[Graves' disease and autoimmune thrombocytopenic purpura: distinct outcomes of the two diseases].

The association of idiopathic thrombocytopenic purpura and Graves' disease is rare. Hence, little is known about the outcomes of these two diseases when associated. We report two cases of idiopathic thrombocytopenic purpura associated with Graves' disease, in which the two diseases had distinct outcomes.

Screening for liver disease using non-invasive biomarkers (FibroTest, SteatoTest and NashTest) in patients with hyperlipidaemia.

Background: Mortality related to complications of cirrhosis is increasing in patients with insulin-resistance factors. Hyperlipidaemic patients have multiple risk factors of insulin resistance. It is impossible to perform liver biopsy in such a large number of hyperlipidaemic patients to identify patients with advanced liver fibrosis or with steatohepatitis (non-alcoholic steatohepatitis, NASH).

Hypertriglyceridemic waist and 7.5-year prospective risk of cardiovascular disease in asymptomatic middle-aged men.

Background: Few studies suggest that the combined increase in plasma triglycerides (TG) and in waist circumference (WC), termed 'hypertriglyceridemic waist' (HTGW), is an interesting marker of risk for cardiovascular disease (CVD).

Objective: Using cutoffs used for defining HTGW, we examined the prospective association of HTGW with CVD risk in a French cohort of men.

Design: Men were participants in the SU.

Alterations in lipoprotein defense against oxidative stress in metabolic syndrome.

Metabolic syndrome (MetS) is a high-risk condition for premature atherosclerotic vascular disease. Patients with MetS display a lipoprotein profile in which dense low-density lipoproteins (LDL), which are more susceptible to oxidation, predominate. Oxidation of lipoproteins can be attenuated in vivo by enzymatic and nonenzymatic antioxidant defenses, but high-density lipoproteins (HDL) play a key role in the protection of LDL from oxidation.

[Treatment of obstructive aortic atheroma in homozygotic familial hypercholesterolemia].

The object of this report is to describe the surgical treatment of a rare clinical form of homozygotic familial hypercholesterolaemia (HFH) associating valvular and supravalvular stenosis with coronary ostial stenosis. Three patients, two male and one female, aged 15, 23 and 41 respectively, suffering from HFH diagnosed in early childhood, presented with obstacles to left ventricular ejection and myocardial ischaemia due to coronary ostial stenosis. Surgery consisted of corrections in a single procedure of all abnormalities by aortic valve replacement, ascending aortic replacement and widening of the coronary artery ostia which were reimplanted on the aortic tube.

One third of the variability in HDL-cholesterol level in a large dyslipidaemic population is predicted by age, sex and triglyceridaemia: The Paris La Pitié Study.

Objective: The objective of this study was to identify key determinants of high-density lipoprotein-cholesterol (HDL-C) level, including subclinical inflammation and insulin resistance, and to determine the prevalence of a low HDL-C phenotype in dyslipidaemic patients at high cardiovascular risk.

Methods: In a cross-sectional study, we assessed the prevalence of low HDL-C phenotypes in 14 667 dyslipidaemic patients attending our specialised lipid clinic and evaluated the potential relationships between HDL-C level and 16 clinical and biological parameters.

Results: In univariate analysis, women exhibited higher plasma concentrations of HDL-C as compared with men.

Increased adiponectin receptor-1 expression in adipose tissue of impaired glucose-tolerant obese subjects during weight loss.

Objective: To investigate the mRNA expression of adiponectin, AdipoR1 and AdipoR2, the two recently cloned adiponectin receptors and peroxisome proliferator activated receptor (PPAR)gamma2 in adipose tissue of obese individuals before and during a very low calorie diet (VLCD) inducing weight loss.

Methods: Twenty-three non-diabetic obese subjects with normal (NGT, n = 11) or impaired glucose tolerance (IGT, n = 12) (age, 47 +/- 3 years; body mass index, 39.3 +/- 1.

Cardiovascular risk and rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion.

Objective: To develop clinical practice guidelines for the evaluation and management of cardiovascular risk in patients with rheumatoid arthritis (RA), using the evidence-based approach and expert opinion.

Methods: Recommendations were developed using the evidence-based approach and expert opinion: A scientific committee used a Delphi procedure to select five questions, which formed the basis for developing the recommendations; Evidence providing answers to the five questions was sought in the literature; Based on this evidence, recommendations were developed by a panel of experts.

