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Costa, Carlos Alberto de Souza
Texto completo SciELO Brasil
[PMID]:29267665
[Au] Autor:Leite MLAES; Soares DG; Basso FG; Hebling J; Costa CAS
[Ad] Endereço:Universidade Estadual Paulista "Júlio de Mesquita Filho" - Unesp, School of Dentistry, Department of Dental Materials and Prosthodontics, Araraquara, SP, Brazil.
[Ti] Título:Biostimulatory effects of simvastatin on MDPC-23 odontoblast-like cells.
[So] Source:Braz Oral Res;31:e104, 2017 Dec 18.
[Is] ISSN:1807-3107
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to evaluate the bioactivity and cytocompatibility of simvastatin (SV) applied to MDPC-23 odontoblast-like cells. For this purpose, MDPC-23 cells were seeded in 96-well plates and submitted to treatments with 0.01 or 0.1 µM of SV for 24 h, 72 h or continuously throughout the experimental protocol. The negative control group (NC) was maintained in DMEM. Cell viability (MTT), ALP activity (thymolphthalein monophosphate), and mineralized matrix deposition (alizarin red) were analyzed at several time points. The data were submitted to ANOVA and Tukey's test (α = 0.05). Although cell viability was observed in the groups treated with SV, these groups did not differ from the NC up to 7 days. There was a reduction in cell viability for the groups treated with 0.1 µM of SV for 72 h, and submitted to continuous mode after 14 days. A significant increase in ALP activity occurred in the group treated with 0.01 µM of SV for 24 h, compared with the NC; however, only the group treated with 0.1 µM of SV in continuous mode reduced the ALP activity, in comparison with the NC. After 14 days, only continuous treatment with 0.1 µM of SV did not differ from NC, whereas the other experimental groups showed increased mineralized matrix deposition. Thus, it was concluded that low concentrations of simvastatin were bioactive and cytocompatible when applied for short periods to cultured MDPC-23 odontoblast-like cells.
[Mh] Termos MeSH primário: Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia
Odontoblastos/efeitos dos fármacos
Sinvastatina/farmacologia
[Mh] Termos MeSH secundário: Animais
Antraquinonas
Linhagem Celular
Sobrevivência Celular/efeitos dos fármacos
Ratos
Valores de Referência
Timolftaleína/análogos & derivados
Timolftaleína/análise
Fatores de Tempo
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anthraquinones); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 17016-43-2 (thymolphthalein monophosphate); 60MEW57T9G (alizarin); AGG2FN16EV (Simvastatin); YG5I28WSQP (Thymolphthalein)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:28468836
[Au] Autor:Yoshikado T; Toshimoto K; Nakada T; Ikejiri K; Kusuhara H; Maeda K; Sugiyama Y
[Ad] Endereço:Sugiyama Laboratory, RIKEN Innovation Center, RIKEN, Kanagawa, Japan (T.Y., K.T., Y.S.); DMPK Research Laboratories Sohyaku, Innovative Research Division, Mitsubishi Tanabe Pharma, Saitama, Japan (T.N.); and Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Sciences, Univer
[Ti] Título:Comparison of Methods for Estimating Unbound Intracellular-to-Medium Concentration Ratios in Rat and Human Hepatocytes Using Statins.
[So] Source:Drug Metab Dispos;45(7):779-789, 2017 Jul.
[Is] ISSN:1521-009X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:It is essential to estimate concentrations of unbound drugs inside the hepatocytes to predict hepatic clearance, efficacy, and toxicity of the drugs. The present study was undertaken to compare predictability of the unbound hepatocyte-to-medium concentration ratios (K ) by two methods based on the steady-state cell-to-medium total concentration ratios at 37°C and on ice (K ) and based on their initial uptake rates (K ). Poorly metabolized statins were used as test drugs because of their concentrative uptake via organic anion-transporting polypeptides. K values of these statins provided less interexperimental variation than the K values, because only data at longer time are required for K K values for pitavastatin, rosuvastatin, and pravastatin were 1.2- to 5.1-fold K in rat hepatocytes; K values in human hepatocytes also tended to be larger than corresponding K To explain these discrepancies, theoretical values of K and K were compared with true K (K ), considering the inside-negative membrane potential and ionization of the drugs in hepatocytes and medium. Membrane potentials were approximately -30 mV in human hepatocytes at 37°C and almost abolished on ice. Theoretical equations considering the membrane potentials indicate that K values for the statins are 0.85- to 1.2-fold K , whereas K values are 2.2- to 3.1-fold K , depending on the ratio of the passive permeability of the ionized to nonionized forms. In conclusion, K values of anions are similar to K when the inside-negative membrane potential is considered. This suggests that K is preferable for estimating the concentration of unbound drugs inside the hepatocytes.
