1
|
Haskiah F, Abdelhai K, Hilu R, Khaskia A. Sex Differences in Low-Density Lipoprotein Cholesterol Treatment Among Young Israeli Patients Following Premature Acute Coronary Syndrome. Metab Syndr Relat Disord 2024; 22:439-446. [PMID: 38546443 DOI: 10.1089/met.2023.0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
Introduction: Effective management of dyslipidemias is crucial for reducing morbidity and mortality among patients after acute coronary syndrome (ACS). Sex differences in dyslipidemia management after premature ACS in Israeli patients have not been extensively studied. This study aimed to investigate potential disparities between men and women in managing dyslipidemia, considering current guidelines. Methods: This retrospective cohort study examined patients who were 55 years old or younger and admitted to Meir Medical Center for ACS from January 2018 to February 2019. The study aimed to evaluate the use of lipid-lowering therapy (LLT), measure the achievement of target low-density lipoprotein cholesterol (LDL-C) levels, and analyze the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in both male and female patients. Results: The study included a total of 687 participants, of which 23.3% were identified as females. Upon discharge, ∼80% of the patients were prescribed high-intensity statins. After 1 year, it was observed that females had higher levels of LDL-C and lower rates of achieving target LDL-C levels (<70 and 55 mg/dL) as compared with males (45% vs. 54.6% and 30% vs. 42.2%, respectively). The use of non-statin LLT at the 1-year mark was minimal in both groups. Finally, it was found that the occurrence of MACCE was similar between males and females. Conclusion: Sex disparities in dyslipidemia management after a premature ACS were apparent, with females having higher LDL-C levels and lower rates of target achievement. Intervention is necessary to address these disparities and encourage greater use of non-statin LLT.
Collapse
Affiliation(s)
- Feras Haskiah
- Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
- Leviev Heart Center, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Karam Abdelhai
- Department of Internal Medicine D, Meir Medical Center, Kfar Saba, Israel
| | - Ranin Hilu
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
| | - Abid Khaskia
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
| |
Collapse
|
2
|
Čereškevičius D, Zabiela V, Aldujeli A, Lesauskaitė V, Zubielienė K, Raškevičius V, Čiapienė I, Žaliaduonytė D, Giedraitienė A, Žvikas V, Jakštas V, Skipskis V, Dobilienė O, Šakalytė G, Tatarūnas V. Impact of CYP2C19 Gene Variants on Long-Term Treatment with Atorvastatin in Patients with Acute Coronary Syndromes. Int J Mol Sci 2024; 25:5385. [PMID: 38791422 PMCID: PMC11120965 DOI: 10.3390/ijms25105385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 05/26/2024] Open
Abstract
The effectiveness of lipid-lowering therapies may be insufficient in high-risk cardiovascular patients and depends on the genetic variability of drug-metabolizing enzymes. Customizing statin therapy, including treatment with atorvastatin, may improve clinical outcomes. Currently, there is a lack of guidelines allowing the prediction of the therapeutic efficacy of lipid-lowering statin therapy. This study aimed to determine the effects of clinically significant gene variants of CYP2C19 on atorvastatin therapy in patients with acute coronary syndromes. In total, 92 patients with a confirmed diagnosis of ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) were sequenced for target regions within the CYP2C19 gene on the Illumina Miniseq system. The CYP2C19 poor metabolizer phenotype (carriers of CYP2C19*2, CYP2C19*4, and CYP2C19*8 alleles) was detected in 29% of patients. These patients had significantly lower responses to treatment with atorvastatin than patients with the normal metabolizer phenotype. CYP2C19-metabolizing phenotype, patient age, and smoking increased the odds of undertreatment in patients (∆LDL-C (mmol/L) < 1). These results revealed that the CYP2C19 phenotype may significantly impact atorvastatin therapy personalization in patients requiring LDL lipid-lowering therapy.
