Displaying publications 61 - 80 of 90 in total

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  1. Fulltext Familial hypercholesterolaemia: an updated overall management
    Noor Alicezah Mohd Kasim, Chua Yung An, Hapizah Nawawi
    Journal of Clinical and Health Sciences, 2020;5(2):19-38.
    MyJurnal
    Familial hypercholesterolaemia (FH), the commonest and serious but potentially treatable
    form of inherited dyslipidaemias, is characterised by severely elevated plasma low-density
    lipoprotein-cholesterol (LDL-C) level, which subsequently leads to premature coronary artery
    disease (pCAD). Effectiveness of FH early detection and treatment is supported by the
    outcome of several international cohort studies. Optimal FH management relies on
    prescription of statins either alone or together with other lipid-lowering therapies (LLT).
    Intensive lifestyle intervention is required in parallel with LLT, which should be commenced at
    diagnosis in adults and childhood. Treatment with high intensity statin should be started as
    soon as possible. Combination with ezetimibe and/or bile acid sequestrants is indicated if
    target LDL-C is not achieved. For FH patients in the very-high risk category, if their LDL-C
    targets are not achieved, despite being on maximally tolerated statin dose and ezetimibe,
    proprotein convertase subtilisin/kexin type1 inhibitor (PCSK9i) is recommended. In statin
    intolerance, ezetimibe alone, or in combination with PCSK9i may be considered. Clinical
    evaluation of response to treatment and safety are recommended to be done about 4-6 weeks
    following initiation of treatment. Homozygous FH (HoFH) patients should be treated with
    maximally tolerated intensive LLT and, when available, with lipoprotein apheresis. This review
    highlights the overall management, and optimal treatment combinations in FH in adults and
    children, newer LLT including PCSK9i, microsomal transfer protein inhibitor, allele-specific
    oligonucleotide to ApoB100 and PCSK9 mRNA. Family cascade screening and/or screening
    of high-risk individuals, is the most cost-effective way of identifying FH cases and initiating
    early and adequate LLT.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  2. Management of Dyslipidemia in Individuals with Low-to-Moderate Cardiovascular Risk: Role of Nutraceuticals
    Dolzhenko MM, Barnett OY, Grassos C, Dragomiretska NV, Goloborodko BI, Ilashchuk TO, et al.
    Adv Ther, 2020 11;37(11):4549-4567.
    PMID: 32979190 DOI: 10.1007/s12325-020-01490-z
    Cardiovascular diseases (CVDs) are the leading cause of premature deaths globally and in Ukraine. Dyslipidemia is a recognized risk factor for the development of CVD. Therefore, early detection and appropriate management of dyslipidemia are essential for the primary prevention of CVDs. However, currently, there is a lack of Ukraine-specific guideline recommendations focusing on the management of dyslipidemia in individuals with low-to-moderate CV risk, thus creating an urgent need for structured and easily implementable clinical recommendations/guidelines specific to the country. An expert panel of cardiologists, endocrinologists, and family physicians convened in Ukraine in March 2019. The expert panel critically reviewed and analyzed the current literature and put forth the following recommendations for the management of dyslipidemia in individuals with low-to-moderate risk of CVDs specific to Ukraine: (1) family physicians have the greatest opportunities in carrying out primary prevention; (2) lipid-lowering interventions are essential for primary prevention as per guidelines; (3) a number of nutraceuticals and nutraceutical combinations with clinically established lipid-lowering properties can be considered for primary prevention; they also have a suggested role as an alternative therapy for statin-intolerant patients; (4) on the basis of clinical evidence, nutraceuticals are suggested by guidelines for primary prevention; (5) red yeast rice has potent CV-risk-lowering potential, in