Defining the Role of Trimetazidine in the Treatment of Cardiovascular Disorders: Some Insights on Its Role in Heart Failure and Peripheral Artery Disease

Trimetazidine is a cytoprotective drug whose cardiovascular effectiveness, especially in patients with stable ischemic heart disease, has been the source of much controversy in recent years; some have gone so far as to treat the medication as a ‘placebo drug’ whose new side effects, such as Parkinsonian symptoms, outweigh its benefits. This article is an attempt to present the recent key studies, including meta-analyses, on the use of trimetazidine in chronic heart failure, also in patients with diabetes mellitus and arrhythmia, as well as in peripheral artery disease. This paper also includes the most recent European Society of Cardiology guidelines, including those of 2013, on the use of trimetazidine in cardiovascular disease

The effects of statins on blood pressure: current knowledge and future perspectives

Statin therapy has gained interest in the field of hypertension due to the potential role of different statin agents in blood pressure (BP) lowering [1-3]. The potential mechanisms involved include the downregulation of the angiotensin II-type 1 receptor, the decrease of vasoconstrictor endothelin-1 levels, and the increase in the endothelial production of nitric oxide (NO), an effect that is correlated with the upregulation of endothelial NO synthase expression [4-6]. Furthermore, we have recently reported the effects of statin treatment on endothelial function, oxidative stress and inflammation in patients with hypertension and normal cholesterol levels [7]. Yet, despite the beneficial effects shown by statins in hypertensive animal models as well as in small clinical studies, the results from meta-analyses and large clinical trials have been controversial. Indeed, the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA) [8] demonstrated that the combination of amlodipinebased therapy and atorvastatin was highly effective in preventing cardiovascula

Why patients with familial hypercholesterolemia are at high cardiovascular risk? Beyond LDL-C levels

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A systematic review and meta-analysis on the effects of statins on pregnancy outcomes.

Abstract Background and aims Statins are contraindicated in pregnancy, due to their potential teratogenicity. However, data are still inconsistent and some even suggest a potential benefit of statin use against pregnancy complications. We aimed to investigate the effects of statins on pregnancy outcomes, including stillbirth, fetal abortion, and preterm delivery, through a systematic review of the literature and a meta-analysis of the available clinical studies. Methods A literature search was performed through PubMed, Scopus, and Web of Science up to 16 May 2020. Data were extracted from 18 clinical studies (7 cohort studies, 2 clinical trials, 3 case reports, and 6 case series). Random effect meta-analyses were conducted using the restricted maximum likelihood method. The common effect sizes were calculated as odds ratios (ORs) and their 95% confidence interval (CI) for each main outcome. Results Finally, nine studies were included in the meta-analysis. There was no significant association between statin therapy and stillbirth [OR (95% CI) = 1.30 (0.56, 3.02), p=0.54; I2 = 0%]. While statin exposure was significantly associated with increased rates of spontaneous abortion [OR (95% CI) = 1.36 (1.10–1.68), p=0.004, I2 = 0%], it was non-significantly associated with increased rates of induced abortion [OR (95% CI) = 2.08 (0.81, 5.36), p=0.129, I2 = 17.33%] and elective abortion [OR (95% CI) = 1.37 (0.68, 2.76), p=0.378, I2 = 62.46%]. A non-significant numerically reduced rate of preterm delivery was observed in statin users [OR (95% CI) = 0.47 (0.06, 3.70), p=0.47, I2 = 76.35%]. Conclusions Statin therapy seems to be safe as it was not associated with stillbirth or induced and elective abortion rates. Significant increase after statin therapy was, however, observed for spontaneous abortion. These results need to be confirmed and validated in future studies

Incretins and microRNAs: Interactions and physiological relevance

MicroRNAs (miRNA) are one class of the small regulatory RNAs that can impact the expression of numerous genes including incretin hormones and their G protein-coupled receptors. Incretin peptides, including GLP-1, GLP-2, and GIP, are released from the gastrointestinal tract and have an crucial role in the glucose hemostasis and pancreatic beta-cell function. These hormones and their analogs with a longer half-life, glucagon like peptide-1 receptor agonists (GLP1RA), modify the expression of miRNAs. Dipeptidyl peptidase IV (DPP-4) is an enzyme that degrades the incretin hormones and is inactivated by DPP-4 inhibitors, which are a class of compounds used in the management of type 2 diabetes. DPP-4 inhibitors may also increase or reduce the expression of miRNAs. In this review, we describe the possible interactions between miRNAs and incretin hormones and the relevance of such interactions to physiological processes and diseases