Collapse
Affiliation(s)
- Darius Čereškevičius
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Vytautas Zabiela
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Ali Aldujeli
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Vaiva Lesauskaitė
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Kristina Zubielienė
- Department of Cardiology, Kaunas Hospital of the Lithuanian University of Health Sciences, Hipodromo 13, LT 45130 Kaunas, Lithuania; (K.Z.); (D.Ž.)
| | - Vytautas Raškevičius
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Ieva Čiapienė
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Diana Žaliaduonytė
- Department of Cardiology, Kaunas Hospital of the Lithuanian University of Health Sciences, Hipodromo 13, LT 45130 Kaunas, Lithuania; (K.Z.); (D.Ž.)
| | - Agnė Giedraitienė
- Institute of Microbiology and Virology, Lithuanian University of Health Sciences, Eivenių 4, LT 50161 Kaunas, Lithuania;
| | - Vaidotas Žvikas
- Institute of Pharmaceutical Technologies, Sukileliu 13, LT 50103 Kaunas, Lithuania; (V.Ž.); (V.J.)
| | - Valdas Jakštas
- Institute of Pharmaceutical Technologies, Sukileliu 13, LT 50103 Kaunas, Lithuania; (V.Ž.); (V.J.)
| | - Vilius Skipskis
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Olivija Dobilienė
- Department of Cardiology, Lithuanian University of Health Sciences, Eivenių 2, LT 50009 Kaunas, Lithuania;
| | - Gintarė Šakalytė
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| | - Vacis Tatarūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu 15, LT 50103 Kaunas, Lithuania; (D.Č.); (V.Z.); (A.A.); (V.L.); (V.R.); (I.Č.); (V.S.); (G.Š.)
| |
Collapse
|
3
|
Bhatnagar R, Dixit NM, Yang EH, Sallam T. Cancer therapy's impact on lipid metabolism: Mechanisms and future avenues. Front Cardiovasc Med 2022; 9:925816. [PMID: 36017084 PMCID: PMC9396263 DOI: 10.3389/fcvm.2022.925816] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Atherosclerotic cardiovascular disease is a growing threat among cancer patients. Not surprisingly, cancer-targeting therapies have been linked to metabolic dysregulation including changes in local and systemic lipid metabolism. Thus, tumor development and cancer therapeutics are intimately linked to cholesterol metabolism and may be a driver of increased cardiovascular morbidity and mortality in this population. Chemotherapeutic agents affect lipid metabolism through diverse mechanisms. In this review, we highlight the mechanistic and clinical evidence linking commonly used cytotoxic therapies with cholesterol metabolism and potential opportunities to limit atherosclerotic risk in this patient population. Better understanding of the link between atherosclerosis, cancer therapy, and cholesterol metabolism may inform optimal lipid therapy for cancer patients and mitigate cardiovascular disease burden.
Collapse
Affiliation(s)
- Roshni Bhatnagar
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Neal M. Dixit
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Eric H. Yang
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Tamer Sallam
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
4
|
Zullig LL, Sung AD, Khouri MG, Jazowski S, Shah NP, Sitlinger A, Blalock DV, Whitney C, Kikuchi R, Bosworth HB, Crowley MJ, Goldstein KM, Klem I, Oeffinger KC, Dent S. Cardiometabolic Comorbidities in Cancer Survivors. JACC CardioOncol 2022; 4:149-165. [PMID: 35818559 PMCID: PMC9270612 DOI: 10.1016/j.jaccao.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 12/28/2022] Open
Abstract
There are nearly 17 million cancer survivors in the United States, including those who are currently receiving cancer therapy with curative intent and expected to be long-term survivors, as well as those with chronic cancers such as metastatic disease or chronic lymphocytic leukemia, who will receive cancer therapy for many years. Current clinical practice guidelines focus on lifestyle interventions, such as exercise and healthy eating habits, but generally do not address management strategies for clinicians or strategies to increase adherence to medications. We discuss 3 cardiometabolic comorbidities among cancer survivors and present the prevalence of comorbidities prior to a cancer diagnosis, treatment of comorbidities during cancer therapy, and management considerations of comorbidities in long-term cancer survivors or those on chronic cancer therapy. Approaches to support medication adherence and potential methods to enhance a team approach to optimize care of the individual with cancer across the continuum of disease are discussed. Cancer survivors are at increased risk for several chronic conditions, including hypertension, dyslipidemia, and diabetes. Determining optimal management of comorbidities for patients with cancer is critical. A multidisciplinary care approach is recommended throughout the continuum of active cancer treatment and survivorship. Survivorship research should focus on medication adherence and coordination of care.
