Assessment of post-myocardial infarction lipid levels and management:Results from a tertiary care hospital of Pakistan

BACKGROUND Lipid treatment practices and levels in post-acute myocardial infarction(AMI)patients,which are crucial for secondary prevention.AIM To evaluate the lipid treatment practices and lipid levels in post-myocardial infarction(MI)patients at a tertiary care hospital in Pakistan.METHODS In this cross-sectional study,we analyzed patients who had experienced their first AMI event in the past 3 years.We assessed fasting and non-fasting lipid profiles,reviewed statin therapy prescriptions,and examined patient compliance.The recommended dose was defined as rosuvastatin≥20 mg or atorvastatin≥40 mg,with target total cholesterol levels set at<160 mg/dL and target low-density lipoprotein cholesterol(LDL-C)at<55 mg/dL.RESULTS Among 195 patients,71.3%were male,and the mean age was 57.1±10.2 years.The median duration since AMI was 36(interquartile range:10-48)months and 60% were diagnosed with ST-segment elevation MI.Only 13.8% of patients were advised to undergo lipid profile testing after AMI,88.7% of patients were on the recommended statin therapy,and 91.8% of patients were compliant with statin therapy.Only 11.5% had LDL-C within the target range and 71.7% had total cholesterol within the target range.Hospital admission in the past 12 months was reported by 14.4%,and the readmission rate was significantly higher among non-compliant patients(37.5%vs 5.6%).Subsequent AMI event rate was also significantly higher among non-compliant patients(43.8%vs 11.7%).CONCLUSION Our study highlights that while most post-AMI patients received the recommended minimum statin therapy dose,the inadequate practice of lipid assessment may compromise therapy optimization and raise the risk of subsequent events.

Plasma apo CⅢ Levels in Relation to Inflammatory Traits and Metabolic Syndrome in Patients not Treated with Lipid-lowering Drugs Undergoing Coronary Angiography

Objective Assessment of the comprehensive relationship among apolipoprotein CIII（apoCⅢ） levels, inflammation, and metabolic disorders is rare. Methods A total of 1455 consecutive patients not treated with lipid-lowering drugs and undergoing coronary angiography were enrolled in this cross-sectional study. A mediation analysis was used to detect the underlying role of apoCⅢ in the association of inflammation with metabolic syndrome（MetS）. Results Patients with MetS showed higher levels of apoCⅢ [95.1（73.1-131.4） vs. 81.7（58.6-112.4） μg/mL, P 〈 0.001] and inflammatory markers [high sensitivity C-reactive protein, 1.7（0.8-3.4） vs. 1.1（0.5-2.2） mg/L; white blood cell count,（6.48 ± 1.68） vs.（6.11 ± 1.67） × 10~9/L]. The levels of apoCⅢ and inflammatory markers increased with the number of metabolic risk components（all P 〈 0.001）. Furthermore, apoCⅢ levels were associated with virtually all individual MetS risk factors and inflammatory markers（all P 〈 0.05）. Importantly, the prevalence of MetS in each metabolic disorder rose as apoCⅢ levels increased（all P 〈 0.05）. Mediation analysis showed that apoCⅢ partially mediated the effect of inflammation on MetS independently from triglycerides. Conclusion Plasma apoCⅢ levels were significantly associated with the development and severity of MetS, and a role of apoCⅢ in the effect of inflammation on the development of MetS was identified.

脉平片药效学研究

目的观察脉平片抗血栓、降脂、耐缺氧的药理作用。方法通过测定脉平片对实验性大鼠血栓模型血栓形成时间的影响,观察其抗血栓作用;建立大鼠高脂血症病理模型,观察脉平片的降脂作用;通过小鼠耐缺氧实验,观察脉平片的耐缺氧作用。结果脉平片3个剂量组均能够延长小鼠凝血时间,明显延长血浆凝血酶原时间、凝血酶原消耗时间及白陶土部分凝血活酶时间;脉平片高剂量组能够明显降低血清总胆固醇及三酰甘油含量,提高高密度脂蛋白胆固醇含量;脉平片3个剂量组常压下均能够提高小鼠低氧条件下的生存能力。结论脉平片有较好的抗凝、降脂及耐缺氧作用。

A randomized clinical efficacy trial of Hehui capsule against hyperlipidemia

Hehui capsule(Hhc)has been used as an assistant treatment for hyperlipidemia.According to the previous studies,miltiorrhiza and Chavica roxburghii may reduce the serum lipid level.This study aims at examining the efficiency of Hehui capsule with regards to treating hyperlipidemia in a randomized control,double-blind clinical trial.In the research,we assigned 104 eligible subjects to Hehui capsule group and placebo groups(52:52,respectively).Subjects used self-control and inter-group controls to compare serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL)and other changes before and after the test group and the test group and the control group.During the 45 days intervention,101 cases were actually included,among which 51 cases for test group,and other 50 cases for placebo group.The total effective rate of blood lipid reduction(90.20%)in the test group was significantly higher than that in the control group(26.00%)(P<0.01).Together,the result indicates that Hhc has a certain curative effect on dyslipidemia,with no obvious adverse reactions,which can be developed into a new drug for hyperlipidemia.

RNAi technique, how far is it from pediatrics?

The new technology of ribonucleic acid interference(RNAi)or small/short interfering RNA(siRNA)can be used to reduce expression of genes in a sequence specific manner,and thereby can treat various diseases caused by expression or overexpression of genes.Phase 1 and phase 2 clinical studies on application of this technology to treat diseases have demonstrated efficacy and safety of this approach in a few specialties/subspecialties.However,no clinical trials have been reported in the fields of pediatrics.This article aimed to describe very briefly what the RNAi technique is,examples of demonstration of the efficacy and safety of RNAi techniques in a few different fields of clinical medicine,and to encourage pediatricians and pediatric researchers to actively participate in studies on this new therapeutic approach for treatment of various pediatric diseases.