[Mh] Termos MeSH primário: Hepatócitos/metabolismo
Inibidores de Hidroximetilglutaril-CoA Redutases/metabolismo
[Mh] Termos MeSH secundário: Animais
Transporte Biológico/fisiologia
Seres Humanos
Fígado/metabolismo
Masculino
Potenciais da Membrana/fisiologia
Transportadores de Ânions Orgânicos/metabolismo
Permeabilidade
Pravastatina/metabolismo
Quinolinas/metabolismo
Ratos
Ratos Sprague-Dawley
Rosuvastatina Cálcica/metabolismo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Organic Anion Transporters); 0 (Quinolines); 83MVU38M7Q (Rosuvastatin Calcium); KXO2KT9N0G (Pravastatin); M5681Q5F9P (pitavastatin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1124/dmd.116.074823


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[PMID]:29397593
[Au] Autor:Committee of Cardio-Cerebro-Vascular Diseases of Gerontological Society of China; Working Group of Chinese Expert Consensus on the Use of Xuezhikang
[Ti] Título:[Chinese expert consensus on the use of Xuezhikang (2017 revised edition)].
[So] Source:Zhonghua Nei Ke Za Zhi;57(2):97-100, 2018 Feb 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Xuezhikang, a Chinese traditional medicine, contains natural statin and is effective on dyslipidemia by inhibiting cholesterol synthesis. Xuezhikang therapy for 8 weeks in patients with hyperlipidemia reduced total cholesterol (TC) by 23%, low density lipoprotein cholesterol (LDL-C) by 28.5% and triglyceride(TG) by 36.5%, and increased high density lipoprotein cholesterol (HDL-C) by 19.6%, respectively. Data from China Coronary Secondary Prevention Study (CCSPS) showed that treatment with Xuezhikang lowered the risks of major coronary events, death from coronary heart disease, and all cause death in patients with myocardial infarction, indicating that Xuezhikang can be used in the primary and secondary prevention of cardiovascular disease.
[Mh] Termos MeSH primário: Consenso
Medicamentos de Ervas Chinesas/uso terapêutico
Dislipidemias/tratamento farmacológico
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
[Mh] Termos MeSH secundário: Grupo com Ancestrais do Continente Asiático
Causas de Morte
China
LDL-Colesterol
Seres Humanos
Infarto do Miocárdio
Prevenção Secundária
Triglicerídeos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cholesterol, LDL); 0 (Drugs, Chinese Herbal); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Triglycerides); 0 (xuezhikang)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2018.02.003


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[PMID]:29220566
[Au] Autor:Couillard K
[Ti] Título:Statines. Un nouveau calcul du risque d'événements cardiovasculaires pour mieux les prescrire..
[So] Source:Perspect Infirm;14(3):56, 2017 May-Jun.
[Is] ISSN:1708-1890
[Cp] País de publicação:Canada
[La] Idioma:fre
[Mh] Termos MeSH primário: Doenças Cardiovasculares/prevenção & controle
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
[Mh] Termos MeSH secundário: Doenças Cardiovasculares/epidemiologia
Seres Humanos
Medição de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


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[PMID]:28454732
[Au] Autor:Yang Z; Su Z; DeWitt JP; Xie L; Chen Y; Li X; Han L; Li D; Xia J; Zhang Y; Yang Y; Jin C; Zhang J; Li S; Li K; Zhang Z; Qu X; He Z; Chen Y; Shen Y; Ren M; Yuan Z
[Ad] Endereço:Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, Yunnan 650118, China. Electronic address: yangzuozhang@163.com.