Collapse
Affiliation(s)
- Leah L. Zullig
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Address for correspondence: Dr Leah Zullig, Duke University, 411 West Chapel Hill Street, Suite 600, Durham, North Carolina 27701, USA. @LeahZullig
| | - Anthony D. Sung
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Michel G. Khouri
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Shelley Jazowski
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Nishant P. Shah
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Andrea Sitlinger
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Dan V. Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Colette Whitney
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Cascades East–Oregon Health and Science University, Klamath Falls, Oregon, USA
| | - Robin Kikuchi
- Keck School of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Hayden B. Bosworth
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Matthew J. Crowley
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Karen M. Goldstein
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Igor Klem
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Kevin C. Oeffinger
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Susan Dent
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| |
Collapse
|
5
|
Han KT, Choi DW, Kim S. Regional and income disparities in treatment and drug adherence of patients with dyslipidemia: a retrospective cohort study in South Korea, 2003-2015. BMC Geriatr 2021; 21:585. [PMID: 34674649 PMCID: PMC8529775 DOI: 10.1186/s12877-021-02510-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/01/2021] [Indexed: 11/25/2022] Open
Abstract
Backgrounds Health disparities represent a major public health problem that needs to be addressed, and a variety of factors, including geographical location and income, can contribute to these disparities. Although previous studies have suggested that health differs by region and income, evidence on the difference in treatment rate is relatively insufficient. To identify differences in prescription rates by region and income in patients with dyslipidemia. Methods Using data from the National Health Insurance Service senior cohort, we included older adults who were diagnosed with dyslipidemia in Korea from 2003 to 2015. Overall prescription rate was determined for patients with dyslipidemia. In addition, medication possession ratio and a defined daily dose were analyzed in patients who were prescribed statins. A generalized estimating equation Poisson model was used to assess differences in prescription rates. Results Patients living in rural areas (Chungcheong-do, Jeolla-do, and Gyeongsang-do) had a significantly higher prescription rate than those in metropolitan cities. Unlike the prescription rate, the drug adherence was significantly higher in Seoul, Gyeonggi-do, and Gangwon-do but lower in Jeolla-do and Gyeongsang-do than in metropolitan cities. Patients with low income had lower prescription rates than those with high income, but this difference was not statistically significant. Conclusion Our findings demonstrate differences in the treatment rates of patients with dyslipidemia by region and income. Appropriate interventions are needed in vulnerable regions and groups to increase the treatment rate for patients with dyslipidemia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02510-5.
Collapse
Affiliation(s)
- Kyu-Tae Han
- Division of Cancer Control and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, 10408, Republic of Korea
| | - Dong-Woo Choi
- Cancer Data Center, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, 10408, Republic of Korea
| | - Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
| |
Collapse
|
6
|
Kim SJ, Kwon OD, Lee EJ, Ock SM, Kim KS. Impact of a family history of cardiovascular disease on prevalence, awareness, treatment, control of dyslipidemia, and healthy behaviors: Findings from the Korea National Health and Nutrition Examination Survey. PLoS One 2021; 16:e0254907. [PMID: 34324532 PMCID: PMC8321108 DOI: 10.1371/journal.pone.0254907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Family history (FH) is one of important risk factors for cardiovascular disease (CVD). However, little is known about its impact on dyslipidemia prevalence and management status. Thus, we aimed to investigate the impact of FH of CVD on dyslipidemia prevalence, awareness, treatment, control, and healthy behaviors in Korean adults. METHODS We conducted a cross-sectional study using representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2014-2018. A total of 22,024 participants aged ≥ 19 years without histories of CVDs were classified into two groups according to the presence of FH of CVD (with FH, n = 3,778; without FH, n = 18,246). FH of CVD was defined as having a first-degree relative with ischemic heart disease or stroke. Multivariate logistic regression analyses were performed to evaluate the association between FH of CVD and dyslipidemia prevalence, awareness, treatment, control, and healthy behaviors (weight control, non-smoking, non-risky drinking, sufficient physical activity, and undergoing health screening). RESULTS FH of CVD was significantly associated with a higher dyslipidemia prevalence (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.18-1.51), better awareness (aOR 1.54, 95%CI 1.19-2.00), and treatment rates (aOR 1.34, 95%CI 1.12-1.60), but not control. Having an FH of CVD was not predictive of any healthy behaviors in dyslipidemia patients. For non-dyslipidemia patients, FH of CVD even showed significant association with smoking (aOR 1.18, 95%CI 1.02-1.36), and risky drinking (aOR 1.20, 95%CI 1.03-1.40) while it was predictive of receiving health screening (aOR 1.14, 95% CI 1.02-1.27). CONCLUSIONS Having an FH of CVD might positively trigger dyslipidemia patients to start pharmacological intervention, but not non-pharmacological interventions. Therefore, physicians should make more efforts to educate and promote the importance of non-pharmacological behavioral modification in dyslipidemia patients with an FH of CVD.
