The use of statins in people at risk of developing diabetes mellitus: Evidence and guidance for clinical practice
Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these clai…
Vorapaxar in the secondary prevention of atherothrombotic events
BACKGROUND: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1. METHODS: We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients …
Tratamiento hipolipemiante en los pacientes con enfermedad cardiovascular de riesgo muy elevado. Documento de consenso SEC sobre las indicaciones de los iPCSK9 en la práctica clínica
Different primary and secondary prevention studies have documented that a greater degree of reduction in low-density lipoprotein cholesterol (LDL-C) levels is associated with a greater decrease in cardiovascular event rates. PCSK9 inhibitors achieve important, rapid and sustained decreases in LDL-C. New clinical practice guidelines for the management of dyslipidemia establish reduced target levels of LDL-C. These goals are hardly achievable with a statin-only treatment, even in combination with ezetimibe. The addition of PCSK9 inhibitors can play a determining role in achieving these recommendations. However, it is important to identify the patient subgroups that can most benefit from this …