Unmet need in the hyperlipidaemia population with high risk of cardiovascular disease: a targeted literature review of observational studies

BACKGROUND: The aim of this study was to examine recommended target levels of low-density lipoprotein cholesterol (LDL-C) for hyperlipidaemia patients at high risk (i.e., with two or more risk factors or coronary heart disease or its risk equivalents) for cardiovascular disease (CVD); to determine LDL-C targets recommended by guidelines, and to examine the proportions of patients who do not achieve targeted LDL-C levels in real-world studies. METHODS: Electronic databases were searched: Medline, Medline In-Process, Embase, BIOSIS, and the Cochrane Library (1 January 2005 to 31 December 2013). Guideline searches were limited to publications in the last 5 years. There were no geographical or language restrictions. RESULTS: Seventeen guidelines and 42 observational studies that reported on high-risk hyperlipidaemia patients were identified. The National Cholesterol Education Program–Adult Treatment Panel III’s LDL-C target levels were the most common guidelines used for patients with very high hyperlipidaemia. However, between 68 and 96 % of patients in the studies did not achieve an LDL-C goal <70 mg/dL, except in one study conducted in China (16.9 %). In high-risk patients, 61.8 to 93.8 % did not achieve a target of <100 mg/dL. Regarding common comorbidities, patients with concomitant CVD or diabetes were least likely to reach their target LDL-C goals. CONCLUSION: In patients with high risk for CVD, the majority of patients do not attain recommended LDL-C goals, highlighting worldwide suboptimal hyperlipidaemia management and missed opportunities for reduction of the patients CVD risk. Lipid-modifying management strategies need to be intensified. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12872-016-0241-3) contains supplementary material, which is available to authorized users

Evaluation of the left ventricular systolic and diastolic functions by echocardiography in patients with acute leukemia

Eighteen patients with acute leukemia were studied to evaluate their left ventricular systolic and diastolic function by M mode, two-dimensional and Doppler echocardiographic techniques. The study group was compared with another group of 18 patients of similar age with iron deficiency anemia. The latter group had a comparable heart rare and levels of Hb. There were no differences in systolic function, whereas the diastolic function was lower in patients with acute leukemia (E/A ratio = 1.1 +/- 0.3 vs. 1.42. +/-. 0.5, p < 0.05). It is concluded that left ventricular diastolic dysfunction is more common in patients with acute leukemia and may be an indicator of restrictive cardiomyopathy

SIMULATED MYOCARDIAL-INFARCTION AND SLOW ATRIAL-FLUTTER DUE TO CEREBRAL EMBOLISM FROM A FREE LEFT ATRIAL THROMBUS

The case of a 38-year-old female who suffered a cerebral embolism from a free left atrial thrombus is reported. The clinical picture, including serum enzyme elevations, was consistent with a nontransmural myocardial infarction. Atrial flutter exhibiting very slow (162/min) and tall waves was transiently recorded indicating development of an intra-atrial conduction disturbance

Electrocardiographic findings and prognosis in ischemic stroke

Introduction: Electrocardiographic (ECG) changes are observed in patients with acute stroke and are related with the prognosis. Aims: To determine the frequency and significance of ECG changes in patients with acute ischemic stroke. Material and Methods: In a prospective hospital-based study 87 patients with cerebral infarction were observed for ECG changes during their stay in the hospital. All the patients had ischemic stroke for the first time. The ECG changes observed were compared with those of the control group consisting of 87 patients. Results: Of the 87 patients of the study group, 47.1% were females and 52.9% males. The mean age was 65.5+/-11.9. (range 31-91 yrs). The control group consisted of 50.6% females and 49.4% males. The mean age was 64.5+/-9.1 (range 31-87 yrs). The frequency of the ECG changes observed in patients with cerebral infarct was 62.1% while it was 29.9% in the control group (P<0.0001). ECG changes observed were mostly related to myocardial ischemia. The six-month mortality rate in the patients with ECG changes was 38.9% whereas it was 15.2% in those with normal ECG (P<0.05). Conclusions: The observations of this study suggest that cardiac evaluation in patients with acute ischemic stroke is of prognostic importance

Coexisting dyslipidemia in hypertensive patients

We point out that a peculiar annihilation of a vortex-antovortex pairobserved numerically by Hertel and Schneider [Phys. Rev. Lett. 97, 177202(2006)] represents the formation and subsequent decay of a skyrmion