addition to lipid-lowering properties; (6) in patients with low-to-moderate cardiovascular risk, a nutraceutical combination of low-dose red yeast rice and synergic lipid-lowering compounds can be used as integral part of guideline-recommended lifestyle interventions for effective primary prevention strategy; (7) nutraceutical combination can be used in patients aged 18 to 75+ years; its use is particularly appropriate in the age group of 18-44 years; (8) it is necessary to attract the media (websites, etc.) to increase patient awareness on the importance of primary prevention; and (9) it is necessary to legally separate nutraceuticals from dietary supplements. These consensus recommendations will help physicians in Ukraine effectively manage dyslipidemia in individuals with low-to-moderate CV risk.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  3. Prevalence of plasma lipid disorders with an emphasis on LDL cholesterol in selected countries in the Asia-Pacific region
    Lee ZV, Llanes EJ, Sukmawan R, Thongtang N, Ho HQT, Barter P, et al.
    Lipids Health Dis, 2021 Apr 15;20(1):33.
    PMID: 33858442 DOI: 10.1186/s12944-021-01450-8
    Cardiovascular disease (CVD) is a major cause of mortality and morbidity within the Asia-Pacific region, with the prevalence of CVD risk factors such as plasma lipid disorders increasing in many Asian countries. As members of the Cardiovascular RISk Prevention (CRISP) in Asia network, the authors have focused on plasma lipid disorders in the six countries within which they have clinical experience: Indonesia, Malaysia, Philippines, Thailand, Vietnam, and Australia. Based on country-specific national surveys, the prevalence of abnormal levels of total cholesterol, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), and triglycerides (TG) are reported. An important caveat is that countries have used different thresholds to define plasma lipid disorders, making direct comparisons difficult. The prevalence of abnormal lipid levels was as follows: high total cholesterol (30.2-47.7%, thresholds: 190-213 mg/dL); high LDL-C (33.2-47.5%; thresholds: 130-135 mg/dL); low/abnormal HDL-C (22.9-72.0%; thresholds: 39-50 mg/dL); and high/abnormal TG (13.9-38.7%; thresholds: 150-177 mg/dL). Similarities and differences between country-specific guidelines for the management of plasma lipid disorders are highlighted. Based on the authors' clinical experience, some of the possible reasons for suboptimal management of plasma lipid disorders in each country are described. Issues common to several countries include physician reluctance to prescribe high-dose and/or high-intensity statins and poor understanding of disease, treatments, and side effects among patients. Treatment costs and geographical constraints have also hampered disease management in Indonesia and the Philippines. Understanding the factors governing the prevalence of plasma lipid disorders helps enhance strategies to reduce the burden of CVD in the Asia-Pacific region.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  4. Fulltext Acute Deterioration of Kidney Function after Total Hip Arthroplasty
    Takeshita S, Sonohata M, Kitajima M, Kawano S, Eto S, Mawatari M
    Malays Orthop J, 2020 Jul;14(2):111-119.
    PMID: 32983385 DOI: 10.5704/MOJ.2007.020
    Introduction: Post-operative acute kidney injury is a serious complication and identifying modifiable factors could assist in peri-operative management. This study aimed to identify the pre-operative and intra-operative factors associated with the incidence of post-operative acute kidney injury and acute deterioration of kidney function after total hip arthroplasty.Materials and methods: This single-center, retrospective, observational study included 203 patients who underwent unilateral primary total hip arthroplasty. Acute kidney injury was determined using biochemical markers according to the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) criteria. Acute deterioration of kidney function was defined as the reduction of estimated glomerular filtration rate by ≥10ml/min/1.73m2.

