Guest guest Posted May 3, 2007 Report Share Posted May 3, 2007 This article is part of the following , and this The new data show that LDL levels above 130 mg/dL are not the chief concern. Less than one-quarter of 136,905 patients hospitalized for CAD in January 2000-April 2006 at 541 U.S. hospitals participating in the quality improvement initiative had an LDL above 130 mg/dL. Just under 18% had an LDL below 70 mg/dL. On the other hand, fewer than 8% had an HDL greater than 60 mg/dL. And a mere 1.4% had the ideal lipid profile of an LDL below 70 mg/dL plus an HDL greater than 60 mg/dL, Dr. Gregg C. Fonarow reported at the annual meeting of the American College of Cardiology. These registry data strengthen support for the recent National Cholesterol Education Program guideline revision creating an optional, more aggressive LDL target of less than 70 mg/dL, he added. Of patients admitted for CAD, 79% had an acute coronary syndrome (ACS). Only 21% of the total patient population was lipid-lowering therapy prior to admission. The mean age of the patients was 65 years; 80% were white, 32% had diabetes, 63% were men, 33% were smokers, 20% had had a prior MI, and nearly 7% had a history of stroke. Mean lipid values recorded within the first 24 hours of hospitalization for CAD were 105 mg/dL for LDL, 40 mg/dL for HDL, and 161 mg/dL for triglycerides, although lipid levels during an ACS are probably lower than baseline chronic levels, said Dr. Fonarow, professor of medicine at the University of California, Los Angeles, and director of the Ahmanson-UCLA Cardiomyopathy Center. Mean LDL, HDL, and triglycerides at admission declined over the study period. Discussant Dr. H. Stein called the Get With the Guidelines report an invaluable snapshot of how patients with ACS are presenting at a wide range of U.S. hospitals. It's a picture that contains surprises. " We often hear messages that we're not getting LDLs to target, but this shows we actually are, " observed Dr. Stein, associate professor of medicine and director of the vascular health screening program at the University of Wisconsin Hospital and Clinics, Madison. But getting LDL down to a target of 100 mg/dL just isn't good enough to guarantee cardiovascular protection, because one-half of patients with an ACS had an LDL below that value, he added. Many patients with an LDL below 100 mg/dL also had low HDL, suggesting the importance of combining LDL-lowering with HDL-raising as a preventive strategy. " The small studies that have combined niacin with statins or resins have the greatest relative risk reduction, " Dr. Stein said. The key lesson provided by the Get With the Guidelines database is that it takes more factors than an LDL of less than 100 mg/dL to prevent coronary events. " People still have ACS at that level, so we need to do more. We can lower it further. We can raise HDL. We can work on the predictors of these abnormalities by helping people lose weight and avoid diabetes and treat dyslipidemia more aggressively, " the cardiologist concluded. New Report from the American heart Asociation's " Get With the Guidelines Program " doi:10.1016/S1097-8690(07)70432-8 See Diabetes In Control latest newsletter visit our Search Diabetes In Control Browse our other news categories below. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | http://www.diabetesincontrol.com/aserver/adclick.php?n=ada6a766 New Product Visit our New Products Section Special Offers http://www.diabetesincontrol.com/aserver/adclick.php?n=a989bec4 Free CE Available CE Programs On Diabetes Available Shop Amazon Shop Amazon, courtesy of Diabetes In Control, for the best selection of Diabetes related books and merchandise. Just one click, and you can save on all of Amazon''s products. / / / For Advertising: Flash movie end Print The Newsletter Print This Weeks Newsletter Here Newsletter is in Adobe format If you don't have Adobe Acrobat Reader, you can download it for Free here. Adobe format click here. acrobat/readstep Special Offers aserver/adview This article is part of the following Newsletter , and this Category LDL Under 100 Not Low Enough: and HDL of 60 Gains Support Fully half of U.S. patients hospitalized for coronary artery disease now have an LDL cholesterol level of 100 mg/dL or less on admission. The new data show that LDL levels above 130 mg/dL are not the chief concern. Less than one-quarter of 136,905 patients hospitalized for CAD in January 2000-April 2006 at 541 U.S. hospitals participating in the quality improvement initiative had an LDL above 130 mg/dL. Just under 18% had an LDL below 70 mg/dL. On the other hand, fewer than 8% had an HDL greater than 60 mg/dL. And a mere 1.4% had the ideal lipid profile of an LDL below 70 mg/dL plus an HDL greater than 60 mg/dL, Dr. Gregg C. Fonarow reported at the annual meeting of the American College of Cardiology. These