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Ciccarone Articles

Ciccarone Center Research

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Cholesterol / Lipids / Statins

Landmark Articles

The role of statins in diabetes treatment.
By: Subedi BH, Tota-Maharaj R, Silverman MG, Minder CM, Martin SS, Ashen MD, Blumenthal RS, Blaha MJ.
Diabetes is considered a risk equivalent for coronary heart disease (CHD). The use of statins for primary and secondary prevention in patients with diabetes is well established and supported by robust data from randomized, controlled trials and national guidelines. It is reasonable to match the intensity of statin therapy with patients’ baseline CVD risk.
Response to letter by Dr. Lin regarding article, “HDL cholesterol subclasses, myocardial infarction, and mortality in secondary prevention: the lipoprotein investigators collaborative.
By: Martin SS, Li Y, Spertus JA, Jones SR.
The wait is over: The new cholesterol treatment guidelines are here.
By: Martin SS, Blumenthal RS.

Well-intentioned CV specialists often disagree, but we wholeheartedly support at least 90% of the new guidelines, which declare that primary prevention is here to stay. While many more adults will now qualify for statin therapy, heart-healthy dietary and exercise habits remain the foundation of primary prevention efforts. Following these new guidelines will allow clinicians to markedly reduce CVD events in their patients.

A clinician’s guide to the updated ABCs of cardiovascular disease prevention.
By: Kohli P, Whelton SP, Hsu S, Yancy CW, Stone NJ, Chrispin J, Gilotra NA, Houston B, Ashen MD, Martin SS, Joshi PH, McEvoy JW, Gluckman TJ, Michos ED, Blaha MJ, Blumenthal RS.

To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.

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Improving lipid control following myocardial infarction.
By: Ankam J, Feldman DI, Blaha MJ, Martin SS.

Following a myocardial infarction, lipid-lowering therapy is an established intervention to reduce the risk of recurrent cardiovascular events. Prior studies show a need to improve clinical practice in this area. Here, we review the latest research and perspectives on improving postmyocardial infarction lipid control. Optimizing lipid control could further enhance clinical outcomes after myocardial infarction.

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Low HDL cholesterol but not high LDL cholesterol is independently associated with subclinical coronary atherosclerosis in healthy octogenarians.
By: Freitas WM, Quaglia LA, Santos SN, de Paula RC, Santos RD, Blaha M, Rivera JJ, Cury R, Blumenthal R, Nadruz-Junior W, Agatston A, Figueiredo VN, Nasir K, Sposito AC; The Brazilian Study on Healthy Aging.

In a healthy cohort of individuals aged of 80 years or more the association between LDL-C and coronary atherosclerosis weakens with aging, while the opposite occurs with the levels of HDL-C.

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Association of high-density lipoprotein subclasses and incident coronary heart disease: The Jackson Heart and Framingham Offspring cohort studies.
By: Joshi PH, Toth PP, Lirette ST, Griswold ME, Massaro JM, Martin SS, Blaha MJ, Kulkarni KR, Khokhar AA, Correa A, D’Agostino Sr RB, Jones SR, on behalf of the Lipoprotein Investigators Collaborative (LIC) Study Group.
This study found that smaller, denser HDL3-C levels are primarily responsible for the inverse association between HDL-C and incident CHD in this diverse group of primary prevention subjects.
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High-density lipoprotein subfractions: current views and clinical practice applications.
By: Martin SS, Jones SR, Toth PP.
This report prioritizes higher-resolution HDL measurement techniques that capture better the biologically and clinically important characteristics of HDL.
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Non-cardiovascular effects associated with statins.
By: Desai CS, Martin SS, Blumenthal RS.
This is a state-of-art review on the possible effects of statin therapy on organs not in the cardiovascular system.
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Is LDL-C measurement better than estimating absolute risk for treating increased cholesterol?
By: Feldman DI, Martin SS.

LDL-C measurements and absolute risk assessments are important and provide complimentary information. More research is needed, but based on the best available evidence it appears that a balance of estimating risk (ARR) and measuring LDL-C (RRR) is appropriate.