    Results: Prior to total hip arthroplasty, 20% of all patients met the chronic renal dysfunction criterion of glomerular filtration rates <60ml/min/1.73m2 (glomerular filtration rate categories G3a-G5). Incidence rates of acute kidney injury and acute deterioration of kidney function after total hip arthroplasty were 0.49% and 6.9%, respectively. Multivariate regression analysis showed that diabetes mellitus and use of nonsteroidal anti-inflammatory drugs before total hip arthroplasty were significant risk factors for acute deterioration of kidney function. Advanced age, preoperative renal dysfunction, antihypertensive, diuretics, or statin use, operation time, total blood loss, type of anesthetic, and body mass index were not significant risk factors.

    Conclusion: Diabetes mellitus and use of nonsteroidal anti-inflammatory drugs were controllable risks, and multidisciplinary approaches are a reasonable means of minimising peri-operative acute kidney injury or acute deterioration of kidney function.

    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  5. Fulltext Effectiveness and prescription pattern of lipid-lowering therapy and its associated factors among patients with type 2 diabetes mellitus in Malaysian primary care settings
    Elnaem MH, Mohamed MHN, Huri HZ, Shah ASM
    Ther Clin Risk Manag, 2019;15:137-145.
    PMID: 30705590 DOI: 10.2147/TCRM.S182716
    Background: Cardiovascular diseases (CVDs) are the main complication leading to morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). There is a large amount of evidence to support the use of lipid-lowering therapy (LLT) for the prevention of CVD. This study aimed to assess the effectiveness and prescription quality of LLT among T2DM patients and to identify its associated factors.

    Methods: A multicenter cross-sectional study included 816 T2DM patients from four different primary care centers in Pahang, Malaysia. We involved LLT-eligible T2DM patients as per the national clinical practice guidelines (CPG). The assessment of therapy effectiveness focused on the attainment of target lipid measures stated in the CPG. Evaluation of the prescription quality was classified into appropriate, potentially inappropriate, and inappropriate, based on the compliance with guidelines and existence of potential safety concerns. Binomial logistic regression was employed to identify the predictors of LLT effectiveness and prescription quality.

    Results: The overall percentage of T2DM patients receiving statin therapy was 87.6% (715/816). Statin therapy was appropriately prescribed in 71.5% of the cases. About 17.5% of the LLT prescriptions have at least one significant drug interaction with co-prescribed medications. The achievement of the primary target of low-density lipoprotein cholesterol (LDL-C) levels was observed in only 37% of T2DM patients. The LLT indication and appropriateness of prescription were significantly associated with the attainment of LDL-C treatment goals. Primary prevention, Malay race, and hypertension were identified as predictors for appropriate prescribing of LLT among T2DM subjects.

