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Hypertriglyceridemia: HELP
Articles from Illinois
Based on 51 articles published since 2010

These are the 51 published articles about Hypertriglyceridemia that originated from Illinois during 2010-2020.
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Assessment of omega-3 carboxylic acids in statin-treated patients with high levels of triglycerides and low levels of high-density lipoprotein cholesterol: Rationale and design of the STRENGTH trial. 2018

Nicholls, Stephen J / Lincoff, A Michael / Bash, Dianna / Ballantyne, Christie M / Barter, Philip J / Davidson, Michael H / Kastelein, John J P / Koenig, Wolfgang / McGuire, Darren K / Mozaffarian, Dariush / Pedersen, Terje R / Ridker, Paul M / Ray, Kausik / Karlson, Björn W / Lundström, Torbjörn / Wolski, Kathy / Nissen, Steven E. ·South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia. · Department of Cardiovascular Medicine and Cleveland Clinic Coordinating Center for Clinical Research, Cleveland Clinic, Cleveland, Ohio. · Baylor College of Medicine, Houston, Texas. · University of New South Wales, Sydney, Australia. · University of Chicago, Chicago, Illinois. · Academic Medical Center, Amsterdam, The Netherlands. · Deutsches Herzzentrum München, Technische Universität München, and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. · Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas. · Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts. · Oslo University Hospital, Oslo, Norway. · Harvard Medical School, Boston, Massachusetts. · Imperial College of London, London, UK. · Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · AstraZeneca Pharmaceuticals, Gothenburg, Sweden. ·Clin Cardiol · Pubmed #30125052.

ABSTRACT: It is uncertain whether omega-3 fatty acids are beneficial in statin-treated patients. Epanova is a mix of omega-3 free fatty acids, not requiring co-ingestion with food, which can lower triglycerides by up to 31%. STRENGTH will examine whether Epanova 4 g daily reduces the rate of cardiovascular events in statin-treated patients with hypertriglyceridemia and low levels of HDL-C at high risk for developing cardiovascular events. STRENGTH is a randomized, double-blind, placebo-controlled trial. Patients had a triglyceride level ≥ 180 to <500 mg/dL and HDL-C < 42 mg/dL (men) or < 47 mg/dL (women) in the presence of either (1) established atherosclerotic cardiovascular disease, (2) diabetes with one additional risk factor, or (3) were other high-risk primary prevention patients, based on age and risk factor assessment. Patients should be treated with a statin, for >4 weeks, and have LDL-C < 100 mg/dL, but were also eligible if LDL-C was ≥100 mg/dL while on maximum tolerated statin therapy. The study will extend from October 30, 2014 to October 30, 2019. 13 086 patients were randomized to Epanova 4 g or placebo daily in addition to standard medical therapy. The primary efficacy outcome is time to first event of cardiovascular death, myocardial infarction, stroke, coronary revascularization or hospitalization for unstable angina. The trial will continue until 1600 patients reach the primary endpoint, with a median duration of therapy of 3 years. STRENGTH will determine whether Epanova 4 g daily will reduce cardiovascular events in statin-treated high-risk patients with hypertriglyceridemia and low HDL-C levels.

2 Review Hypertriglyceridemia and cardiovascular risk: a cautionary note about metabolic confounding. 2018

Sniderman, Allan D / Couture, Patrick / Martin, Seth S / DeGraaf, Jacqueline / Lawler, Patrick R / Cromwell, William C / Wilkins, John T / Thanassoulis, George. ·McGill University Health Centre, Montreal, Quebec, Canada allan.sniderman@mcgill.ca. · Centre Hospitalier Universitaire de Québec, Quebec, Quebec, Canada. · Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Heart Disease, John Hopkins University School of Medicine, Baltimore, MD. · Department of General Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. · Peter Munk Cardiac Centre, University Health Network, Heart and Stroke, Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, Ontario, Canada. · Lipoprotein and Metabolic Disorders Institute, Raleigh, NC. · Departments of Medicine (Cardiology) and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. · McGill University Health Centre, Montreal, Quebec, Canada. ·J Lipid Res · Pubmed #29769239.

ABSTRACT: Triglycerides are the conventional tool to measure VLDLs, whereas LDL cholesterol (LDL-C) is the conventional tool to measure LDLs. Multiple epidemiological studies, including a series of genetically based analyses, have demonstrated that cardiovascular risk is related to triglycerides independently of LDL-C, and this has led to a series of new therapeutic agents designed specifically to reduce plasma triglycerides. The triglyceride hypothesis posits that increased levels of triglycerides increase cardiovascular risk and decreasing plasma triglycerides decreases cardiovascular risk. In this work, we will examine the validity of the triglyceride hypothesis by detailing the biological complexities associated with hypertriglyceridemia, the genetic epidemiological evidence in favor of hypertriglyceridemia, the evidence from the fibrate randomized clinical trials relating triglycerides and clinical outcomes, and the completeness of the evidence from the initial studies of novel mutations and the therapeutic agents based on these mutations that lower triglycerides. Because of the multiple metabolic links between VLDL and LDL, we will try to demonstrate that measuring triglycerides and LDL-C alone are inadequate to document the lipoprotein profile. We will try to demonstrate that apoB must be measured, as well as triglycerides and cholesterol, to have an accurate estimate of lipoprotein status.

3 Review Evolution of Omega-3 Fatty Acid Therapy and Current and Future Role in the Management of Dyslipidemia. 2018

Benes, Lane B / Bassi, Nikhil S / Kalot, Mohamad A / Davidson, Michael H. ·Section of Cardiology, The University of Chicago Medicine, 5841 South Maryland Avenue, MC 6080, Chicago, IL 60637, USA. · Section of Cardiology, University of California - Los Angeles, UCLA Cardiovascular Center (Westwood), 100 UCLA Medical Plaza, Suite 630, Los Angeles, CA 90095, USA. · Department of Medicine, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon. · Section of Cardiology, The University of Chicago Medicine, 5841 South Maryland Avenue, MC 6080, Chicago, IL 60637, USA. Electronic address: mdavidso@bsd.uchicago.edu. ·Cardiol Clin · Pubmed #29609757.