registry data strengthen support for the recent National Cholesterol Education Program guideline revision creating an optional, more aggressive LDL target of less than 70 mg/dL, he added. Of patients admitted for CAD, 79% had an acute coronary syndrome (ACS). Only 21% of the total patient population was lipid-lowering therapy prior to admission. The mean age of the patients was 65 years; 80% were white, 32% had diabetes, 63% were men, 33% were smokers, 20% had had a prior MI, and nearly 7% had a history of stroke. Mean lipid values recorded within the first 24 hours of hospitalization for CAD were 105 mg/dL for LDL, 40 mg/dL for HDL, and 161 mg/dL for triglycerides, although lipid levels during an ACS are probably lower than baseline chronic levels, said Dr. Fonarow, professor of medicine at the University of California, Los Angeles, and director of the Ahmanson-UCLA Cardiomyopathy Center. Mean LDL, HDL, and triglycerides at admission declined over the study period. Discussant Dr. H. Stein called the Get With the Guidelines report an invaluable snapshot of how patients with ACS are presenting at a wide range of U.S. hospitals. It's a picture that contains surprises. " We often hear messages that we're not getting LDLs to target, but this shows we actually are, " observed Dr. Stein, associate professor of medicine and director of the vascular health screening program at the University of Wisconsin Hospital and Clinics, Madison. But getting LDL down to a target of 100 mg/dL just isn't good enough to guarantee cardiovascular protection, because one-half of patients with an ACS had an LDL below that value, he added. Many patients with an LDL below 100 mg/dL also had low HDL, suggesting the importance of combining LDL-lowering with HDL-raising as a preventive strategy. " The small studies that have combined niacin with statins or resins have the greatest relative risk reduction, " Dr. Stein said. The key lesson provided by the Get With the Guidelines database is that it takes more factors than an LDL of less than 100 mg/dL to prevent coronary events. " People still have ACS at that level, so we need to do more. We can lower it further. We can raise HDL. We can work on the predictors of these abnormalities by helping people lose weight and avoid diabetes and treat dyslipidemia more aggressively, " the cardiologist concluded. New Report from the American heart Asociation's " Get With the Guidelines Program " doi:10.1016/S1097-8690(07)70432-8 Article Options Print Print Send to Friend Send to friend This article is part of the following Newsletter This article is also part of the following Category See Diabetes In Control latest newsletter visit our home page. Search Diabetes In Control table with 2 columns and 2 rows Article Title: Article Description: table end Search Browse our other news categories below. A. Lee Dellon, MD | Beverly Price | Birgitta I. Rice, MS | Did You Know | Dr. Bernstein | Dr. Jakes, Jr. | Dr. Varon, DDS | Dr. Fred Pescatore | Dr. Walter Willett | Education | S. Freedland | Evan D. Rosen | Facts | Features | Ginger Kanzer- | Items for the Week | , MD | ph M. Caporusso | a Sandstedt | Plunkett | Leonard Lipson, M.A. | Lester A. Packer | Diane | New Products | Newsflash | Chous, M.A., OD | Philip A. Wood PhD | R. | Sheri R. Colberg PhD | Sherri Shafer | Steve Pohlit | Studies | Test Your Knowledge | Theresa L. Garnero | Tools | Vickie R. Driver | Looking for a particular Newsletter Issue? Click Here Patients are Seeking Physicians If you are a physician, nurse practitioner, physician assistant or a diabetes educator working with a physician who supports the concept that diabetics are entitled to the same blood sugars as non-diabetics and the treatments advocated in DIABETES SOLUTION, and would like referrals, read more... Free Newsletter Not Subscribed? Get the FREE Diabetes In Control Newsletter today. Click Here Special Offers aserver/adview New Product Visit our New Products Section Special Offers aserver/adview Free CE Available CE Programs On Diabetes Available Shop Amazon Shop Amazon, courtesy of Diabetes In Control, for the best selection of Diabetes related books and merchandise. Just one click, and you can save on all of Amazon''s products. Click here Special Offers aserver/adview Jump To: Home | Advertising | All News Categories | Classifieds | Downloads | Education | Features | Feedback | Items of the Week | Links | Most Recent Additions | New Products | NewsFeed | Past Newsletters | Recommend Us | Search | Studies | Subscribe | Test Your Knowledge | This Week's Newsletter | Tools For Your Practice | Writers Archives | Go Way Back Privacy / About DIC / Advertising With Us / Contact DIC aserver/adview Falk AdSolution For Advertising: images/gnm_logo_1 Copyright @ 1999-2006 Diabetes In Control, Inc.. All rights reserved. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.