[Ti] Título:Fluvastatin Prevents Lung Adenocarcinoma Bone Metastasis by Triggering Autophagy.
[So] Source:EBioMedicine;19:49-59, 2017 May.
[Is] ISSN:2352-3964
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Bone is one of the most preferred sites of metastasis in lung cancer. Currently, bisphosphonates and denosumab are major agents for controlling tumor-associated skeletal-related events (SREs). However, both bisphosphonates and denosumab significantly increase the risk for jaw osteonecrosis. Statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and the most frequently prescribed cholesterol-lowering agents, have been reported to inhibit tumor progression and induce autophagy in cancer cells. However, the effects of statin and role of autophagy by statin on bone metastasis are unknown. In this study, we report that fluvastatin effectively prevented lung adenocarcinoma bone metastasis in a nude mouse model. We further reveal that fluvastatin-induced anti-bone metastatic property was largely dependent on its ability to induce autophagy in lung adenocarcinoma cells. Atg5 or Atg7 deletion, or 3-methyadenine (3-MA) or Bafilomycin A1 (Baf A1) treatment prevented the fluvastatin-induced suppression of bone metastasis. Furthermore, we reveal that fluvastatin stimulation increased the nuclear p53 expression, and fluvastatin-induced autophagy and anti-bone metastatic activity were mostly dependent on p53.
[Mh] Termos MeSH primário: Adenocarcinoma/tratamento farmacológico
Antineoplásicos/uso terapêutico
Neoplasias Ósseas/prevenção & controle
Ácidos Graxos Monoinsaturados/uso terapêutico
Indóis/uso terapêutico
Neoplasias Pulmonares/tratamento farmacológico
[Mh] Termos MeSH secundário: Adenocarcinoma/metabolismo
Adenocarcinoma/patologia
Animais
Antineoplásicos/farmacologia
Autofagia/efeitos dos fármacos
Neoplasias Ósseas/metabolismo
Neoplasias Ósseas/secundário
Linhagem Celular Tumoral
Ácidos Graxos Monoinsaturados/farmacologia
Feminino
Seres Humanos
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Indóis/farmacologia
Neoplasias Pulmonares/metabolismo
Neoplasias Pulmonares/patologia
Camundongos Endogâmicos BALB C
Camundongos Nus
Proteína Supressora de Tumor p53/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Fatty Acids, Monounsaturated); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Indoles); 0 (Tumor Suppressor Protein p53); 4L066368AS (fluvastatin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29419393
[Au] Autor:Ford TJ; Rocchiccioli P
[Ad] Endereço:British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
[Ti] Título:A keen eye for risk.
[So] Source:BMJ;360:j5884, 2018 02 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Arco Senil/diagnóstico
Doenças da Córnea/diagnóstico
Doença da Artéria Coronariana/diagnóstico
Hiperlipoproteinemia Tipo II/diagnóstico
Receptores de LDL/genética
[Mh] Termos MeSH secundário: Anticorpos Monoclonais/administração & dosagem
Anticorpos Monoclonais/uso terapêutico
Anticolesterolemiantes/administração & dosagem
Anticolesterolemiantes/uso terapêutico
Arco Senil/etiologia
Colesterol/sangue
Doenças da Córnea/etiologia
Doença da Artéria Coronariana/complicações
Doença da Artéria Coronariana/etiologia
Feminino
Seres Humanos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Hiperlipoproteinemia Tipo II/sangue
Hiperlipoproteinemia Tipo II/tratamento farmacológico
Hiperlipoproteinemia Tipo II/genética
Injeções Subcutâneas
Meia-Idade
Mutação
Pró-Proteína Convertase 9/antagonistas & inibidores
Xantomatose/diagnóstico
Xantomatose/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Anticholesteremic Agents); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Receptors, LDL); 97C5T2UQ7J (Cholesterol); EC 3.4.21.- (PCSK9 protein, human); EC 3.4.21.- (Proprotein Convertase 9); LKC0U3A8NJ (evolocumab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5884


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[PMID]:29181932
[Au] Autor:Aambø A; Klemsdal TO
[Ti] Título:Cardiovascular disease and diabetes in patients with African or Asian background.