ABSTRACT: Omega-3 fatty acids have shown modest benefit in certain subgroups at higher cardiovascular risk. Ongoing trials are investigating cardiovascular event rate reduction with newer, more efficacious formulations with a focus on these higher risk patients. This article focuses on the previously demonstrated benefits of omega-3 fatty acid therapies, currently available formulations, and their current and future role in reducing cardiovascular risk.

4 Review Not every patient needs a triglyceride check, but all can get pancreatitis: a systematic review and clinical characterization of isotretinoin-associated pancreatitis. 2017

Opel, D / Kramer, O N / Chevalier, M / Bigby, M / Albrecht, J. ·Division of Dermatology, Department of Medicine, Loyola University Medical Center, Maywood, IL, U.S.A. · Medical School, University of Illinois, Chicago, IL, U.S.A. · Apex Dermatology, Littleton, CO, U.S.A. · Department of Dermatology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, U.S.A. · Division of Dermatology, Department of Medicine, J.H. Stroger Hospital of Cook County, Chicago, IL, U.S.A. · Department of Dermatology, Rush Medical College, Chicago, IL, U.S.A. ·Br J Dermatol · Pubmed #27893168.

ABSTRACT: Monitoring of triglycerides for patients on isotretinoin is practised primarily to avoid hypertriglyceridaemia-associated pancreatitis. The aim of this study was to describe clinically the published cases of hypertriglyceride-associated pancreatitis. A comprehensive search strategy using MEDLINE, Embase and grey literature was conducted (1960 to January 2016) to identify all case reports of isotretinoin-associated pancreatitis and all relevant studies of isotretinoin and triglycerides for any indication (≥ 20 patients). Terms related to isotretinoin, triglycerides and pancreatitis were searched with all available synonyms. Any studies that used isotretinoin and mentioned triglycerides or pancreatitis were searched in full text, where available, for cases of pancreatitis. Studies from all countries and published in any language were included, but Korean and Turkish studies could not be analysed. Two authors independently reviewed the publications to determine eligibility, and for data extraction. In total, 125 papers fulfilled the inclusion criteria and were searched for cases of pancreatitis. Eleven papers with 25 cases of pancreatitis associated with isotretinoin were identified; four of these cases were likely due to hypertriglyceridaemia. Three patients had elevated baseline triglycerides, but no monitoring. Pancreatitis occurred 6 and 7 weeks, and 6 months after initiation of therapy. For the fourth patient who was treated for glioblastoma and died, no detailed clinical information was available. Idiosyncratic pancreatitis associated with isotretinoin is the most frequent pancreatitis on isotretinoin, and patients should be warned about it. Hypertriglyceride-associated pancreatitis is an exceedingly rare adverse event of isotretinoin therapy. Our data cannot give a frequency or risk for either adverse event. Based on the clinical information of the patients available, we conclude that for patients without elevated baseline triglycerides, or risk thereof, monitoring of triglycerides during therapy is of little value.

5 Review Omega-3 carboxylic acids monotherapy and combination with statins in the management of dyslipidemia. 2016

Benes, Lane B / Bassi, Nikhil S / Davidson, Michael H. ·Department of Medicine, Section of Cardiology. · Department of Medicine, University of Chicago, Chicago, IL, USA. ·Vasc Health Risk Manag · Pubmed #28003756.

ABSTRACT: The 2013 American College of Cardiology/American Heart Association guidelines on cholesterol management placed greater emphasis on statin therapy given the well-established benefits in primary and secondary prevention of cardiovascular disease. Residual risk may remain after statin initiation, in part because of triglyceride-rich lipoprotein cholesterol. Several large trials have failed to show benefit with non-statin cholesterol-lowering medications in the reduction of cardiovascular events. Yet, subgroup analyses showed a benefit in those with hypertriglyceridemia and lower high-density lipoprotein cholesterol level, a high-risk pattern of dyslipidemia. This review discusses the benefits of omega-3 carboxylic acids, a recently approved formulation of omega-3 fatty acid with enhanced bioavailability, in the treatment of dyslipidemia both as monotherapy and combination therapy with a statin.

6 Review Triglyceride-rich lipoproteins as a causal factor for cardiovascular disease. 2016

Toth, Peter P. ·Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, IL, USA. ·Vasc Health Risk Manag · Pubmed #27226718.

ABSTRACT: Approximately 25% of US adults are estimated to have hypertriglyceridemia (triglyceride [TG] level ≥150 mg/dL [≥1.7 mmol/L]). Elevated TG levels are associated with increased cardiovascular disease (CVD) risk, and severe hypertriglyceridemia (TG levels ≥500 mg/dL [≥5.6 mmol/L]) is a well-established risk factor for acute pancreatitis. Plasma TG levels correspond to the sum of the TG content in TG-rich lipoproteins (TRLs; ie, very low-density lipoproteins plus chylomicrons) and their remnants. There remains some uncertainty regarding the direct causal role of TRLs in the progression of atherosclerosis and CVD, with cardiovascular outcome studies of TG-lowering agents, to date, having produced inconsistent results. Although low-density lipoprotein cholesterol (LDL-C) remains the primary treatment target to reduce CVD risk, a number of large-scale epidemiological studies have shown that elevated TG levels are independently associated with increased incidence of cardiovascular events, even in patients treated effectively with statins. Genetic studies have further clarified the causal association between TRLs and CVD. Variants in several key genes involved in TRL metabolism are strongly associated with CVD risk, with the strength of a variant's effect on TG levels correlating with the magnitude of the variant's effect on CVD. TRLs are thought to contribute to the progression of atherosclerosis and CVD via a number of direct and indirect mechanisms. They directly contribute to intimal cholesterol deposition and are also involved in the activation and enhancement of several proinflammatory, proapoptotic, and procoagulant pathways. Evidence suggests that non-high-density lipoprotein cholesterol, the sum of the total cholesterol carried by atherogenic lipoproteins (including LDL, TRL, and TRL remnants), provides a better indication of CVD risk than LDL-C, particularly in patients with hypertriglyceridemia. This article aims to provide an overview of the available epidemiological, clinical, and genetic evidence relating to the atherogenicity of TRLs and their role in the progression of CVD.

