies
Rosiglitazone safety questions remain after RECORD interim analysis
06 Jun 2007
Rosiglitazone: Seeking A Balanced Approach To Avoid Panic Among Patients - The Lancet
24 May 2007
Avandia No Riskier Than Other Diabetes Drugs Says Interim Study
06 Jun 2007
Data Affirms Avandia (Rosiglitazone Maleate) Cardiovascular Safety Profile
31 May 2007
FDA Issues Safety Alert On Avandia
23 May 2007

Journal Watch
Selected headlines from the top Cardiology journals

Practicing paramedics cannot generate or estimate safe endotracheal tube cuff pressure using standard techniques

In a study to determine the ability of paramedics to generate or estimate safe endotracheal tube cuff pressure every paramedic inflated the cuff above the safe limit, and 87% could not detect an overinflated cuff by palpation of the pilot balloon. Prehosp Emerg Care 2007; Jul-Sep;11(3):307-11

Trial Watch
Trial Updates from the ACC 07 Scientific Sessions (NGC)

Contradictory Effects of Torcetrapib

Two ATHEROSCLEROSIS trials show that the cholesterol ester transfer protein (CETP)-inhibitor, torcetrapib has virtually no effect on either coronary or carotid disease, despite improving LDL-C and HDL-C levels dramatically.

1. ILLUSTRATE Trial

Investigation of Lipid Level management using coronary UltraSound To assess Reduction of Atherosclerosis by CETP Inhibition and HDL Elevation
Torcetrapib failed to reduce progression or induce regression of atherosclerosis when used with atorvastatin for CAD patients compared to patients taking atorvastatin alone. However, HDL-C increases and LDL-C reductions were significant. Read more

2. RADIANCE I/II Trials

Rating Atherosclerotic Disease Change by Imaging with A New CEtp Inhibitor
Torcetrapib failed induce regression of atherosclerosis when used with atorvastatin for patients with heterozygous hypercholesterolemia (HFH; RADIANCE I) and mixed hyperlipidemia (RADIANCE II) and compared to patients taking atorvastatin alone. However, HDL-C increases and LDL-C reductions were significant in both cases. Read more


Guidelines Watch
A round up of the latest Clinical Guidelines
Stable coronary artery disease
Secondary prevention of coronary artery disease clinical practice guidelines
AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2006 Update
NCEP Report - Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines
Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

Upcoming Events
EuroPCR
13 -  16 May 2008
The CCIB, Barcelona, Spain
Heart Rhythm 2008 - 29th Annual Scientific Sessions
14 -  17 May 2008
Moscone Convention Center, San Francisco, USA
XVI World Congress of Cardiology
18 -  21 May 2008
Buenos Aires, Argentina


Hypercholesterolemia Trials
Combination of Telmisartan and Simvastatin in the Treatment of Hypertension and Hypercholesterolemia
Systematic Management of High Cholesterol Utilizing Computer Monitoring
Effect of TAK-475 or Placebo co-Administered With Current Lipid-Lowering Treatment on Blood Cholesterol Levels in Subjects With Homozygous Familial Hypercholesterolemia
Open Label Extension of ISIS 301012 to Treat Familial Hypercholesterolemia
Program on Surgical Control of Hyperlipidemias (POSCH)
Effect of an Internet Based Compliance Enhancement Tool in Subjects With Hypercholesterolemia

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Specialities :
Arrhythmia Cardiac Imaging Congenital Heart Disease Coronary Artery Disease Heart Disease Prevention Heart Failure Hyperlipidemia Hypertension Interventional Cardiology Pediatric Cardiology Peripheral Artery Disease

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