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Efficacy and safety of statin use in children and adolescents with familial hypercholesterolaemia: A systematic review and meta-analysis of randomized-controlled trials. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.132] [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: 11/26/2022]
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P705Step by step diagnosis and management of statin intolerance: position paper from an international lipid expert panel. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0310] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Statin intolerance is a clinical syndrome whereby adverse effects associated with statin therapy (most commonly muscle symptoms) result in the discontinuation of therapy. Statin discontinuation is associated with increased risk of adverse cardiac outcomes. Many patients who initially experience adverse effects are able to tolerate statin therapy to some extent. Careful stepwise diagnosis and management of individuals who experience adverse effects is essential to enable optimal reduction of cardiovascular risk.
Purpose
In this Position Paper of the International Lipid Expert Panel (ILEP), we present a step by step approach to the diagnosis and practical management of statin intolerance resulting from muscle symptoms, and other adverse effects with demonstrated statin causality.
Methods
Relevant clinical evidence and international clinical guidelines were discussed and assimilated by ILEP members. Consensus was used to formulate recommendations for the diagnosis and management of statin intolerance.
Results
Consensus resulted in the adoption of three parts to the recommendation. 1) diagnosis of Statin Intolerance; 2) advice for management of all patients with statin intolerance; 3) specific advice for patients who have partial (rather than complete) statin intolerance. Patients with partial statin intolerance are likely to make up the vast majority (even 95%) of statin-intolerant individuals. Each part of the recommendation consists of a four-step process and has an associated acronym to aid memory (see attached recommendations). We adopted the Banach and Mikhailidis four-step approach to diagnosis and we developed novel recommendations for management.
Summary of the ILEP SI recommendations.
Conclusions
We present recommendations, which will enable clinicians to distinguish between rare, severe adverse effects; true statin intolerance, and symptoms incorrectly attributed to statin therapy. In each case we summarize guidelines, clinical evidence and expert opinion pertaining to the optimal management of cardiovascular disease in these patients.
Acknowledgement/Funding
None
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3104Associations between cardiovascular disease, cancer and very low hdl cholesterol in the reasons for geographical and racial differences in stroke (REGARDS) study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3104] [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: 11/14/2022] Open
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81Efficacy and safety of alternate-day versus daily dosing of statins: a systematic review and meta-analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.81] [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: 11/14/2022] Open
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3100Effects of morning versus evening statin therapy on lipid profile: a systematic review and meta-analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3100] [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: 11/14/2022] Open
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Long-term Mortality in Patients with Asymptomatic Carotid Stenosis: Implications for Statin Therapy. J Vasc Surg 2015. [DOI: 10.1016/j.jvs.2015.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Emerging Vascular Risk Factors in Women: Any Differences from Men? Curr Med Chem 2015; 22:3565-79. [DOI: 10.2174/0929867322666150904110053] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/20/2015] [Accepted: 08/31/2015] [Indexed: 11/22/2022]
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Impact of metabolic syndrome in surgical patients: should we bother? Br J Anaesth 2015; 115:194-202. [DOI: 10.1093/bja/aev199] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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11
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Lack of efficacy of resveratrol on cardiovascular parameters? Results from a systematic review and meta-analysis of randomized controlled trials. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.932] [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: 10/23/2022]
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High-density Lipoprotein, Vascular Risk, Cancer and Infection: A Case of Quantity and Quality? Curr Med Chem 2014; 21:2917-26. [DOI: 10.2174/0929867321666140303152132] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 01/25/2014] [Accepted: 01/25/2014] [Indexed: 11/22/2022]
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OP-218 Endocan: A Novel Inflammatory Indicator in Newly Diagnosed Hypertensive Patients? A pilot Study. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.117] [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: 10/25/2022]
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OP-333 Bilirubin Levels and their Association with Carotid Intima Media Thickness and High-Sensitivity C-Reactive Protein in Patients with Psoriasis Vulgaris. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.204] [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: 10/25/2022]
