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Atherosclerosis III: Management01:26

Atherosclerosis III: Management

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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Coronary Artery Disease IV: Preventive Measures01:26

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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Related Experiment Video

Updated: Sep 1, 2025

LDL Cholesterol Uptake Assay Using Live Cell Imaging Analysis with Cell Health Monitoring
08:45

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Lipid Modification to Reduce Cardiovascular Risk in Secondary Prevention Patients with Special Emphasis on PCSK9

Pınar Kızılırmak1, Zeki Öngen2, Sadi Güleç3

  • 1AMGEN, İstanbul, Turkey.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|August 17, 2022
PubMed
Summary

Many patients with atherosclerotic cardiovascular disease do not achieve low-density lipoprotein cholesterol goals despite current therapies. Expert opinion suggests underutilization of protein convertase subtilisin/kexin type 9 inhibitors, indicating a gap between guidelines and practice.

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Area of Science:

  • Cardiology
  • Pharmacotherapy
  • Preventive Medicine

Background:

  • Secondary prevention patients with atherosclerotic cardiovascular disease (ASCVD) often have inadequate low-density lipoprotein cholesterol (LDL-C) control.
  • Current treatment strategies may not be sufficient for a significant portion of high-risk patients.

Purpose of the Study:

  • To analyze low-density lipoprotein cholesterol-lowering therapies in secondary prevention patients.
  • To assess current treatment, plasma LDL-C levels, and the need for protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in patients with inadequate response.

Main Methods:

  • A Delphi panel of 12 experienced cardiologists was convened.
  • A questionnaire was used to gather expert opinions on LDL-C-lowering therapy practices for high and very high cardiovascular risk patients with ASCVD.

Main Results:

  • An estimated 18.6% of ASCVD patients experience recurrent vascular events.
  • Despite guidelines, PCSK9 inhibitor use is very low (1.2% on max tolerated dose statin+ezetimibe+PCSK9 inhibitor).
  • The need for PCSK9 inhibitors increases significantly with rising LDL-C levels, from 9.1% (70-99 mg/dL) to 50.8% (≥160 mg/dL).

Conclusions:

  • A substantial proportion of secondary prevention patients do not meet LDL-C goals.
  • There is a significant discrepancy between recommended PCSK9 inhibitor use and current Turkish practice.
  • Further studies are needed to explain the gap between guidelines and clinical practice regarding PCSK9 inhibitor utilization.