7 Review Asparaginase-associated toxicity in children with acute lymphoblastic leukemia. 2016

Hijiya, Nobuko / van der Sluis, Inge M. ·a Division of Hematology/Oncology/Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago and Department of Pediatrics, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA ; · b Department of Pediatric Oncology/Hematology , Erasmus MC-Sophia Children's Hospital , Rotterdam , The Netherlands. ·Leuk Lymphoma · Pubmed #26457414.

ABSTRACT: Asparaginase is an integral component of multiagent chemotherapy regimens for the treatment of children with acute lymphoblastic leukemia. Positive outcomes are seen in patients who are able to complete their entire prescribed course of asparaginase therapy. Toxicities associated with asparaginase use include hypersensitivity (clinical and subclinical), pancreatitis, thrombosis, encephalopathy, and liver dysfunction. Depending on the nature and severity of the toxicity, asparaginase therapy may be altered or discontinued in some patients. Clinical hypersensitivity is the most common asparaginase-associated toxicity requiring treatment discontinuation, occurring in up to 30% of patients receiving Escherichia coli-derived asparaginase. The ability to rapidly identify and manage asparaginase-associated toxicity will help ensure patients receive the maximal benefit from asparaginase therapy. This review will provide an overview of the common toxicities associated with asparaginase use and recommendations for treatment management.

8 Review Hypertriglyceridemia and Cardiovascular Outcomes. 2016

Malhotra, Gurveen / Sethi, Ankur / Arora, Rohit. ·1Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL; 2Department of Cardiology, Mount Sinai Hospital, Chicago, IL; and 3Department of Medicine, James Lovell Federal Health Care Center, North Chicago, IL. ·Am J Ther · Pubmed #25415545.

ABSTRACT: Cardiovascular disease, particularly ischemic heart disease, is one of the most common causes of morbidity and mortality in the United States. Atherosclerosis, the root cause of ischemic heart disease, is promoted by risk factors like elevated plasma low-density lipoprotein, low plasma high-density lipoprotein, smoking, hypertension, and diabetes mellitus. Even 66 years after a relation between triglycerides (TG) and cardiovascular disease was first suspected, TGs still continue to be a controversial risk factor and target for therapy. Some previous studies did not show any significant positive relationship between TG and cardiovascular mortality; however, recent meta-analyses found otherwise. The role of elevated TG in patients with low low-density lipoprotein and interventions to lower TG to reduce cardiovascular mortality and morbidity is an area of active research.

9 Review Genetics and causality of triglyceride-rich lipoproteins in atherosclerotic cardiovascular disease. 2014

Rosenson, Robert S / Davidson, Michael H / Hirsh, Benjamin J / Kathiresan, Sekar / Gaudet, Daniel. ·Mount Sinai Heart, Cardiometabolic Disorders, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: robert.rosenson@mssm.edu. · Division of Cardiology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois. · Mount Sinai Heart, Mount Sinai Hospital, New York, New York. · Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. · ECOGENE-21 and Lipid Clinic, Department of Medicine, Université de Montreal, Chicoutimi, Quebec, Canada. ·J Am Coll Cardiol · Pubmed #25500239.

ABSTRACT: Triglycerides represent 1 component of a heterogeneous pool of triglyceride-rich lipoproteins (TGRLs). The reliance on triglycerides or TGRLs as cardiovascular disease (CVD) risk biomarkers prompted investigations into therapies that lower plasma triglycerides as a means to reduce CVD events. Genetic studies identified TGRL components and pathways involved in their synthesis and metabolism. We advocate that only a subset of genetic mechanisms regulating TGRLs contribute to the risk of CVD events. This "omic" approach recently resulted in new targets for reducing CVD events.

10 Review Addition of omega-3 carboxylic acids to statin therapy in patients with persistent hypertriglyceridemia. 2014

Davidson, Michael H / Phillips, Alyssa K / Kling, Douglas / Maki, Kevin C. ·Department of Medicine, The University of Chicago, 5841 S. Maryland Avenue, MC 6080, Chicago, IL 60637, USA. ·Expert Rev Cardiovasc Ther · Pubmed #25089906.

ABSTRACT: The incidence of hypertriglyceridemia has grown alongside that of obesity. Statin therapy has been widely recommended for the treatment of dyslipidemias. Omega-3 (OM3) fatty acid concentrates are commonly prescribed concurrently with statins in patients with persistent hypertriglyceridemia for additional lowering of triglyceride and non-HDL cholesterol. The bioavailability of currently available OM3 ethyl ester drugs is limited by their need for hydrolysis by pancreatic lipases, largely stimulated by dietary fat, prior to intestinal absorption. This review will discuss the chemistry, pharmacokinetics and clinical efficacy of a novel OM3 carboxylic acid drug that provides polyunsaturated docosahexaenoic and eicosapentaenoic acids in the free fatty acid form, which is readily absorbed by the intestine. This drug was approved in May 2014 as an adjunct to diet to reduce triglyceride levels in adults with severe (≥500 mg/dl) hypertriglyceridemia.