Collapse
Affiliation(s)
- Seung Jae Kim
- Department of Family Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- International Healthcare Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | - Eung-Joon Lee
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sun Myeong Ock
- Department of Family Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Soo Kim
- Department of Family Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
7
|
Halasz G, Piepoli MF. Focus on Atherosclerosis and Lipids. Eur J Prev Cardiol 2021; 28:799-802. [PMID: 34057988 DOI: 10.1093/eurjpc/zwab090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Geza Halasz
- Cardiac Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy
| | - Massimo F Piepoli
- Cardiac Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy.,Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
| |
Collapse
|
8
|
Post-Diagnostic Statin Use Reduces Mortality in South Korean Patients with Dyslipidemia and Gastrointestinal Cancer. J Clin Med 2021; 10:jcm10112361. [PMID: 34072162 PMCID: PMC8198926 DOI: 10.3390/jcm10112361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 12/09/2022] Open
Abstract
Background: Statins play a role in lowering serum cholesterol and are known to have pleiotropic effects in a variety of diseases, including cancer. Despite the beneficial effects of statins in dyslipidemia patients, the treatment rate for dyslipidemia in Korea remains low, and evidence supporting the continued use of statins is lacking. The purpose of this study was to evaluate the effect of continued statin use and dosage on patient mortality after diagnosis of dyslipidemia and gastrointestinal (GI) cancer. Methods: We used data from the National Health Insurance Sampling (NHIS) cohort to evaluate patients diagnosed with dyslipidemia from 2002 to 2015. A total of 901 GI cancer patients with dyslipidemia and 62,727 non-cancer dyslipidemia patients were included in the study. During the study period, each patient’s medication possession ratio (MPR) after diagnosis was evaluated as a measure of continued statin use. Statin dosage was measured based on a defined daily dose (DDD). Finally, we used Cox-proportional hazard ratios to identify associations between the continual use of statins and mortality in patients with dyslipidemia and GI cancer. Results: In our study, mortality decreased with increasing MPR and reached significance in MPRs exceeding 50% for GI cancer patients and 75% for dyslipidemia patients compared to patients that did not use statins. Moreover, patients with high MPRs had significantly reduced 5-year mortality compared to non-users, and cause-specific mortality analyses revealed that high MPR was associated with decreased colorectal cancer death. We did not find a significant dose–response relationship between statins and mortality. Conclusion: Our findings suggest that continued statin use after diagnosis is associated with reduced patient mortality. Altogether, these results support the continued use of statins in dyslipidemia patients with and without GI cancer and highlight the importance of patient education by healthcare providers.