    Conclusion: There is a need to enhance the quality of LLT prescribing in the primary care setting to cover all eligible high-risk patients and ensure patient safety. Strategies to improve the achievement of LDL-C goals among patients with T2DM, such as investigating the potential role of the combination therapy and high-intensity statin therapy, are required.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  6. A successful pregnancy outcome of homozygous familial hypercholesterolaemia patient on statin therapy
    Mohd Kasim NA, Al-Khateeb A, Chua YA, Sanusi AR, Mohd Nawawi H
    Malays J Pathol, 2021 Apr;43(1):87-93.
    PMID: 33903311
    Homozygous familial hypercholesterolaemia (HoFH) is a rare genetic disorder of lipoprotein metabolism mainly due to mutation of the low-density lipoprotein (LDL)-receptor gene (LDLR). It is a life-threatening disease that causes accelerated, multi-vessel atherosclerosis presented in early childhood. Pregnancy in HoFH may pose early coronary morbidity and mortality to both the foetus and mother. The combination of HoFH and pregnancy can be a fatal condition. While statins are very effective in lowering low-density lipoprotein cholesterol (LDL-C) levels, they are generally contraindicated during pregnancy, thus their use during pregnancy is uncommon. On the other hand, lipid apheresis (LA) has turned into an effective treatment to control cholesterol level amid pregnancy. However, the procedure is not widely available in our region. To date, there are scarcely documented case reports of HoFH in pregnancy in which the majority of them underwent LA to keep LDL-C at a low level. We report a rare case of successful pregnancy outcome of HoFH patient treated with lipid-lowering drugs including statin without LA therapy. Apart from that, we also discussed the genetic findings of the proband and all screened family members in which to the best of our knowledge, the first study using the whole-exome sequencing technique to identify the causative gene mutations for familial hypercholesterolaemia among the Malaysian population.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  7. Fulltext The effectiveness of probiotics, prebiotics, and dietary fiber on the lowering of cholesterol level and improvement of full lipid profile
    Farah Izzati binti Farush Khan, Yasmin Ooi Beng Houi, Patricia Matanjun, Fredie Robinson
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):31-31.
    MyJurnal
    Introduction: Coronary heart disease (CHD) has become the number one cause of death worldwide. Past studies have established the efficiency of prebiotics, probiotics, and their combination on lowering blood lipids. However, the mechanism(s) on the reduction of cholesterol involved is not fully understood due to limited in-vivo studies. Therefore, the reported hypocholesterolaemic potential of probiotics and prebiotics supplementations warrants fur-ther research. This study examined the effectiveness of the intervention products on improving lipid profiles, (to-tal cholesterol (TC), HDL-C, LDL-C, TG). Methods: A randomized, single blind intervention involving 8 weeks of treatment followed by 4 weeks of washout period was carried out on 29 volunteers with TC 5.2-6.0 mmol/L who were screened from 517 volunteers. Exclusion criteria included chronic diseases, immune-compromised diseases, consumption of cholesterol-lowering drugs, and pregnancy if female. Informed consent was obtained before com-mencement of the study. Participants were randomly assigned to receive 2g/d Lactobacillus Acidophilus NCFM pro-biotic powder, 10g/d inulin, 10g/d dietary fibre, control intervention of 20mg/d statin, or control intervention of diet counseling. Results: No significant (p>0.05) changes were observed in the fasting blood glucose, physical activities and total nutrient intake of all the groups. Inulin reduced LDL-C by 12.13%. Probiotic reduced TC by 6.98%. Dietary fibre reduced TC by 8.6%, and LDL-C by 16.08%. Conclusion: Although the results showed no significant changes, it may be clinically significant as the intervention products improve the lipid profiles. It was concluded that the im-provement in the lipid profiles may be attributable to the intervention products.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  8. Fulltext Assessment of clinical, risk factors profile and clinical pharmacist care services on management and prevention of coronary artery disease complications among diabetic patients in a tertiary care hospital practice
    Abbavannagari Bharath Kumar, Marakanam Srinivasan Umashankar, Sandeep Podda
    Malaysian Journal of Medicine and Health Sciences, 2020;16(3):21-28.
    MyJurnal
    Introduction: Diabetes is a chronic metabolic disease and noted to be incidence is intensifying globally and contem- plated as epidemic. The study is aimed to assess the coronary artery disease risk profile associated diabetes mellitus patient and to identify the clinical pharmacist care services in the management and to control the risk burden in the clinical practice. Method: A prospective observational study was conducted among the consecutive patients of coronary artery disease associated diabetic patients in a tertiary care teaching hospital over 6 months period. A sam- ple of 150 patients was recruited in the study. Data analysis was done with graph pad prism software 5.01. Results: The present study revealed that coronary artery disease in diabetes was more prevalent in age group between 41-50 years. About 54.66% patients with hyperlipidemia were at risk to develop the coronary artery disease complication. Glycated hemoglobin test was detected in 40% of the patient showing abnormal levels and around 43.33% of patient had an abnormal fasting blood sugar level. The study showed only 32% of patients was prescribed Insulin & oral hy- poglycemic agents and 13 % were treated with statins. Conclusion: It could be concluded that the causative factors should be controlled and treated with an early need for amalgamation of clinical pharmacist care services with the health care team on life style modification counseling could ultimately improve the patient health outcomes and also lowers progression of coronary artery disease risk complications among diabetic patients.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  9. Fulltext Necrotizing autoimmune myopathy: a case series
    Narisa Sulaiman Sahari, Abdul Aziz Marwan, Dayang Masyrinartie Suahilai, Nurulraziquin Mohd Jamid, Nor Shuhaila Shahril
    Malaysian Journal of Medicine and Health Sciences, 2020;16(108):78-80.
    MyJurnal