11 Review Treatment options for the management of hypertriglyceridemia: strategies based on the best-available evidence. 2012

Maki, Kevin C / Bays, Harold E / Dicklin, Mary R. ·Biofortis Clinical Research, 211 E. Lake Street, Addison, IL 60101, USA. Kevin.Maki@mxns.com ·J Clin Lipidol · Pubmed #23009777.

ABSTRACT: A severe elevation in triglycerides (TG; ≥500 mg/dL) increases the risk for pancreatitis. TG levels ≥200 mg/dL are associated with a greater risk of atherosclerotic coronary heart disease (CHD). However, no outcomes trials exist to assess the efficacy of TG lowering for preventing pancreatitis in patients with severe hypertriglyceridemia. Similarly, no completed prospective outcomes trial exists to support or refute a reduction in CHD risk resulting from lipid-altering therapy in patients specifically selected for the presence of hypertriglyceridemia. This review examines the available evidence for the use of statins, omega-3 fatty acids, fibrates, and niacin in the management of hypertriglyceridemic patients. Results from CHD outcomes trials support statins as the first-line lipid-altering drug therapy to reduce CHD in hypercholesterolemic patients, and subgroup analyses suggest statins are efficacious in hypertriglyceridemic patients with fasting TG levels <500 mg/dL. Omega-3 fatty acids and fibrates are reasonable first drug options for patients with TG ≥500 mg/dL and often are used to lower TG levels with the objective of reducing pancreatitis risk, although a statin or niacin may also be reasonable options. Combination lipid drug therapy may be needed to achieve both low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol treatment goals for CHD prevention in patients with elevated TG levels, particularly those with TG ≥500 mg/dL. Additional clinical outcomes data are needed to provide a more evidence-based rationale for clinical lipid management of hypertriglyceridemic patients.

12 Review Management of severe hypertriglyceridemia in the hospital: a review. 2012

Schaefer, Eric W / Leung, Alicia / Kravarusic, Jelena / Stone, Neil J. ·Division of Hospital Medicine, Northwestern University, Chicago, Illinois, USA. eschaefe@nmh.org ·J Hosp Med · Pubmed #22128096.

ABSTRACT: For hospitalists, hypertriglyceridemia (HTG) is more than cardiovascular risk. Severe HTG occurs when serum triglycerides rise above 1000 mg/dL, and it carries a risk of abdominal pain and pancreatitis. The etiology of severe HTG is usually a combination of genetic and secondary factors. A detailed history with attention to family history, medications, and alcohol consumption can often lead to the cause. Physical examination findings may stretch across multiple organ systems. Patients with severe HTG should be admitted to the hospital for aggressive medical therapy if they develop symptoms such as abdominal pain or pancreatitis. Asymptomatic patients with severe HTG who have significant short-term risk for developing symptoms require urgent consultation that may lead to a brief hospitalization to address exacerbating factors. Treatment of severe HTG includes a combination of pharmacologic agents and a restriction on dietary triglyceride intake. If oral medications fail to adequately lower triglyceride levels, intravenous insulin and in rare cases therapeutic plasma exchange may be required. To prevent recurrent severe HTG, the patient should be counseled about adherence to long-term medications and lifestyle changes.

13 Review Novel developments in omega-3 fatty acid-based strategies. 2011

Davidson, Michael H / Kling, Douglas / Maki, Kevin C. ·University of Chicago Pritzker School of Medicine, Chicago, IL 60654, USA. mdavidso@medicine.bsd.uchicago.edu ·Curr Opin Lipidol · Pubmed #21986642.

ABSTRACT: PURPOSE OF REVIEW: Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been attributed with several health benefits, including triglyceride lowering and cardiovascular disease risk reduction. This review focuses on new prescription omega-3 fatty acid products in development and recently published data regarding omega-3 fatty acid effects on arrhythmias, heart failure, and platelet inactivation. RECENT FINDINGS: A free fatty acid form of n-3 PUFA was found to produce a four-fold higher area under the plasma n-3 PUFA curve than prescription omega-3-acid ethyl esters in patients on a low-fat diet. Eicosapentaenoic acid ethyl esters reduced triglyceride without significantly elevating LDL cholesterol in patients with severe hypertriglyceridemia and in those with mixed dyslipidemia. Recent investigations of n-3 PUFA effects on ventricular and atrial arrhythmias, including studies in patients with implanted defibrillators, failed to demonstrate a significant benefit. However, increased fatty fish or n-3 PUFA consumption was associated with a lower rate of hospitalization in heart failure patients. A further important finding was potentiation of the antiplatelet response when n-3 PUFAs were added to aspirin + clopidogrel. SUMMARY: Although n-3 PUFA therapy continues to show promise in the prevention and management of cardiovascular diseases, further research is necessary to more fully elucidate its role in specific disorders.

14 Review Chronic pancreatitis and exocrine insufficiency. 2011

Affronti, John. ·Division of Gastroenterology, Hepatology and Nutrition, Stritch School of Medicine, Loyola University of Chicago, 2160 South First Avenue, Maywood, IL 60153, USA. jaffronti@lumc.edu ·Prim Care · Pubmed #21872095.

ABSTRACT: The evaluation, management, and follow-up of patients with chronic pancreatitis (CP) can be simple, but it can also be complex, so having a good referral network of subspecialists experienced in this field is essential. Identifying the cause of CP requires a systematic review of the many potential causes when the cause is not obvious. The identification of patients with autoimmune CP is particularly important because treatment with steroids may be effective. Alterations in pain or other symptoms in patients with CP should not be attributed to worsening disease before evaluations for complications including malignancy are done.

