New European guidelines for the management of dyslipidaemia in cardiovascular prevention

The new guidelines from the European Atherosclerosis Society and the European Society of Cardiology include a number of updated items. In this paper, we summarize 4 of these changes that we consider to be the most pertinent. Firstly, cardiovascular risk is now stratified according to 4 (previously 2) categories: "very high risk" (patients with cardiovascular disease, patients with diabetes > 40 years old who have at least one other risk factor, patients with kidney failure, or patients in primary prevention with a SCORE value > or = 10%); "high risk" (patients in primary prevention with a SCORE value > or = 5% and or = 1% and < 5%); and "low risk" (primary prevention with SCORE < 1%). The SCORE value for patients in primary prevention is estimated using the SCORE table (calibrated for Belgium). Risk in this table may now be corrected according to HDL cholesterol level. Secondly, the therapeutic targets for each category are now more stringent: LDL cholesterol < 70 mg/dl (or reduced by at least 50%) if the risk is "very high"; < 100 mg/dl if the risk is "high"; and < 115 mg/dl if the risk is "moderate". Thirdly, for patients at "high" or "very high" risk, particularly in patients with combined dyslipidaemia, two further therapeutic targets should be considered: non-HDL cholesterol and apolipoprotein B levels. Fourthly, the follow-up of efficacy (lipid profile) and tolerance (hepatic and muscular enzymes) is described in more details so as to harmonize case management in clinical practice.Peer reviewe

ES8 COST-EFFECTIVENESS OF DARUNAVIR/R IN HIGHLY TREATMENT-EXPERIENCED HIV/AIDS PATIENTS IN DIFFERENT EUROPEAN HEALTH CARE SETTINGS

Large-scale molecular interaction data sets have the potential to provide a comprehensive, system-wide understanding of biological function. Although individual molecules can be promiscuous in terms of their contribution to function, molecular functions emerge from the specific interactions of molecules giving rise to modular organisation. As functions often derive from a range of mechanisms, we demonstrate that they are best studied using networks derived from different sources. Implementing a graph partitioning algorithm we identify subnetworks in yeast protein-protein interaction (PPI), genetic interaction and gene co-regulation networks. Among these subnetworks we identify cohesive subgraphs that we expect to represent functional modules in the different data types. We demonstrate significant overlap between the subgraphs generated from the different data types and show these overlaps can represent related functions as represented by the Gene Ontology (GO). Next, we investigate the correspondence between our subgraphs and the Gene Ontology. This revealed varying degrees of coverage of the biological process, molecular function and cellular component ontologies, dependent on the data type. For example, subgraphs from the PPI show enrichment for 84%, 58% and 93% of annotated GO terms, respectively. Integrating the interaction data into a combined network increases the coverage of GO. Furthermore, the different annotation types of GO are not predominantly associated with one of the interaction data types. Collectively our results demonstrate that successful capture of functional relationships by network data depends on both the specific biological function being characterised and the type of network data being used. We identify functions that require integrated information to be accurately represented, demonstrating the limitations of individual data types. Combining interaction subnetworks across data types is therefore essential for fully understanding the complex and emergent nature of biological function

Health-related costs in a sample of premenopausal non-diabetic overweight or obese females in Antwerp region : a cost-of-illness analysis

Background: People with overweight or obesity are at increased risk for disease later in life which cause important health costs. The aim of this study was to estimate the health status and the corresponding costs in a sample of females with overweight or obesity which were participating in a Randomized Controlled Trial (RCT) exploring the effect of lifestyle habits changes on ectopic adipose tissue. Methods: Sixty-two non-diabetic premenopausal females without major comorbidities of overweight and obesity were recruited among patients visiting endocrinologists at the obesity clinic of the University Hospital of Antwerp and the University of Antwerp. A RCT-embedded cost-of-illness approach with societal perspective, based on self-reported questionnaires and cost diaries (3 months recall) was applied to estimate the prevalence of different comorbidities and the related direct and indirect costs in this sample of overweight or obese females. The European Quality-of-Life-5D questionnaire was used to define the health state and the corresponding utility index of the participants. Results: The average direct health costs and health utilities observed in this sample were comparable with the general Flemish female population. This may partially be explained by the strict inclusion criteria of the RCT (i.e. overweight or obesity without diabetes type 2 or cardiovascular diseases). However, 15% of the participants had five or more comorbidities resulting in higher average costs and lower average health utility as compared to the general population, only 3 participants were diagnozed with the metabolic syndrome. In this subsample productivity was low due to high average absenteeism, yielding important total costs for the society. Conclusion: Secondary prevention to avoid health deterioration in overweight or obese females without major comorbidies is needed to contain health care costs. Trial registration: ClinicalTrials.gov: NCT02831621, approval of the ethics committee of the University Hospital of Antwerp (number: 14/17/205 -ref: 7543075363)