    Necrotizing autoimmune myopathy (NAM) is considered a new subgroup of a rare autoimmune idiopathic inflam- matory myopathies. Classically, NAM presented with sub-acute onset of proximal muscle loss of power with raised creatinine kinase and characteristic muscle biopsy showing muscle necrosis and regeneration with little inflamma- tion. Statin use, connective tissue diseases, malignancy and HIV infection are the identified risk factors for NAM. The autoantibodies expected to be presented in NAM are anti-signal recognition particle (SRP) and anti-hydroxymethylgl- utaryl-coenzyme A reductase (anti-HMGCR) antibodies. In this article, we present three cases of NAM with different risk factors and autoantibodies which we believe to have impact on the clinical course and outcome of our patients
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  10. Fulltext Effect of Atorvastatin on the Disease Activity and Severity of Rheumatoid Arthritis: Double-Blind Randomized Controlled Trial
    Mowla K, Rajai E, Ghorbani A, Dargahi-Malamir M, Bahadoram M, Mohammadi S
    J Clin Diagn Res, 2016 May;10(5):OC32-6.
    PMID: 27437268 DOI: 10.7860/JCDR/2016/16538.7814
    INTRODUCTION:
    HMG-CoA (3-hydroxy-3- methylglutary lcoenzyme A) reductase inhibitors (statins) have anti-inflammatory properties which may be particularly useful in rheumatoid arthritis to suppress disease activity and inflammatory factors.

    AIM:
    The purpose of this clinical trial was to determine anti-inflammatory properties of statins in rheumatoid arthritis.

    MATERIALS AND METHODS:
    Eighty Iranian patients with rheumatoid arthritis, aged between 19 to 75 years were recruited to take part in this randomized, double-blind placebo-controlled trial. Subjects were randomly allocated to two groups to take atorvastatin or placebo 40 mg daily as an adjunct to current disease-modifying anti-rheumatic drugs (DMARDs) treatment. Disease Activity Score-28 (DAS28), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), swollen joint count (SJC) & tender joint count (TJC) were assessed before and after three months intervention.

    RESULTS:
    Analysis was based on intention to treat. DAS28 significantly declined in the atorvastatin group in comparison with placebo (p< 0.001). SJC, TJC, CRP and ESR also were significantly dropped in the atorvastatin group in comparison with placebo.

    CONCLUSION:
    It can be concluded that atorvastatin can suppress RA activity and inflmmatory factors in RA patients for high to moderate grade of inflmmation.

    KEYWORDS:
    Anti-inflammatory agents; Erythrocyte sedimentation rate; HMG-CoA; Swollen joint count; Tender joint count
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  11. Fulltext Should statins be started in all type 2 diabetics irrespective of LDL-cholesterol level?
    Vasanthakumar SS, Teng CL
    Malays Fam Physician, 2007;2(2):74-75.
    PMID: 25606085 MyJurnal
    Mr S is a 38 year old Indian man who has type 2 diabetes mellitus for 3 years. He is currently on metformin 500mg BD. His BMI is 24.9 kg/m2 (weight 72 kg, height 170 cm). His blood glucose is well controlled (HbA1c 6%). His fasting lipid levels are as follow: Total cholesterol 5.0 mmol/L, HDL-C 1.60 mmol/L, LDL-C 2.6 mmol/L and triglyceride 0.9 mmol/L. He has no family history of acute myocardial infarction. He is a smoker (14 sticks/day, 12 years) but non-hypertensive. He asks if he should take atorvastatin, a lipid-lowering drug that his father is taking. Should statins be started in type 2 diabetic patients without pre-existing coronary artery disease whose lipid level is not elevated?
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  12. Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia
    Boettiger DC, Law MG, Ross J, Huy BV, Heng B, Ditangco R, et al.
    Journal of virus eradication, 2020 Feb 20;6(1):11-18.
    PMID: 32175086
    Objectives: Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- and middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia.

    Methods: Sixteen LMIC sites included in the International Epidemiology Databases to Evaluate AIDS - Asia-Pacific network were surveyed.

    Results: Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). A total of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%).

    Conclusion: The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMIC clinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.