Collapse
|
9
|
Kim SJ, Kwon OD, Kim KS. Prevalence, awareness, treatment, and control of dyslipidemia among diabetes mellitus patients and predictors of optimal dyslipidemia control: results from the Korea National Health and Nutrition Examination Survey. Lipids Health Dis 2021; 20:29. [PMID: 33771170 PMCID: PMC8004432 DOI: 10.1186/s12944-021-01455-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to investigate the prevalence, awareness, treatment, and control rates of dyslipidemia and identify the predictors of optimal control (low-density lipoprotein cholesterol < 100 mg/dL) among patients with diabetes mellitus (DM). Methods A cross-sectional study was conducted using the representative Korea National Health and Nutrition Examination Survey (2014–2018). Overall, 4311 patients with DM, aged ≥19 years, and without cardiovascular diseases were selected, and the prevalence, awareness, treatment, and control rates of dyslipidemia were calculated. Univariate and multivariate logistic regression analyses were conducted to evaluate the factors influencing the optimal control of dyslipidemia. Results Dyslipidemia was prevalent in 83.3% of patients with DM, but the awareness and treatment rates were 36.5 and 26.9%, respectively. The control rate among all patients with dyslipidemia was 18.8%, whereas it was 61.1% among those being treated. Prevalence and awareness rates were also significantly higher in women than in men. Dyslipidemia was most prevalent in those aged 19–39 years, but the rates of awareness, treatment, and control among all patients with dyslipidemia in this age group were significantly lower than those in other age groups. The predictors of optimal control were age ≥ 40 years [range 40–49 years: adjusted odds ratio (aOR) 3.73, 95% confidence interval (CI) 1.43–9.72; 50–59 years: aOR 6.25, 95% CI 2.50–15.65; 60–69 years: aOR 6.96, 95% CI 2.77–17.44; 70–79 years: aOR 9.21, 95% CI 3.58–23.74; and ≥ 80 years: aOR 4.43, 95% CI 1.60–12.27]; urban living (aOR 1.44, 95% CI 1.15–1.80); higher body mass index (aOR 1.27, 95% CI 1.13–1.42); lower glycated hemoglobin levels (aOR 0.71, 95% CI 0.67–0.76); hypertension (aOR 1.53, 95% CI 1.22–1.92); poorer self-rated health status (aOR 0.72, 95% CI 0.62–0.84); and receiving regular health check-ups (aOR 1.58, 95% CI 1.25–2.00). Conclusions Most patients with DM were diagnosed with dyslipidemia, but many were unaware of or untreated for their condition. Therefore, their control rate was suboptimal. Thus, by understanding factors influencing optimal control of dyslipidemia, physicians should make more effort to encourage patients to undergo treatment and thus, adequately control their dyslipidemia.
Collapse
Affiliation(s)
- Seung Jae Kim
- Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,International Healthcare Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Oh Deog Kwon
- Republic of Korea Navy 2nd Fleet Medical Corps, Pyeongtaek-si, Gyeonggi-do, Republic of Korea
| | - Kyung-Soo Kim
- Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
10
|
Association between Dyslipidemia and Mercury Exposure in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020775. [PMID: 33477628 PMCID: PMC7831478 DOI: 10.3390/ijerph18020775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/26/2022]
Abstract
Background-Dyslipidemia is one of the prominent risk factors for cardiovascular disease, which is the leading cause of death worldwide. Dyslipidemia has various causes, including metabolic capacity, genetic problems, physical inactivity, and dietary habits. This study aimed to determine the association between dyslipidemia and exposure to heavy metals in adults. Methods-Using data from the seventh Korean National Health and Nutrition Examination Survey (2016-2017), 5345 participants aged ≥20 years who were tested for heavy metal levels were analyzed in this study. Multiple logistic regression was conducted to assess the factors affecting the prevalence of dyslipidemia. Results-The risks of dyslipidemia among all and male participants with mercury (Hg) levels of ≥2.75 μg/L (corresponding to the Korean average level) were 1.273 and 1.699 times higher than in those with levels of <2.75 μg/L, respectively. The factors that significantly affected the dyslipidemia risk were age, household income, body mass index, and subjective health status in both males and females. Conclusions-In adult males, exposure to Hg at higher-than-average levels was positively associated with dyslipidemia. These results provide a basis for targeted prevention strategies for dyslipidemia using lifestyle guidelines for reducing Hg exposure and healthy behavioral interventions.
