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Ciccarone Articles

Ciccarone Center Research

Journal

Clinical Cardiology

Landmark Article

  • Early in 2012, a debate over the merits of statin therapy in primary prevention was published in the Wall Street Journal. The statin opponent claimed that statins should only be used in secondary prevention and never in any primary-prevention patients at risk for cardiovascular events. In this evidence-based rebuttal to those claims, we review the evidence supporting the efficacy of statin therapy in primary prevention. Cardiovascular risk is a continuum in which those at an elevated risk of events stand to benefit from early initiation of therapy. Statins should not be reserved until after a patient suffers the catastrophic consequences of atherosclerosis. Contrary to the assertions of the statin opponent, this principle has been demonstrated through reductions in heart attacks, strokes, and mortality in numerous randomized controlled primary-prevention statin trials. In selected at-risk individuals, the combination of pharmacotherapy and lifestyle changes is more effective than either alone. Future investigation in prevention should focus on improving our ability to identify these at-risk individuals.
    Published in: Clinical Cardiology
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Rationale and design of the Henry Ford exercise testing project (The FIT Project).
By: Al-Mallah MH, Keteyian SJ, Brawner CA, Whelton S, Blaha MJ.
The FIT Project, the largest study of physical fitness to date, uses electronic clinical epidemiologic techniques to answer many clinically relevant questions related to exercise capacity and prognosis.
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Neck circumference is not associated with subclinical atherosclerosis in retired national football league players.
By: Pokharel Y, Macedo FY, Nambi V, Martin SS, Nasir K, Wong ND, Boone J, Roberts AJ, Ballantyne CM, Virani SS.
In retired NFL players with a high prevalence of CAC and carotid artery plaque, neck circumference was not associated with coronary or carotid subclinical atherosclerosis.
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Very large database of lipids: rationale and design.
By: Martin SS, Blaha MJ, Toth PP, Joshi PH, McEvoy JW, Ahmed HM, Elshazly MB, Swiger KJ, Michos ED, Kwiterovich PO, Kulkarni KR, Chimera J, Cannon CP, Blumenthal RS, Jones SR.
The Very Large Database of Lipids database is an ongoing protocol that harnesses de-identified data from the daily operations of a commercial lipid laboratory and provides an opportunity for collaboration and new knowledge generation through careful examination of granular lipid data on a large scale.
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Landmark lipid-lowering trials in the primary prevention of cardiovascular disease.
By: Chrispin J, Martin SS, Hasan RK, Joshi PH, Minder CM, McEvoy JW, Kohli P, Johnson AE, Wang L, Blaha MJ, Blumenthal RS.
Over the past 25?years, lipid-lowering therapies have been developed that are proven to not only lower cholesterol, but also to decrease adverse cardiovascular events and CVD mortality. This review highlights some key clinical trials encompassing several classes of lipid-lowering medications that have provided clinicians with an evidence-based framework for managing their patients’ cardiovascular risk.
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A clinician’s guide to the ABCs of cardiovascular disease prevention: The Johns Hopkins Ciccarone Center for the prevention of Heart Disease and American College of Cardiology Cardiosource approach to the Million Hearts Initiative.
By: Hsu S, Ton VK, Ashen MD, Martin SS, Gluckman TJ, Kohli P, Sisson SD, Blumenthal RS, Blaha MJ.
As part of an initiative that aims to prevent 1 million myocardial infarctions and strokes over the next 5 years, we present the simply organized “ABCDE” approach for guiding a consistent comprehensive approach to managing cardiovascular risk in daily clinical practice. We summarize recommendations related to each topic and reference landmark trials and data that support our approach.
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Comparing the new European cardiovascular disease prevention guideline with prior American Heart Association guidelines: an editorial review.
By: Ton VK, Martin SS, Blumenthal RS, Blaha MJ.
Despite some minor disagreements on the weight of recommendations in certain areas, CVD prevention experts across two continents agree on one thing: prevention works in halting the progression of atherosclerosis and decreasing disease burden over a lifetime.
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C-reactive protein level and the incidence of eligibility for statin therapy: the multi-ethnic study of atherosclerosis.
By: Mann DM, Shimbo D, Cushman M, Lakoski S, Greenland P, Blumenthal RS, Michos ED, Lloyd-Jones DM, Muntner P.
Findings from this study suggest that many patients with an elevated hsCRP level may not receive the benefits of statins if hsCRP is not incorporated into the NCEP screening strategy.
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A point-by-point response to recent arguments against the use of statins in primary prevention.
By: Joshi PH, Chaudhari S, Blaha MJ, Jones SR, Martin SS, Post WS, Cannon CP, Fonarow GC, Wong ND, Amsterdam E, Hirshfeld JW, Blumenthal RS.
Early in 2012, a debate over the merits of statin therapy in primary prevention was published in the Wall Street Journal. The statin opponent claimed that statins should only be used in secondary prevention and never in any primary-prevention patients at risk for cardiovascular events. In this evidence-based rebuttal to those claims, we review the evidence supporting the efficacy of statin therapy in primary prevention. Cardiovascular risk is a continuum in which those at an elevated risk of events stand to benefit from early initiation of therapy. Statins should not be reserved until after a patient suffers the catastrophic consequences of atherosclerosis. Contrary to the assertions of the statin opponent, this principle has been demonstrated through reductions in heart attacks, strokes, and mortality in numerous randomized controlled primary-prevention statin trials. In selected at-risk individuals, the combination of pharmacotherapy and lifestyle changes is more effective than either alone. Future investigation in prevention should focus on improving our ability to identify these at-risk individuals.
Read on Pubmed