    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  13. Fulltext Management of Takotsubo Syndrome: A Comprehensive Review
    Sattar Y, Siew KSW, Connerney M, Ullah W, Alraies MC
    Cureus, 2020 Jan 03;12(1):e6556.
    PMID: 32042529 DOI: 10.7759/cureus.6556
    Takotsubo syndrome (TTS), also known as Takotsubo cardiomyopathy, is a transient left ventricular wall dysfunction that is often triggered by physical or emotional stressors. Although TTS is a rare disease with a prevalence of only 0.5% to 0.9% in the general population, it is often misdiagnosed as acute coronary syndrome. A diagnosis of TTS can be made using Mayo diagnostic criteria. The initial management of TTS includes dual antiplatelet therapy, anticoagulants, beta-blockers, angiotensin-converting enzyme inhibitors or aldosterone receptor blockers, and statins. Treatment is usually provided for up to three months and has a good safety profile. For TTS with complications such as cardiogenic shock, management depends on left ventricular outflow tract obstruction (LVOTO). In patients without LVOTO, inotropic agents can be used to maintain pressure, while inotropic agents are contraindicated in patients with LVOTO. In TTS with thromboembolism, heparin should be started, and patients should be bridged to warfarin for up to three months to prevent systemic emboli. Our comprehensive review discussed the management in detail, derived from the most recent literature from observational studies, systematic review, and meta-analyses.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  14. Fulltext Hypocholesterolemic and Antiatherosclerotic Potential of Basella alba Leaf Extract in Hypercholesterolemia-Induced Rabbits
    Baskaran G, Salvamani S, Azlan A, Ahmad SA, Yeap SK, Shukor MY
    Evid Based Complement Alternat Med, 2015;2015:751714.
    PMID: 26697097 DOI: 10.1155/2015/751714
    Hypercholesterolemia is the major risk factor that leads to atherosclerosis. Nowadays, alternative treatment using medicinal plants gained much attention since the usage of statins leads to adverse health effects, especially liver and muscle toxicity. This study was designed to investigate the hypocholesterolemic and antiatherosclerotic effects of Basella alba (B. alba) using hypercholesterolemia-induced rabbits. Twenty New Zealand white rabbits were divided into 5 groups and fed with varying diets: normal diet, 2% high cholesterol diet (HCD), 2% HCD + 10 mg/kg simvastatin, 2% HCD + 100 mg/kg B. alba extract, and 2% HCD + 200 mg/kg B. alba extract, respectively. The treatment with B. alba extract significantly lowered the levels of total cholesterol, LDL, and triglycerides and increased HDL and antioxidant enzymes (SOD and GPx) levels. The elevated levels of liver enzymes (AST and ALT) and creatine kinase were noted in hypercholesterolemic and statin treated groups indicating liver and muscle injuries. Treatment with B. alba extract also significantly suppressed the aortic plaque formation and reduced the intima: media ratio as observed in simvastatin-treated group. This is the first in vivo study on B. alba that suggests its potential as an alternative therapeutic agent for hypercholesterolemia and atherosclerosis.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  15. Fulltext Achievement of LDL Cholesterol Goal and Adherence to Statin by Diabetes Patients in Kelantan
    Yudin ZM, Yaacob LH, Hassan NB, Ismail SB, Draman N, Yusoff SSM
    Malays J Med Sci, 2017 May;24(3):44-50.
    PMID: 28814932 MyJurnal DOI: 10.21315/mjms2016.24.3.6
    BACKGROUND: Statins are a class of potent drugs that can be used to reduce cholesterol, especially low-density lipoprotein cholesterol (LDL-C). However, their effectiveness is limited if adherence to treatment is poor. The objectives of the study are to estimate the proportion of diabetic patient who has achieved LDL-C goal and to determine the association of LDL-C achievement with socio demographic factors and statin therapy adherence.

    METHODS: This is a cross-sectional study involving 234 patients with type 2 diabetes mellitus (T2DM) and dyslipidaemia attending an outpatient clinic in a hospital in Kelantan. Interviews and self-administered questionnaires were used to determine their sociodemographic and clinical characteristics. Adherence to therapy was assessed using the Medication Compliance Questionnaire (MCQ). The associations between the achievement of LDL targets and sociodemographic/clinical factors, including adherence, were analysed with simple logistic regression.

