tailieunhanh - Ebook Managing cardiovascular complications in diabetes: Part 2

(BQ) Part 2 book “Managing cardiovascular complications in diabetes” has contents: Dyslipidemia and its management in type 2 diabetes, thrombosis in diabetes and its clinical management, management of acute coronary syndrome, management of peripheral arterial disease, and other contents. | CHAPTER 7 Dyslipidemia and Its Management in Type 2 Diabetes D. John Betteridge University College London Hospital, London, UK Key Points • Dyslipidemia is an integral component of metabolic syndrome and type 2 diabetes. • Dyslipidemia involves both quantitative and qualitative lipid and lipoprotein abnormalities: moderate hypertriglyceridemia, low HDL-cholesterol, small dense LDL particles, and accumulation of cholesterol-rich remnant particles. • Dyslipidemia is a major independent risk predictor for atherosclerosis-related disease. • Increasing LDL-cholesterol concentrations and decreasing HDL-cholesterol concentrations were the strongest risk predictors for myocardial infarction observed in UKPDS. • Patients with type 2 diabetes are at high risk of CVD events and the majority will fulfill criteria for pharmacotherapy to lower LDL-cholesterol. • Statins are the cornerstone of therapy and their use is based on a wealth of data from well-conducted robust RCT. • Some patients are statin intolerant and other drug classes such as ezetimibe, fibrates, nicotinic acid, and colesevalam may be required. • New LDL-cholesterol-lowering strategies are in development that should ensure, if proved to be effective and safe, that more patients achieve LDL-cholesterol goals. • Low HDL-cholesterol remains a significant risk predictor even when low LDL-cholesterol levels are achieved in the statin trials. • To date no evidence is available from RCT to support measures to increase HDLcholesterol to lower CVD events. • Intensive management of dyslipidemia should be part of a global approach to CVD risk reduction in the diabetic population. Introduction Atherosclerosis-related disease, coronary heart disease (CHD), peripheral vascular disease (PVD), and thrombotic stroke are major complications in Managing Cardiovascular Complications in Diabetes, First Edition. Edited by D. John Betteridge and Stephen Nicholls. © 2014 John Wiley & Sons, Ltd. Published 2014 by John Wiley & Sons, .

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