[Ti] Título:Kardiovaskulær sykdom og diabetes ved afrikansk eller asiatisk bakgrunn..
[So] Source:Tidsskr Nor Laegeforen;137(22), 2017 11 28.
[Is] ISSN:0807-7096
[Cp] País de publicação:Norway
[La] Idioma:eng; nor
[Ab] Resumo:BACKGROUND: Population groups of different ancestry appear to have varying prevalence of diabetes, different risks of developing cardiovascular disease and different responses to certain drugs that are used for these conditions. We wished to review the literature in this field. MATERIAL AND METHOD: We have performed searches in several databases for systematic review articles published from the year 2000 onwards, and supplemented these with articles from reference lists, our own literature archives and a pyramid search in the Norwegian Electronic Health Library database. Altogether 37 articles were included. RESULTS: With regard to diagnosed diabetes, the prevalence of coronary heart disease and stroke varies among groups of South Asian, East Asian, African and European ancestry. In patients of South Asian ancestry, the risk of coronary heart disease appears to be twice that of Europeans, and the disease occurs 5­10 years earlier. The prevalence of stroke is especially high in persons of African ancestry. Risk factors such as dyslipidemia and hypertension are distributed differently among these groups. The therapeutic response to drugs such as beta blockers, ACE inhibitors and various statins differs; for example, statin doses in Asians may often be halved in relation to those used for Caucasians, and ACE inhibitors are not recommended as monotherapy for hypertension in persons of African ancestry. These differences are partly attributable to variations in genetic disposition. INTERPRETATION: The findings are clinically significant ­ better insight in this field enables optimal tailoring of treatment for each patient, with more rapid achievement of goals and reduced risk of adverse effects. The recommendations given in this article are consistent with and complement the Directorate of Health's revised guidelines for the treatment of diabetes.
[Mh] Termos MeSH primário: Grupo com Ancestrais do Continente Africano/genética
Anti-Hipertensivos/farmacologia
Grupo com Ancestrais do Continente Asiático/genética
Doenças Cardiovasculares/etnologia
Diabetes Mellitus/etnologia
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia
[Mh] Termos MeSH secundário: Anti-Hipertensivos/administração & dosagem
Doenças Cardiovasculares/tratamento farmacológico
Doenças Cardiovasculares/epidemiologia
Diabetes Mellitus/tratamento farmacológico
Diabetes Mellitus/epidemiologia
Grupo com Ancestrais do Continente Europeu/genética
Seres Humanos
Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem
Farmacogenética
Acidente Vascular Cerebral/tratamento farmacológico
Acidente Vascular Cerebral/epidemiologia
Acidente Vascular Cerebral/etnologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.4045/tidsskr.16.0680


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[PMID]:28460645
[Au] Autor:Vangala C; Lenihan CR; Montez-Rath ME; Nair SS; Navaneethan SD; Ramanathan V; Winkelmayer WC
[Ad] Endereço:Baylor College of Medicine, Section of Nephrology, One Baylor Plaza, BCM 620 - 11D32.5, Houston, TX, 77030, USA.
[Ti] Título:Statin use and hip fractures in U.S. kidney transplant recipients.
[So] Source:BMC Nephrol;18(1):145, 2017 May 01.