15 Clinical Trial Effects of n-3 fatty acid treatment on monocyte phenotypes in humans with hypertriglyceridemia. 2017

Dai Perrard, Xiao-Yuan / Lian, Zeqin / Bobotas, George / Dicklin, Mary R / Maki, Kevin C / Wu, Huaizhu. ·Department of Medicine, Baylor College of Medicine, Houston, TX, USA. · Matinas BioPharma, Inc, Bedminster, NJ, USA. · Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Glen Ellyn, IL, USA. · Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. Electronic address: hwu@bcm.edu. ·J Clin Lipidol · Pubmed #28942094.

ABSTRACT: BACKGROUND: Hypertriglyceridemia increases risk for atherosclerotic cardiovascular disease and may contribute to atherosclerosis by changing circulating monocyte phenotypes. High-dose n-3 polyunsaturated fatty acids reduce blood triglyceride levels. Effects of triglyceride-lowering therapy on monocyte phenotypes are not well known. OBJECTIVE: We examined effects of n-3 polyunsaturated fatty acid treatments (eicosapentaenoic acid [EPA] plus docosapentaenoic acid [MAT9001] vs EPA ethyl esters [EPA-EE]) on monocyte phenotypes in individuals with hypertriglyceridemia. METHODS: Individuals with triglycerides 200 to 400 mg/dL were recruited. Subjects received 2 treatments in randomized order for 14 days each: MAT9001 and EPA-EE, at 4 g/d. At 2 days before the start of, and on the last day of, each treatment, nile red staining for lipids and phenotypes of each monocyte subset were examined by flow cytometry after an overnight fast and postprandially after a high-fat meal. RESULTS: Treatment with MAT9001 or EPA-EE reduced fasting triglyceride levels and decreased proportions of intermediate monocytes. Only MAT9001 decreased postprandial blood triglyceride levels, lowered fasting nile red levels, indicating less lipid in classical and intermediate monocytes, and reduced postprandial CD11c levels on nonclassical monocytes. MAT9001 and EPA-EE each reduced fasting and postprandial CD11c and CD36 levels on classical and intermediate monocytes and postprandial CCR5 levels on intermediate and nonclassical monocytes, with no significant differences between the 2 treatments. CONCLUSIONS: Treatment with MAT9001 in individuals with hypertriglyceridemia reduced fasting nile red staining for lipids in classical and intermediate monocytes. MAT9001 and EPA-EE each improved fasting and postprandial monocyte phenotypes, which could potentially help to protect against atherosclerosis.

16 Clinical Trial Assessment of pharmacokinetic interaction between omega-3 carboxylic acids and the statins rosuvastatin and simvastatin: Results of 2 phase I studies in healthy volunteers. 2017

Offman, Elliot / Davidson, Michael / Nilsson, Catarina. ·Certara Strategic Consulting, Montreal, QC, Canada. Electronic address: elliot.offman@certara.com. · Department of Cardiology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA; Corvidia Therapeutics, Waltham, MA, USA. · Quantitative Clinical Pharmacology, AstraZeneca Gothenburg, Mölndal, Sweden. ·J Clin Lipidol · Pubmed #28506390.

ABSTRACT: BACKGROUND: Omega-3 carboxylic acids (OM3-CA) can lower triglyceride levels. OM3-CA is often prescribed concomitantly with a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin). OBJECTIVE: The aim of the article was to assess the potential for pharmacokinetic interaction between OM3-CA and the statins rosuvastatin and simvastatin. METHODS: Data from 2 phase I studies (ECLIPSE III and OM-EPA-007 [NCT01486433]) were analyzed. In ECLIPSE III, 59 participants received OM3-CA 4 g once daily for 13 days, with rosuvastatin 40 mg (single dose) co-administered with the 11th dose. In OM-EPA-007, 52 participants received simvastatin 40 mg plus acetylsalicylic acid 81 mg daily for 14 days, with or without OM3-CA. Lack of a drug-drug interaction was declared if the 90% confidence interval (CI) of the geometric least-squares mean ratio of pharmacokinetic parameters was in the range 80% to 125%. RESULTS: For rosuvastatin, values for the geometric mean ratio (90% CI) with:without OM3-CA were 86.38% (80.68-92.48), 90.50% (85.99-95.25), and 89.01% (84.30-93.98), respectively, for maximum plasma concentration (C CONCLUSION: OM3-CA can be administered with either rosuvastatin or simvastatin without affecting the pharmacokinetics of these statins.

17 Clinical Trial A Novel ω-3 Acid Ethyl Ester Formulation Incorporating Advanced Lipid Technologies 2017

Lopez-Toledano, Miguel A / Thorsteinsson, Thorsteinn / Daak, Ahmed / Maki, Kevin C / Johns, Colleen / Rabinowicz, Adrian L / Sancilio, Frederick D. ·Department of Research and Development Sancilio and Company, Inc, Riviera Beach, Florida. Electronic address: mltoledano@sancilio.com. · Department of Research and Development Sancilio and Company, Inc, Riviera Beach, Florida. · Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Glen Ellyn, Illinois. ·Clin Ther · Pubmed #28189364.