Statyny — leki stosowane w Polsce wciąż za rzadko lub w zbyt małych dawkach

Hipercholesterolemia jest najczęstszym czynnikiem ryzyka chorób układu sercowo-naczyniowego w populacji polskiej. Większość chorych nie ma świadomości obecności tego czynnika ryzyka, kolejna duża grupa pacjentów, mimo świadomości choroby, nie stosuje ani niefarmakologicznych, ani farmakologicznych metod obniżania stężenia cholesterolu. W artykule przedstawiono niepokojące dane epidemiologicznie dotyczące hipercholesterolemii w populacji polskiej, wskazując jednocześnie sposoby poprawienia diagnostyki i leczenia tego zaburzenia

Fenofibrate — a place in contemporary pharmacotherapy

Farmakoterapia zaburzeń lipidowych w ostatnich latach ulega dynamicznej zmianie w związku z wprowadzaniem na rynek nowych leków o odmiennym mechanizmie działania od dotychczas stosowanych. Niemniej, w codziennej praktyce klinicznej wciąż najpopularniejszymi preparatami, obok statyn, pozostają fibraty, a zwłaszcza fenofibrat. W artykule autorzy omawiają najważniejsze duże, randomizowane badania kliniczne z zastosowaniem tego leku, analizują bezpieczeństwo farmakoterapii tym lekiem, również w skojarzeniu z innymi preparatami oraz wskazują aktualne miejsce fenofibratu w leczeniu zaburzeń lipidowych.Lipid disorder pharmacotherapy has been dynamically changing in recent years in connection with the introduction of new drugs with a different mechanism of action than those previously used. However, in everyday clinical practice still the most common drugs applied, next to statins, are fibrates, and in particular fenofibrate. In the article, the authors discuss the most important large randomized clinical trials using this drug, analyze the safety of pharmacotherapy with this drug also in combination with other drugs, and show the current position of fenofibrate in the treatment of lipid disorders

Multi-criterion fault diagnosis of rolling bearings

In this paper, the possibilities of rolling bearing diagnostics, according to the PN and ISO standards, utilising the dimensionless discriminants of vibroacoustic processes, CPB frequency analysis and envelope detection methods are presented. The test bench, the measuring system, as well as the obtained results are described in detail. The authors’ own algorithm for the course of action during the process of detecting damage torolling bearings, involving the multi-criterion diagnostic utilising the afore methods is also described

Atorvastatin in patients with overweight and obesity

Nadwaga i otyłość stanowią jeden z najpoważniejszych, i według danych WHO — narastających, problemów klinicznych w populacjach krajów uprzemysłowionych, przyczyniając się do rozwoju wielu powikłań zdrowotnych. Najczęstszymi konsekwencjami nadwagi i otyłości są choroby układu sercowo-naczyniowego, zespół metaboliczny i cukrzyca. W artykule autorzy omawiają możliwości zastosowania atorwastatyny jako leku zmniejszającego niebezpieczeństwo występowania tych powikłań, wskazując jednocześnie na bezpieczeństwo podawania go chorym z nadwagą lub otyłością. Opisano również powiązania otyłości z nadmiarem tłuszczowej tkanki nasierdziowej, której rola w rozwoju chorób układu sercowo-naczyniowego jest dotychczas niedostatecznie poznana, a może być istotna parametrem oceny ryzyka.Overweight and obesity is one of the most serious and according to WHO data growing clinical problems in populations of industrialized countries, contributing to the development of many health complications. The most common consequences of overweight and obesity are diseases of the cardiovascular system, metabolic syndrome and diabetes mellitus. In the article, the authors discuss the possibility of applying atorvastatin as a drug reducing the possibility of risk occurrence of these complications, pointing out the safety of this drug in patients who are overweight or obese. They also describe the relationship between obesity and excess epicardial adipose tissue, whose role in the development of cardiovascular diseases hasn’t been so far sufficiently known and might be significant risk predictor

The differences in the prevalence of cardiovascular disease, its risk factors, and achievement of therapeutic goals among urban and rural primary care patients in Poland: Results from the LIPIDOGRAM 2015 study

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record*