    RESULTS: About 37.6% of patients achieved their LDL-C target. The percentage of patients who adhered to statin use was 98.3%, and 20.5% of these patients reported full adherence. There was no significant association between achievement of LDL-C targets with adherence or any other sociodemographic factors, such as age, gender and educational or economic status (all P-value < 0.05).

    CONCLUSION: Despite a high level of adherence, the majority of patients failed to achieve LDL-C targets. More concerted efforts are needed to improve this.

    Study site: primary
    care clinic in Hospital Universiti Sains Malaysia,
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors
  16. Medication prescribing patterns among chronic kidney disease patients in a hospital in Malaysia
    Al-Ramahi R
    Saudi J Kidney Dis Transpl, 2012 Mar;23(2):403-8.
    PMID: 22382249
    To determine the medication prescribing patterns in hospitalized patients with chronic kidney disease (CKD) in a Malaysian hospital, we prospectively studied a cohort of 600 patients in two phases with 300 patients in each phase. The first phase was carried out from the beginning of February to the end of May 2007, and the second phase was from the beginning of March to the end of June 2008. Patients with CKD who had an estimated creatinine clearance ≤ 50 mL/min and were older than 18 years were included. A data collection form was used to collect data from the patients' medical records and chart review. All systemic medications prescribed during hospitalization were included. The patients were prescribed 5795 medications. During the first phase, the patients were prescribed 2814 medication orders of 176 different medications. The prescriptions were 2981 of 158 medications during the second phase. The mean number of medications in the first and second phases was 9.38 ± 3.63 and 9.94 ± 3.78 respectively (P-value = 0.066). The top five used medications were calcium carbonate, folic acid/vitamin B complex, metoprolol, lovastatin, and ferrous sulfate. The most commonly used medication classes were mineral supplements, vitamins, antianemic preparations, antibacterials, and beta-blocking agents. This study provides an overview of prescription practice in a cohort of hospitalized CKD patients and indicates possible areas of improvement in prescription practice.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
  17. Phaleria macrocarpa (Scheff.) Boerl fruit aqueous extract enhances LDL receptor and PCSK9 expression in vivo and in vitro
    Chong SC, Dollah MA, Chong PP, Maha A
    J Ethnopharmacol, 2011 Sep 1;137(1):817-27.
    PMID: 21763412 DOI: 10.1016/j.jep.2011.06.041
    Phaleria macrocarpa (Scheff.) Boerl (Pm) has been shown to reduce cholesterol level in vitro and in vivo experiment.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology
  18. Statin use prior to ischemic stroke onset is associated with decreased in-hospital mortality
    Hassan Y, Al-Jabi SW, Aziz NA, Looi I, Zyoud SH
    Fundam Clin Pharmacol, 2011 Jun;25(3):388-94.
    PMID: 20608996 DOI: 10.1111/j.1472-8206.2010.00846.x
    Statins can reduce the risk of stroke in at-risk populations and improve survival after acute ischemic stroke (AIS) among patients with previous statin use. This study aimed to investigate the impact of statin use before AIS onset on in-hospital mortality and identify the factors related to in-hospital mortality among patients with and without previous statin use. A retrospective cohort study of all patients with AIS attending hospital from June 1, 2008 to December 31, 2008. Data were collected from medical records including demographic information, diagnostic information, risk factors, previous statin use, and vital discharge status. Chi-square, Fisher's exact tests, student's t-test, and Mann-Whitney U test, whatever appropriate, were used to test the significance between the variables, and multiple logistic regression was used to identify factors associated with in-hospital mortality. Altogether, 386 patients with AIS were studied, of which 113 (29.3%) had a documented previous statin use. A total of 62 (16.1%) patients with AIS died in hospital. In-hospital mortality was significantly lower among previous statin users (P = 0.013). The presence of atrial fibrillation (AF) increased in-hospital mortality among patients with or without previous statin use. The independent predictors for in-hospital mortality among AIS patients without previous statin use were the presence of diabetes mellitus (P = 0.047), AF (P = 0.045), and renal impairment (P < 0.001). The prophylactic administration of statins significantly reduces post-AIS in-hospital mortality. Furthermore, the identification of predictors of in-hospital mortality might reduce death rates and enhance the application of specific therapeutic and management strategies to patients at a high risk of dying.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use*
