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Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, and myocardial infarction.
Cholesterol is the principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils.
Low-density lipoprotein (LDL) is one of the five major groups of lipoprotein that transport all fat molecules around the body in extracellular water. These groups, from least dense to most dense, are chylomicrons, very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL delivers fat molecules to cells. LDL is involved in atherosclerosis, a process in which it is oxidized within the walls of arteries.
Atherosclerosis is a pattern of the disease arteriosclerosis, characterized by development of abnormalities called lesions in walls of arteries. These lesions may lead to narrowing of the arterial walls due to buildup of atheromatous plaques. At onset there are usually no symptoms, but if they develop, symptoms generally begin around middle age. In severe cases, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney disorders, depending on which body parts(s) the affected arteries are located in the body.
Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications that reduce illness and mortality in those who are at high risk of cardiovascular disease. They are the most commonly prescribed cholesterol-lowering drugs.
The Scandinavian Simvastatin Survival Study, was a multicentre, randomized, double-blind, placebo-controlled clinical trial, which provided the initial data that supported the use of the cholesterol-lowering drug, simvastatin, in people with a moderately raised cholesterol and coronary heart disease (CHD); that is people who had previously had a heart attack or angina. The study was sponsored by the pharmaceutical company Merck and enrolled 4,444 people from 94 centres in Scandinavia.
Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.
Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. It is a form of hyperlipidemia, hyperlipoproteinemia, and dyslipidemia.
Dyslipidemia is a metabolic disorder characterized by abnormally high or low amounts of any or all lipids or lipoproteins in the blood. Dyslipidemia is a risk factor for the development of atherosclerotic cardiovascular diseases (ASCVD), which include coronary artery disease, cerebrovascular disease, and peripheral artery disease. Although dyslipidemia is a risk factor for ASCVD, abnormal levels don't mean that lipid lowering agents need to be started. Other factors, such as comorbid conditions and lifestyle in addition to dyslipidemia, is considered in a cardiovascular risk assessment. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood. This is often due to diet and lifestyle. Prolonged elevation of insulin resistance can also lead to dyslipidemia. Likewise, increased levels of O-GlcNAc transferase (OGT) may cause dyslipidemia.
The Heart Protection Study was a randomized controlled trial run by the Clinical Trial Service Unit, and funded by the Medical Research Council (MRC) and the British Heart Foundation (BHF) in the United Kingdom. It studied the use of the cholesterol lowering drug, simvastatin 40 mg and vitamin supplementation in people who were at risk of cardiovascular disease. It was led by Jane Armitage, an epidemiologist at the Clinical Trial Service Unit.
Atorvastatin, sold under the brand name Lipitor among others, is a statin medication used to prevent cardiovascular disease in those at high risk and to treat abnormal lipid levels. For the prevention of cardiovascular disease, statins are a first-line treatment. It is taken by mouth.
Simvastatin, sold under the brand name Zocor among others, is a statin, a type of lipid-lowering medication. It is used along with exercise, diet, and weight loss to decrease elevated lipid levels. It is also used to decrease the risk of heart problems in those at high risk. It is taken by mouth.
Pravastatin, sold under the brand name Pravachol among others, is a statin medication, used for preventing cardiovascular disease in those at high risk and treating abnormal lipids. It is suggested to be used together with diet changes, exercise, and weight loss. It is taken by mouth.
Ticagrelor, sold under the brand name Brilinta among others, is a medication used for the prevention of stroke, heart attack and other events in people with acute coronary syndrome, meaning problems with blood supply in the coronary arteries. It acts as a platelet aggregation inhibitor by antagonising the P2Y12 receptor. The drug is produced by AstraZeneca.
The JUPITER trial was a clinical trial aimed at evaluating whether statins reduce heart attacks and strokes in people with normal cholesterol levels.
Professor James Shepherd FMedSci (1944–2022) is a world-leading pioneer in the investigation of the causes, prevention and treatment of coronary heart disease.
Kinesin family member 6 is a protein that in humans is encoded by the KIF6 gene. This gene encodes a member of the kinesin family of proteins. Members of this family are part of a multisubunit complex that functions as a microtubule motor in intracellular organelle transport.
Dr. Robert S. Rosenson is a Professor of Medicine and also lending his services as the Director of cardio metabolic disorders at the Icahn School of Medicine at Mount Sinai.
The Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis in Myocardial Infarction 22 trial, also known as PROVE-IT TIMI 22, was a randomized, double-blind, clinical trial that recruited 4,162 people admitted within 10 days of an acute coronary event and randomised them to the lipid-lowering drugs pravastatin (40 mg) or atorvastatin (80 mg) and a 10-day course of the antibiotic gatifloxacin or placebo. The participants enrolled at 349 sites across Australia, Europe, and North America between November 2000 and December 2001, and the study concluded that statin treatment for secondary prevention reduced coronary heart disease (CHD) events and that atorvastatin had a more marked effect than pravastatin. The study was published in The New England Journal of Medicine and reported at the American College of Cardiology Annual Scientific Session in 2004.
Fenofibrate/pravastatin, sold under the brand name Pravafenix, is a combination medication for the treatment of hypercholesterolemia in adults whose low-density lipoprotein (LDL) cholesterol is already being controlled with pravastatin alone but who still need to improve their cholesterol levels and to reduce their levels of triglycerides. It contains fenofibrate and pravastatin. It is taken by mouth.
References
- ↑ Shepherd, James; Cobbe, Stuart M.; Ford, Ian; Isles, Christopher G.; Lorimer, A. Ross; Macfarlane, Peter W.; McKillop, James H.; Packard, Christopher J. (16 November 1995). "Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia". New England Journal of Medicine. 333 (20): 1301–1308. doi: 10.1056/NEJM199511163332001 . PMID 7566020.
- ↑ Myat, Aung; Gershlick, A. H.; Gershlick, Tony (2012). Landmark Papers in Cardiovascular Medicine. Oxford University Press. p. 32. ISBN 978-0-19-959476-4.
- ↑ "The West of Scotland Coronary Prevention Study: Long-Term Results". Medscape. Retrieved 7 April 2020.
- ↑ Kashef, Mohammed Amin; Giugliano, Gregory (2017). "Legacy effect of statins: 20-year follow up of the West of Scotland Coronary Prevention Study (WOSCOPS)". Global Cardiology Science & Practice. 2016 (4): e201635. doi:10.21542/gcsp.2016.35. ISSN 2305-7823. PMC 5624184 . PMID 28979904.
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