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15
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Assessing the treatment effect in metabolic syndrome without perceptible diabetes (ATTEMPT): A prospective-randomized study in middle aged men and women. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2013.11.057] [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: 11/16/2022]
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16
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Letter to the Editor Atorvastatin in combination with ezetimibe and carotid atherosclerosis. GENETICS AND MOLECULAR RESEARCH 2014; 13:4805-7. [DOI: 10.4238/2014.july.2.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Severe hypertriglyceridaemia revisited. Atherosclerosis 2013. [DOI: 10.1016/j.atherosclerosis.2013.07.018] [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: 10/26/2022]
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Elevated serum levels of endocan in patients with psoriasis vulgaris: correlations with cardiovascular risk and activity of disease. Br J Dermatol 2013; 169:1066-70. [DOI: 10.1111/bjd.12525] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2013] [Indexed: 12/26/2022]
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Cilostazol for peripheral arterial disease could reduce stroke risk? Thromb Res 2013; 132:149-50. [DOI: 10.1016/j.thromres.2013.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 03/12/2013] [Accepted: 03/12/2013] [Indexed: 10/26/2022]
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Critique of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): Flaws in CREST and its Interpretation. Eur J Vasc Endovasc Surg 2013; 45:539-45. [DOI: 10.1016/j.ejvs.2013.03.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 03/14/2013] [Indexed: 10/26/2022]
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Preface. Curr Vasc Pharmacol 2012. [DOI: 10.2174/1570161111309010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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22
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Abstract
We report seven cases of breast adenocarcinoma and hypertriglyceridaemia associated with the use of tamoxifen. Two cases presented with life-threatening acute pancreatitis. Two cases show a rise in serum triglycerides (TG) after starling tamoxifen. Five patients had some degree of insulin resistance or diabetes which may have aggravated the hypertriglyceridaemia. One additional patient had an apolipoprotein phenotype associated with hypertriglyceridaemia. Fibrates effectively reduced serum TG levels. In general, tamoxifen improves the lipid profile and this may account for the reduction in coronary events in patients taking this drug. However, a rise in serum TG levels has been documented in several studies. Our reports suggest that it is important to screen patients on tamoxifen since hypertriglyceridaemia could cause potentially fatal acute pancreatitis or increase the risk of developing ischaemic heart disease.
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Why the United States Center for Medicare and Medicaid Services (CMS) Should not Extend Reimbursement Indications for Carotid Artery Angioplasty/Stenting. Eur J Vasc Endovasc Surg 2012; 43:247-51. [DOI: 10.1016/j.ejvs.2011.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 12/05/2011] [Indexed: 11/30/2022]
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Mean Platelet Volume and Platelet Distribution Width in non-diabetic subjects with Obstructive Sleep Apnoea Syndrome: New indices of severity? Platelets 2011; 23:447-54. [DOI: 10.3109/09537104.2011.632031] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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578 CVD SCREENING IN A FAITH BASED SETTING IMPROVES ACCESS. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70579-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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COMPARISON OF A POINT OF CARE CHOLESTEROL DEVICE AND LABORATORY ANALYSIS IN THE PREDICTION OF CARDIOVASCULAR DISEASE. Atherosclerosis 2009. [DOI: 10.1016/j.atherosclerosis.2009.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Influence of oscillating flow on LDL transport and wall shear stress in the normal aortic arch. Open Cardiovasc Med J 2009; 3:128-42. [PMID: 19834577 PMCID: PMC2761669 DOI: 10.2174/1874192400903010128] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Revised: 08/24/2009] [Accepted: 08/25/2009] [Indexed: 12/02/2022] Open
Abstract
Lipid accumulation in the aortic wall is an important factor in the development of atherosclerosis. The Low Density Lipoprotein (LDL) at the surface of the endothelium in relation to Wall Shear Stress (WSS) in the normal human aortic arch under unsteady, normal flow and mass conditions was computationally analysed. Concave sides of the aortic arch exhibit, relatively to the convex ones, elevated LDL levels at the surface of the endothelium for all time steps. At the peak systolic velocity, the LDL level reaches a value 23.0% higher than that at entrance in the ascending-descending aorta region. The corresponding LDL levels at the surface of the endothelium for the near minimum entrance velocity instant reaches 26.0%. During the cardiac cycle, the highest area averaged normalized LDL taken up as compared to the lowest one is 0.69%. WSS plays an important role in the lipid accumulation. Low WSS regions are exposed to high LDL levels at the surface of the endothelium. Regions of elevated LDL levels do not necessarily co-locate to the sites of lowest WSS. The near wall paths of the velocities might be the most important factor for the elevated LDL levels at the surface of the endothelium.