[Is] ISSN:1471-2369
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Basic and translational research supports beneficial effects of statins on bone metabolism. Clinical studies suggest that statin use may reduce the risk of hip fractures in the general population. Whether statin use is associated with hip fracture risk in kidney transplant recipients, a particularly high-risk group for this outcome, is unknown. METHODS: From the U.S. Renal Data System (2007-2011), we identified all hip fracture events recorded in Medicare billing claims of first-time kidney transplant recipients. We then matched all cases to an unlimited number of controls on age (±3 years), sex, race (black vs. non-black), and time since transplant. Cases and controls were required to have >1 year of Medicare Parts A + B + D coverage and be without a recorded history of hip fracture. We ascertained any statin use in the previous year and defined adherent statin use as those who had filled prescriptions for statins to cover >80% of days in that year (proportion of days covered, PDC). We ascertained several potential confounders (demographics, comorbidities, BMI, transplant-related factors) and applied conditional logistic regression with multiple imputation for missing data to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: We identified 231 hip fracture cases (mean age 51.8 years; 53% female; 11.3% black; 6.9 years from transplant, and 9.9 years from ESRD) and 15,575 matched controls. Any prior statin use was present in 64.1% of cases and 60.3% of controls with 37.2% of cases and 33.9% of controls being found adherent. Unadjusted conditional logistic regression showed an OR of 1.17 (0.89-1.54) for any statin use, and a fully-adjusted OR of 0.89 (0.67-1.19). Compared with statin non-users, the adjusted OR for patients with lesser adherence (PDC ≤80%) and those with greater adherence (PDC >80%) were 0.93 (0.66-1.31) and 0.87 (0.63-1.20), respectively. CONCLUSION: Statin use was not associated with hip fracture risk in first-time kidney transplant recipients.
[Mh] Termos MeSH primário: Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
Fraturas do Quadril/epidemiologia
Fraturas do Quadril/prevenção & controle
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Falência Renal Crônica/epidemiologia
Falência Renal Crônica/reabilitação
Transplante de Rim/utilização
[Mh] Termos MeSH secundário: Conservadores da Densidade Óssea/uso terapêutico
Causalidade
Comorbidade
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico
Feminino
Fraturas do Quadril/diagnóstico
Seres Humanos
Incidência
Falência Renal Crônica/diagnóstico
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1186/s12882-017-0559-9


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[PMID]:28460629
[Au] Autor:Reith C; Staplin N; Herrington WG; Stevens W; Emberson J; Haynes R; Mafham M; Armitage J; Cass A; Craig JC; Jiang L; Pedersen T; Baigent C; Landray MJ; SHARP Collaborative Group
[Ad] Endereço:Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK. christina.reith@ndph.ox.ac.uk.
[Ti] Título:Effect on non-vascular outcomes of lowering LDL cholesterol in patients with chronic kidney disease: results from the Study of Heart and Renal Protection.
[So] Source:BMC Nephrol;18(1):147, 2017 May 01.
[Is] ISSN:1471-2369
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Reducing LDL cholesterol (LDL-C) with statin-based therapy reduces the risk of major atherosclerotic events among patients with chronic kidney disease (CKD), with no evidence of an excess risk of cancer or death from any non-vascular cause. However, non-randomized data have suggested that statin therapy may have effects (both adverse and beneficial) on particular non-vascular conditions that do not cause death. METHODS: The Study of Heart and Renal Protection (SHARP) randomized patients with CKD to simvastatin 20 mg plus ezetimibe 10 mg (simvastatin/ezetimibe) daily versus matching placebo. Participants were followed up at least 6 monthly and all post-randomization serious adverse events (SAEs) were recorded. This supplementary analysis reports the effects of treatment on non-vascular SAEs, overall, by system of disease, by baseline characteristics, and by duration of follow-up. RESULTS: During a median of 4.9 years follow-up, similar numbers of participants in the two groups experienced at least one non-vascular SAE (3551 [76.4%] simvastatin/ezetimibe vs 3537 [76.6%] placebo; risk ratio [RR] 0.99, 95% confidence interval [CI] 0.95-1.04). There was no good evidence of any significant effect of simvastatin/ezetimibe on SAEs attributed to any particular nonvascular disease system (of 43 comparisons, only 3 yielded an uncorrected p value < 0.05, of which the smallest was p = 0.02). The relative risk of any nonvascular SAE did not vary significantly among particular prognostic subgroups or by duration of follow-up. CONCLUSIONS: In the SHARP trial, allocation to simvastatin/ezetimibe combination therapy was not associated with any significant non-vascular hazard. TRIALS REGISTRATION: SHARP was retrospectively registered after the first participant was enrolled in 2003 at ISRCTN (ISRCTN54137607 on 31 January 2005: http://www.isrctn.com/ISRCTN54137607) and ClinicalTrials.gov (NCT00125593 on 29 July 2005: https://clinicaltrials.gov/ct2/show/NCT00125593).