  19. Fulltext Antihypercholesterolemic and antioxidant efficacies of zerumbone on the formation, development, and establishment of atherosclerosis in cholesterol-fed rabbits
    Hemn HO, Noordin MM, Rahman HS, Hazilawati H, Zuki A, Chartrand MS
    Drug Des Devel Ther, 2015;9:4173-208.
    PMID: 26347047 DOI: 10.2147/DDDT.S76225
    Owing to the high incidence of cholesterol-induced cardiovascular disease, particularly atherosclerosis, the current study was designed to investigate the preventive and therapeutic efficacies of dietary zerumbone (ZER) supplementation on the formation and development of atherosclerosis in rabbits fed with a high cholesterol diet. A total of 72 New Zealand white rabbits were divided randomly on two experimental studies carried out 8 weeks apart. The first experiment was designed to investigate the prophylactic efficacy of ZER in preventing early developed atheromatous lesion. The second experimental trial was aimed at investigating the therapeutic effect of ZER in reducing the atherosclerotic lesion progression and establishment. Sudanophilia, histopathological, and ultrastructural changes showed pronounced reduction in the plaque size in ZER-medicated aortas. On the other hand, dietary supplementation of ZER for almost 10 weeks as a prophylactic measure indicated substantially decreasing lipid profile values, and similarly, plaque size in comparison with high-cholesterol non-supplemented rabbits. Furthermore, the results of oxidative stress and antioxidant biomarker evaluation indicated that ZER is a potent antioxidant in suppressing the generation of free radicals in terms of atherosclerosis prevention and treatment. ZER significantly reduced the value of malondialdehyde and augmented the value of superoxide dismutase. In conclusion, our data indicated that dietary supplementation of ZER at doses of 8, 16, and 20 mg/kg alone as a prophylactic measure, and as a supplementary treatment with simvastatin, significantly reduced early plague formation, development, and establishment via significant reduction in serum lipid profile, together with suppression of oxidative damage, and therefore alleviated atherosclerosis lesions.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology
  20. Reduction in serum levels of adhesion molecules, interleukin-6 and C-reactive protein following short-term low-dose atorvastatin treatment in patients with non-familial hypercholesterolemia
    Nawawi H, Osman NS, Yusoff K, Khalid BA
    Horm. Metab. Res., 2003 Aug;35(8):479-85.
    PMID: 12953165 DOI: 10.1055/s-2003-41805
    Hypercholesterolemia causes endothelial dysfunction, an early feature of atherosclerosis, leading to increased production of adhesion molecules and cytokines. The aim of this study was to investigate the effects of three months of treatment with low dose atorvastatin on serum levels of adhesion molecules, interleukin-6 (IL-6) and highly sensitive C-reactive protein (hs-CRP) in patients with non-familial hypercholesterolemia. Fifty-five patients with non-familial hypercholesterolemia were randomized to treatment with atorvastatin 10 mg/day or placebo for 3 months. Soluble intercellular adhesion molecules-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, IL-6 and hs-CRP levels were measured to assess the inflammatory activity of the endothelium. There was a significant reduction in ICAM-1 at 2 weeks (p<0.0001) with further reduction at 3 months (p<0.0001). At 3 months, there were significant reductions in VCAM-1 (p<0.02), IL-6 (p<0.0001) and hs-CRP (p<0.01), but an increase in E-selectin levels (p<0.002). Treatment with statin was an independent determinant of change in ICAM-1 (p<0.05) and IL-6 levels (p<0.05) after correcting for anthropometric indices, blood pressure and lipid profile. Low-dose atorvastatin treatment leads to reduction in proinflammatory markers of endothelial function, suggesting an attenuation of endothelial activation and improvement in endothelial function, independent of lipid lowering. This may lead to a reduction in the progression of atherosclerosis.
    Matched MeSH terms: Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage*
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