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Abstract: P827 PHARMACOGENETIC STUDY OF CHOLESTERYL ESTER TRANSFER PROTEIN GENE AND ATORVASTATIN TREATMENT IN HYPERCHOLESTEROLAEMIC SUBJECTS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71181-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Implementation of strategy for the management of overt dyslipidemia: The IMPROVE-dyslipidemia study. Int J Cardiol 2009; 134:322-9. [DOI: 10.1016/j.ijcard.2009.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 11/21/2008] [Accepted: 02/06/2009] [Indexed: 11/15/2022]
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ESVS Guidelines. Invasive Treatment for Carotid Stenosis: Indications, Techniques. Eur J Vasc Endovasc Surg 2009; 37:1-19. [PMID: 19286127 DOI: 10.1016/j.ejvs.2008.11.006] [Citation(s) in RCA: 412] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Accepted: 11/07/2008] [Indexed: 12/18/2022]
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In vitro and in vivo Effects of Vardenafil (a PDE-5 Inhibitor) on Corpus Cavernosal Smooth Muscle Relaxation in Diabetic Rabbits. Urol Int 2009; 82:101-7. [DOI: 10.1159/000176035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Accepted: 11/19/2007] [Indexed: 11/19/2022]
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CORONA, Statins, and Heart Failure: Who Lost the Crown? Angiology 2008. [DOI: 10.1177/0003319708322391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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34
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Proceedings of the 23rd International Congress of Cardiology organized by the Hellenic Heart Foundation. Angiology 2008; 59:25S. [DOI: 10.1177/0003319708321997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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35
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Survey of patients with familial hypercholestrolaemia in the context of the draft nice guidelines. Atherosclerosis 2008. [DOI: 10.1016/j.atherosclerosis.2008.04.032] [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: 10/21/2022]
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36
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SEASONAL VARIATION IN THE OCCURRENCE OF STROKE IN NORTHERN GREECE: A 10 YEAR STUDY IN 8,204 PATIENTS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70990-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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PO20-609 ASSOCIATION OF DRINKING PATTERN WITH THE PREVALENCE OF METABOLIC SYNDROME, DIABETES, CORONARY HEART DISEASE, STROKE AND PERIPHERAL ARTERIAL DISEASE. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71619-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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PO6-173 THE GENDER-SPECIFIC INFLUENCE OF TAQ1B, I405V POLYMORPHISMS OF THE CHOLESTERYL ESTER TRANSFER PROTEIN GENE ON POSTPRANDIAL LIPEMIA IN FAMILIAL HYPERCHOLESTEROLEMIA. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71183-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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40
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Editorial [ Pharmacological Modulation of Liver Ischemia - Reperfusion Injury Executive Editors: G.K. Glantzounis, D.P. Mikhailidis, A.M. Seifalian and B.R. Davidson ]. Curr Pharm Des 2006. [DOI: 10.2174/138161206777947623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Mo-P1:78 The effect of drinking pattern and type of alcoholic beverage on the prevalence of metabolic syndrome, diabetes, coronary heart disease and stroke in a Mediterranean cohort. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Th-P16:381 Treating to target patients with primary hyperlipidemia: Comparison of the effects of atorvastatin and rosuvastatin (The atoros study). ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)82339-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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43
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T03-P-002 Targeting cardiovascular risk plunge in metabolic syndrome: The targets study. ATHEROSCLEROSIS SUPP 2005. [DOI: 10.1016/s1567-5688(05)80570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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W09.203 The prevalence of the metabolic syndrome in Greece: The MetS-Greece study. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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W12.298 Heterozygote men with familial hypercholesterolaemia (FH) may have an abnormal triglyceride response postprandially: Another predictor of vascular risk in FH. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90297-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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M.561 The effect of alcohol and Gemfibrozil co-administration in Wistar rats. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90559-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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M.453 Effect of statins versus untreated dyslipidemia on serum uric acid levels in patients with coronary heart disease: A Greace substudy. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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W09.202 Multifactorial treatment approach in patients with coronary heart disease and the metabolic syndrome: A greace substudy. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90201-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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W12.299 Influence of natural menopause on postprandial lipaemia in heterozygotes for familial hypercholesterolaemia. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90298-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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