Collapse
|
11
|
The association between olfactory dysfunction and cardiovascular disease and its risk factors in middle-aged and older adults. Sci Rep 2021; 11:1248. [PMID: 33441955 PMCID: PMC7806612 DOI: 10.1038/s41598-020-80943-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/30/2020] [Indexed: 12/31/2022] Open
Abstract
While previous studies have reported olfactory dysfunction (OD) in relation to cardiovascular disease (CVD), few population-based studies have investigated whether such associations differ by sex. The purpose of this study was to identify the association between CVD and its risk factors with OD, and the sex-associated differences within the general population. We examined 20,016 adults aged 40 and older from the Korean National Health and Nutrition Examination Survey. All subjects reported on their history of OD. CVD and its risk factors included coronary artery disease (CAD), stroke, hypertension, diabetes, obesity, abdominal obesity, and hypertriglyceridemia; logistic regression was used to analyse their associations with OD, and additive interaction was used to analyse the interaction between risk factors and sex. In males, CAD was more likely to be associated with OD (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.05–3.14), whereas abdominal obesity was associated with OD in females (OR 1.39, 95% CI 1.06–1.84).Additive interaction were observed between abdominal obesity and female sex with a relative excess risk of interaction of 0.45 (95% CI 0.26–0.63). Our findings suggest the relationship between OD and CVD and its risk factors and sex-associated differences among middle-aged and older adults.
Collapse
|
12
|
Caro-Codón J, López-Fernández T, Álvarez-Ortega C, Zamora Auñón P, Rodríguez IR, Gómez Prieto P, Buño Soto A, Canales Albendea M, Albaladejo A, Mediavilla G, Feliu Batlle J, Rodríguez Fraga O, Martínez Monzonis A, González-Costello J, Serrano Antolín JM, Cadenas Chamorro R, González-Juanatey JR, López-Sendón J. Cardiovascular risk factors during cancer treatment. Prevalence and prognostic relevance: insights from the CARDIOTOX registry. Eur J Prev Cardiol 2020; 29:859-868. [DOI: 10.1093/eurjpc/zwaa034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/29/2020] [Accepted: 07/30/2020] [Indexed: 12/21/2022]
Abstract
Abstract
Aims
The actual usefulness of cardiovascular (CV) risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Prospective multicentre study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk.
Methods and results
A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples, and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years, and 2 years after initiation of cancer therapy. At baseline, 893 patients (67.4%) presented at least one risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity (CTox) and all-cause mortality [hazard ratio (HR) 1.79 (95% confidence interval, CI 1.16–2.76) for SCORE 5–9 and HR 4.90 (95% CI 2.44–9.82) for SCORE ≥10 when compared with patients with lower SCORE (0–4)].
Conclusions
This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline CV risk assessment using SCORE predicted severe CTox and all-cause mortality. Therefore, its use should be considered in the evaluation of cancer patients.
Collapse
Affiliation(s)
- Juan Caro-Codón
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Teresa López-Fernández
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Carlos Álvarez-Ortega
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Pilar Zamora Auñón
- Oncology Department, University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Isabel Rodríguez Rodríguez
- Oncoradiotherapy Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Pilar Gómez Prieto
- Hematology Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Antonio Buño Soto
- Clinical Analytics Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Miguel Canales Albendea
- Hematology Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Ainara Albaladejo
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Guiomar Mediavilla
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Jaime Feliu Batlle
- Oncology Department, University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Olaia Rodríguez Fraga
- Clinical Analytics Department University Hospital La Paz, UAM, IdiPaz, CiberONC, Paseo de la Castellana 261, Madrid 28046, Spain
| | - Amparo Martínez Monzonis
- Department of Cardiology, University Hospital of Santiago de Compostela, CiberCV, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain
| | - José González-Costello
- Department of Cardiology, University Hospital of Bellvitge, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - José María Serrano Antolín
- Department of Cardiology, University Hospital of Fuenlabrada, Camino del Molino, 2, 28942 Fuenlabrada, Madrid, Spain
| | - Rosalía Cadenas Chamorro
- Department of Cardiology, University Hospital Infanta Sofia, Paseo de Europa, 34, 28703 San Sebastián de los Reyes, Madrid, Spain
| | - José R González-Juanatey
- Department of Cardiology, University Hospital of Santiago de Compostela, CiberCV, Rúa da Choupana, s/n, 15706 Santiago de Compostela, A Coruña, Spain
| | - José López-Sendón
- Cardiology Department, University Hospital La Paz, UAM, IdiPaz, CiberCV, Paseo de la Castellana 261, Madrid 28046, Spain
| | | |
Collapse
|