ABSTRACT: PURPOSE: The US Food and Drug Administration has approved several highly purified ω-3 fatty acid prescription drugs for the treatment of severe hypertriglyceridemia. These differ in the amounts and forms of docosahexaenoic acid (DHA) and/or eicosapentaenoic acid (EPA). This study compared the bioavailability of SC401 (1530 mg EPA-ethyl esters [EEs] and DHA-EEs plus Advanced Lipid Technologies METHODS: This was a Phase I, randomized, open-label, single-dose, 2-way crossover study in healthy participants housed from day -3 to day 2 in each treatment period. Blood samples for pharmacokinetic measurements were collected before and after dosing, and safety profile and tolerability were assessed. FINDINGS: In unadjusted analyses, SC401 had 5% lower C IMPLICATIONS: These results indicate that SC401, an ω-3 acid EE formulation containing ALT

18 Clinical Trial Effects of omega-3 carboxylic acids on lipoprotein particles and other cardiovascular risk markers in high-risk statin-treated patients with residual hypertriglyceridemia: a randomized, controlled, double-blind trial. 2015

Dunbar, Richard L / Nicholls, Stephen J / Maki, Kevin C / Roth, Eli M / Orloff, David G / Curcio, Danielle / Johnson, Judith / Kling, Douglas / Davidson, Michael H. ·Division of Translational Medicine & Human Genetics, Perelman School of Medicine at the University of Pennsylvania, 3600 Spruce Street, 8046 Maloney Building, Philadelphia, PA, 19104-2699, USA. richard.dunbar@uphs.upenn.edu. · South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia. stephen.nicholls@sahmri.com. · Midwest Center for Metabolic & Cardiovascular Research, Chicago, IL, USA. kmaki@mc-mcr.com. · Sterling Research Group, Cincinnati, OH, USA. eroth@sterlingresearch.org. · Medpace, Inc., Cincinnati, OH, USA. d.orloff@medpace.com. · Omthera Pharmaceuticals, Princeton, NJ, USA. dcurcio319@gmail.com. · Omthera Pharmaceuticals, Princeton, NJ, USA. judithbjohnson@gmail.com. · Omthera Pharmaceuticals, Princeton, NJ, USA. douglaskling@gmail.com. · Omthera Pharmaceuticals, Princeton, NJ, USA. mdavidson@omthera.com. · AstraZeneca, Wilmington, DE, USA. mdavidson@omthera.com. ·Lipids Health Dis · Pubmed #26328624.

ABSTRACT: BACKGROUND: This study examined the effects of a mixture of highly bioavailable omega-3 carboxylic acids (OM3-CA) on nuclear magnetic resonance spectroscopy-assessed lipoprotein particle concentrations and sizes and other cardiovascular risk markers in statin-treated patients with fasting triglycerides (TG) ≥ 2.3 mmol/L (200 mg/dL) and <5.6 mmol/L (500 mg/dL) and at high cardiovascular risk. METHODS: After a diet lead-in and statin-stabilization period, 647 patients were randomly assigned to receive capsules of control (olive oil, OO) 4 g/d, OM3-CA 2 g/d (plus OO 2 g/d), or OM3-CA 4 g/d for 6 weeks. RESULTS: Compared with OO, low-density lipoprotein (LDL) particle size was increased with OM3-CA 2 g/d (p < 0.01) and 4 g/d (p < 0.001), and very low-density lipoprotein (VLDL) and high-density lipoprotein (HDL) particle sizes were decreased with both OM3-CA dosages vs. OO (p < 0.001 and p < 0.05 for VLDL and HDL, respectively). Total VLDL/chylomicron remnant particle concentration was reduced by 8.5 and 16.0 % with OM3-CA 2 and 4 g/d, respectively, vs. a 6.9 % reduction with OO (p < 0.001 for OM3-CA 4 g/d vs. OO). Total HDL particle concentration was also reduced by 1.5 and 3.2 % with OM3-CA 2 and 4 g/d, respectively, vs. a 0.6 % increase with OO (at least p < 0.05 for both comparisons). Changes in total LDL particle concentration were not significantly different for OO vs. OM3-CA at either dosage. Apolipoprotein (Apo) CIII levels decreased by 7.6 and 13.1 % with OM3-CA 2 and 4 g/d, respectively, vs. 3.2 % with OO (p < 0.001 for OM3-CA 4 g/d vs. OO). Lipoprotein-associated phospholipase A2 (Lp-PLA2) mass was reduced by 6.2 and 10.7 % with OM3-CA 2 and 4 g/d, respectively, vs. a 0.1 % increase with OO (p < 0.001 for both vs. OO). There were no significant differences between treatments in high-sensitivity C-reactive protein responses. CONCLUSION: OM3-CA were associated with shifts in lipoprotein particle sizes and concentrations, and reductions in Apo CIII and Lp-PLA2, in patients with hypertriglyceridemia while taking a statin. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01408303.

19 Article Elevated Triglycerides (≥150 mg/dL) and High Triglycerides (200-499 mg/dL) Are Significant Predictors of New Heart Failure Diagnosis: A Real-World Analysis of High-Risk Statin-Treated Patients. 2019

Toth, Peter P / Philip, Sephy / Hull, Michael / Granowitz, Craig. ·CGH Medical Center, Sterling, IL, USA. · Johns Hopkins University School of Medicine, Baltimore, MD, USA. · Amarin Pharma Inc, Bedminster, NJ, USA. · Optum, Eden Prairie, MN, USA. ·Vasc Health Risk Manag · Pubmed #31824165.

ABSTRACT: Purpose: Real-world data may provide insight into relationships between high triglycerides (TG), a modifiable cardiovascular (CV) risk factor, and increased heart failure (HF) risk. Patients and methods: This retrospective administrative claims analysis included statin-treated patients aged ≥45 years with diabetes and/or atherosclerotic CV disease enrolled in 2010 and followed for ≥6 months to March 2016. Patients with TG ≥150 mg/dL and a comparator cohort with TG <150 mg/dL and high-density lipoprotein cholesterol >40 mg/dL were included. A sub-analysis was conducted in patients with TG 200-499 mg/dL. Hazard ratios (HR) were calculated from multivariate analyses controlled for patient characteristics and comorbidities using Cox proportional hazard modeling. New diagnosis of HF required diagnosis in the follow-up period without prior evidence of HF. Results: Multivariate analyses revealed a 19% higher rate of new HF diagnosis in the TG ≥150 mg/dL cohort (HR=1.192; 95% confidence interval [CI]=1.134-1.252; Conclusion: In a real-world analysis of statin-treated patients with high CV risk, elevated and high TG were significant predictors of new HF diagnosis.