[Mh] Termos MeSH primário: LDL-Colesterol/sangue
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/mortalidade
Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem
Hipercolesterolemia/mortalidade
Hipercolesterolemia/prevenção & controle
Insuficiência Renal Crônica/mortalidade
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Anticolesterolemiantes/administração & dosagem
Causalidade
Comorbidade
Feminino
Seres Humanos
Hipercolesterolemia/sangue
Incidência
Internacionalidade
Masculino
Meia-Idade
Fatores de Risco
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anticholesteremic Agents); 0 (Cholesterol, LDL); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1186/s12882-017-0545-2


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[PMID]:28448291
[Au] Autor:Coca A; Agabiti-Rosei E; Cifkova R; Manolis AJ; Redón J; Mancia G
[Ad] Endereço:aHypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, Spain bDepartment of Clinical and Experimental Sciences, University of Brescia cDepartment of Medicine, Azienda, Spedali Civili di Brescia, Brescia, Italy dCenter for Cardiovascular Prevention, First Faculty of Medicine and Thomayer Hospital, Charles University, Prague, Czech Republic eDepartment of Cardiology, Asklepeion General Hospital, Athens, Greece fINCLIVA, Research Institute, University of Valencia, CIBERObn ISCIII, Madrid, Spain gIRCCS, Istituto Auxologico Italiano hUniversity of Milano-Bicocca, Milano, Italy.
[Ti] Título:The polypill in cardiovascular prevention: evidence, limitations and perspective - position paper of the European Society of Hypertension.
[So] Source:J Hypertens;35(8):1546-1553, 2017 Aug.
[Is] ISSN:1473-5598
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:: Antihypertensive, lipid lowering, antidiabetic and antiplatelet treatments all substantially reduce the risk of cardiovascular morbid and fatal events. In real life, however, effective implementation of these treatments is rare, and thus their contribution to cardiovascular prevention is much less than it could be, based on research data. This article reviews the pros and cons of cardiovascular prevention by the polypill approach. It is argued that the high prevalence of individuals with a multifactorial risk profile provides a strong rationale for a therapeutic strategy based on the combination in a single tablet of drugs against different risk factors. It is further argued that other important favourable arguments exist. First, in real-life adherence to all above treatments is very low, leading to a major increase in the incidence and risk of cardiovascular outcomes. Second, although a large number of factors are involved, adherence is adversely affected by the complexity of the prescribed treatment regimen and can be considerably improved by treatment simplification. Third, recent studies in patients with a history of manifest cardiovascular disease have documented that different cardiovascular drugs can be combined in a single tablet with no loss of their individual efficacy or unexpected inconveniences and this does favour adherence to treatment and multiple risk factor control, supporting use of the polypill in secondary cardiovascular prevention. It is finally also mentioned, however, that the polypill may have some drawbacks and that at present no evidence is available that this approach reduces cardiovascular outcome to a greater degree than standard treatment strategies. Trials are under way to provide an answer to this question and thus allow the therapeutic value of this approach to be known.
[Mh] Termos MeSH primário: Anti-Hipertensivos/administração & dosagem
Doenças Cardiovasculares/prevenção & controle
Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem
Hipoglicemiantes/administração & dosagem
Inibidores da Agregação de Plaquetas/administração & dosagem
[Mh] Termos MeSH secundário: Combinação de Medicamentos
Composição de Medicamentos
Europa (Continente)
Seres Humanos
Sociedades Médicas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antihypertensive Agents); 0 (Drug Combinations); 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors); 0 (Hypoglycemic Agents); 0 (Platelet Aggregation Inhibitors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1097/HJH.0000000000001390



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