20 Article Characterization of lipoprotein profiles in patients with hypertriglyceridemic Fredrickson-Levy and Lees dyslipidemia phenotypes: the Very Large Database of Lipids Studies 6 and 7. 2019

Quispe, Renato / Hendrani, Aditya D / Baradaran-Noveiry, Behnoud / Martin, Seth S / Brown, Emily / Kulkarni, Krishnaji R / Banach, Maciej / Toth, Peter P / Brinton, Eliot A / Jones, Steven R / Joshi, Parag H. ·Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA. · Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY, USA. · Louisiana State University Health Science Center-Shreveport, LA, USA. · Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA. · Center for Inherited Heart Disease, Johns Hopkins Hospital, Baltimore, MD, USA. · VAP Diagnostics Laboratory, Birmingham, AL, USA. · Department of Hypertension, Medical University of Lodz, Lodz, Poland. · Department of Preventive Cardiology, CGH Medical Center, Sterling, IL, USA. · Department of Family and Community Medicine, University of Illinois College of Medicine, Peoria, IL, USA. · Utah Lipid Center, Salt Lake City, UT, USA. · Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA. ·Arch Med Sci · Pubmed #31572464.

ABSTRACT: Introduction: The association between triglycerides (TG) and cardiovascular diseases is complex. The classification of hypertriglyceridemic (HTG) phenotypes proposed by Fredrickson, Levy and Lees (FLL) helps inform treatment strategies. We aimed to describe levels of several lipoprotein variables from individuals with HTG FLL phenotypes from the Very Large Database of Lipids. Material and methods: We included fasting samples from 979,539 individuals from a contemporary large study population of US adults. Lipids were directly measured by density-gradient ultracentrifugation using the Vertical Auto Profile test while TG levels were measured in whole plasma using the Abbott ARCHITECT C-8000 system. Hyperchylomicronemic (Hyper-CM) and non-chylomicronemic (non-CM) phenotypes were defined using computationally derived models. Individuals with FLL type IIa phenotype were excluded. Distributions of lipid variables were compared using medians and Kruskal-Wallis test. Results: A total of 11.9% ( Conclusions: This observational hypothesis-generating study provides insight into the complexity of lipid metabolism in HTG phenotypes, including less traditional lipid measures such as LDL density, HDL subclasses and Lp(a)-C.

21 Article Cardiovascular risk factors among Ghanaian patients with HIV: A cross-sectional study. 2019

Appiah, Lambert T / Sarfo, Fred S / Huffman, Mark D / Nguah, Samuel B / Stiles, Jonathan K. ·Komfo Anokye Teaching Hospital, Kumasi, Ghana. · Kwame Nkrumah University of Science & Technology, School of Medicine and Dentistry, Kumasi, Ghana. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · The George Institute for Global Health, Sydney, Australia. · Morehouse School of Medicine, Atlanta, Georgia. ·Clin Cardiol · Pubmed #31571256.

ABSTRACT: BACKGROUND: Cardiovascular disease (CVD) poses a significant cause of morbidity and mortality among people living with human immunodeficiency virus (HIV). However, data are limited on CVD risk burden among HIV patients in Ghana. We describe the age- and sex-adjusted prevalence of CVD risk factors among HIV patients in Ghana. METHODS: From January 2013 to May 2014, we identified eligible HIV patients 18 years and older, as well as uninfected adult blood donors presenting to the Komfo Anokye Teaching Hospital as controls. Using a standardized protocol, we collected demographic, clinical, laboratory, and electrocardiographic data. We created multivariable logistic regression models to compare the prevalence of abnormal risk factors between the two groups. RESULTS: We recruited 345 patients with HIV (n = 173 on HAART, n = 172 not on HAART) and 161 uninfected adult blood donors. Patients with HIV were older (mean [SD] age: 41 [11] vs 32 [11] years) and were more likely to be female (72% vs 28%) than blood donors. Among patients on HAART, median (interquartile range) treatment duration was 17 (4-52) months. The prevalence of hypertension, hypercholesterolemia, and diabetes mellitus among HIV patients was 9%, 29%, and 5%, respectively, compared with 5%, 15%, and 0.6% among uninfected blood donors. Smoking was the least prevalent CVD risk factor (1%-2%). After adjustment for age, sex, and body mass index, HIV patients had a 10-fold higher odds of prevalent diabetes compared with controls, (adjusted OR = 10.3 [95% CI: 1.2, 86.7]). CONCLUSION: CVD risk factors are common among HIV patients in Ghana, demonstrating the urgent need for creation and implementation of strategic CVD interventions.

22 Article Diabetic Ketoacidosis and the Domino Effect. 2018

Shaikh, Bilal H / Sohaib, Muneebah / Alshantti, Raeda / Barrera, Francisco / Faridi, Farah S / Murvelashvili, Natia. ·Department of Internal Medicine, Presence Saint Francis Hospital, Evanston, IL, USA. ·Am J Case Rep · Pubmed #30413682.

ABSTRACT: BACKGROUND Severe hypertriglyceridemia is a well-known cause of acute pancreatitis. Mild elevations of triglyceride levels are common in patients presenting with diabetic ketoacidosis (DKA). Rarely, DKA can be accompanied by an elevation of serum triglyceride level severe enough to lead to AP. CASE REPORT We report one such case of a young diabetic male who presented with DKA that was complicated by hypertriglyceridemia-induced acute pancreatitis (HTGAP). We were able to treat the condition with a slightly prolonged infusion of intravenous (IV) regular insulin in an efficient and cost-effective manner with a good outcome. CONCLUSIONS From our experience, DKA-associated HTGAP can be rapidly, efficiently, and cost-effectively treated with IV regular insulin and close biochemical monitoring. A high index of suspicion for acute pancreatitis is necessary in patients with DKA, especially with co-existing hypertriglyceridemia; and all efforts should be made to diagnose it in a timely manner to prevent subsequent complications.

23 Article Familial chylomicronemia syndrome: Bringing to life dietary recommendations throughout the life span. 2018

Williams, Lauren / Rhodes, Katherine S / Karmally, Wahida / Welstead, Lori A / Alexander, Lori / Sutton, Lindsey / Anonymous3580948. ·Risk Evaluation to Achieve Cardiovascular Health (REACH) Clinic, Cook Children's Endocrinology Clinic, Fort Worth, TX, USA. Electronic address: lauren.williams2@cookchildrens.org. · Cardiovascular Medicine, Michigan Medicine, Ann Arbor, Michigan, USA. · Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA. · Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medicine, Chicago, IL, USA. · ENCORE Lipid Center of Excellence, Jacksonville Center for Clinical Research, Jacksonville, FL, USA. · FCS Foundation, San Diego, CA, USA. ·J Clin Lipidol · Pubmed #29804909.

ABSTRACT: BACKGROUND: Familial chylomicronemia syndrome (FCS) is a rare autosomal recessive disorder with loss of function mutations of lipoprotein lipase resulting in hypertriglyceridemia and accumulation of chylomicrons in plasma, often leading to acute pancreatitis. The mainstay of treatment is a specialized very-low-fat diet. Even adhering to the diet, some patients may experience high triglycerides and pancreatitis. There currently are no comprehensive dietary guidelines. OBJECTIVE: To report best practices and develop comprehensive dietary guidelines for nutrition therapy in patients with FCS. METHODS: Registered dietitian nutritionists (RDNs) convened to develop this report based on experience treating patients with FCS and a review of current literature on the topic. One author provided a patient perspective of living with FCS. RESULTS: This report provides guidelines and rationales for nutrition therapy associated with FCS across the life span. The top global guidelines are to (1) limit fat to <15 to 20 g per day (<10%-15% of total daily energy intake); (2) meet recommendations for essential fatty acids: α-linolenic acid and linoleic acid; (3) choose complex carbohydrate foods while limiting simple and refined carbohydrate foods; (4) supplement with fat-soluble vitamins, minerals, and medium-chain triglyceride oil, as needed; (5) adjust calories for weight management. Recommended foods include vegetables, whole grains, legumes, lean protein foods, fruits in limited amounts, and fat-free milk products without added sugars. Foods to avoid include alcohol and products high in sugar. CONCLUSIONS: These patient-centered nutrition guidelines provide guidance to help patients adhere to the recommended diet and optimize nutritional needs.

24 Article The burden of familial chylomicronemia syndrome: Results from the global IN-FOCUS study. 2018

Davidson, Michael / Stevenson, Michael / Hsieh, Andrew / Ahmad, Zahid / Roeters van Lennep, Jeanine / Crowson, Caroline / Witztum, Joseph L. ·Department of Medicine, University of Chicago, Chicago, IL, USA. Electronic address: mdavidso@bsd.uchicago.edu. · Akcea Therapeutics, Cambridge, MA, USA. · Division of Nutrition and Metabolic Disease, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands. · Trinity Partners, Waltham, MA, USA. · Division of Endocrinology and Metabolism, Department of Medicine, University of California San Diego, La Jolla, CA, USA. ·J Clin Lipidol · Pubmed #29784572.

ABSTRACT: BACKGROUND: Familial chylomicronemia syndrome (FCS) is a rare genetic disorder characterized by a deficiency of lipoprotein lipase leading to extreme hypertriglyceridemia. Patients' burden of illness and quality of life have been poorly addressed in the literature. OBJECTIVE: To understand the ways in which FCS impacts patients' lives. METHODS: Investigation of Findings and Observations Captured in Burden of Illness Survey (IN-FOCUS) was a global web-based survey open to patients with FCS. Survey questions captured information on diagnostic experience, symptoms, comorbidities, disease management, and impact on multiple life dimensions. RESULTS: Of 166 patients in 10 countries, 62% were from the United States and 70% were male. Median age at the time of the survey was 33 years, and median age at diagnosis was 9 years. Patients saw a mean of 5 physicians from different specialties before their FCS diagnosis and experienced multiple physical, emotional, and cognitive symptoms on a daily to monthly basis; 40% were admitted to the hospital in the past year. A lifetime mean of 13 episodes occurred in the 40% of patients with FCS-related acute pancreatitis. Most patients (>90%) found managing fat intake to be difficult, and 53% experienced symptoms despite adherence to their diets. FCS impacted employment status (94%), emotional/mental well-being (58%-66%), and social relationships (68%-82%). CONCLUSIONS: Patients with FCS experience significant clinical and psychosocial burdens that reduce their quality of life and limit employment and social interactions. Increased awareness among healthcare professionals of the multifaceted nature of the FCS disease burden may help expedite diagnosis and timely institution of treatment and broaden management considerations.

25 Article Triglyceride-rich lipoprotein cholesterol (TRL-C): the ugly stepsister of LDL-C. 2018

Davidson, Michael H. ·Professor, Director of the Lipid Clinic, The University of Chicago Pritzker School of Medicine, 150 E. Huron Chicago, IL 600611, USA. ·Eur Heart J · Pubmed #29342252.

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