Results: The recommendations were as follows: 1) In patients with RA, attention should be given to the risk of cardiovascular disease, which is responsible for an excess burden of morbidity and mortality; 2) It must be recognized that RA may be an independent cardiovascular risk factor.

Blood lipids in brain infarction subtypes.

Background: Little is known about the relationship between hypercholesterolaemia and specific aetiological subtypes of brain infarction (BI).

Methods: In a cross-sectional study of 492 pairs of patients with a BI proven by MRI and matched hospital controls, we determined the blood levels of triglycerides, total, HDL and LDL cholesterol, and apolipoprotein A(1) and B, in the same centralized laboratory. We performed aetiological BI subtype classification.

Use of an indirect effect model to describe the LDL cholesterol-lowering effect by statins in hypercholesterolaemic patients.

Statins are the most commonly prescribed agents for the treatment of hypercholesterolaemia. This is due to their efficacy in reducing low-density lipoprotein cholesterol (LDL) level which is the primary goal of the treatment especially for patients with multiple risk factors or with established coronary heart diseases. The purpose of this study was to develop a pharmacokinetic/pharmacodynamic (PK/PD) model that describes the LDL-lowering process in patients with hypercholesterolaemia treated with atorvastatin, fluvastatin or simvastatin.

Carotid atherosclerosis is not related to past tuberculosis in hypercholesterolemic patients.

Background: Tuberculosis is a chronic recurrent infection and inflammation is part of the disease which may remain undiagnosed for months. Furthermore immunization with recombinant heat shock protein-65-rich mycobacterium tuberculosis increased atherogenesis in hypercholesterolemic animal models.

Objective: To investigate the potential interrelationships between past tuberculosis with carotid and femoral atherosclerosis in hypercholesterolemic patients.

[Patient education and patient at risk. A new approach in cardiology].

For more than 10 years, preventive cardiology has obtained many positive results. Cardiologists can alter the prognosis of cardiovascular disease in primary and secondary prevention. In primary prevention or during the chronic phases of coronary artery disease, prevention is mainly based on drugs.

Mild to moderate muscular symptoms with high-dosage statin therapy in hyperlipidemic patients--the PRIMO study.

Objectives: To characterize the risk factors, rate of occurrence, onset, nature and impact of mild to moderate muscular symptoms with high-dosage HMG-CoA reductase inhibitor (statin) therapy in general practice.

Methods: The Prédiction du Risque Musculaire en Observationnel (Prediction of Muscular Risk in Observational conditions, PRIMO) survey was an observational study of muscular symptoms in an unselected population of 7924 hyperlipidemic patients receiving high-dosage statin therapy in a usual care, outpatient setting in France. Information on patient demographics, treatment history and muscular symptoms was obtained by questionnaires.

High prevalence of low HDL-cholesterol in a pan-European survey of 8545 dyslipidaemic patients.

Objective: Low HDL-cholesterol is a strong independent cardiovascular risk factor recognized as a therapeutic target in recent guidelines. The Pan-European Survey on HDL-cholesterol collected data on plasma lipid profiles from 8545 dyslipidaemic patients in the care of 1339 specialist physicians in 11 European countries. The main objective was to obtain a reliable estimation of the prevalence of low HDL (< 1.

Intake of added oils and fats among middle-aged French adults: relationships with educational level and region of residence.

Objective: To describe the relative contribution of 10 created food groups to total fat intake in middle-aged subjects. The relationship of added oil and fat intake with region of residence and educational level was also assessed.

Design: Cross-sectional study.

Elevated serum levels of proinflammatory cytokines and biomarkers of matrix remodeling in never-treated patients with familial hypercholesterolemia.

Background: Familial hypercholesterolemia (FH) is a common inherited disorder of lipoprotein metabolism, whose origin involves mutations in the gene coding for the low-density lipoprotein receptor protein. Although FH is monogenic, wide variation occurs in the onset and severity of atherosclerosis in these patients.

Methods: Since data on levels of inflammatory proteins and/or active factors in FH patients who have never received lipid-lowering treatment are lacking, serum levels of MMP-3, active MMP-9 and TIMP-1 as well as pro-inflammatory cytokines (TNF-alpha, IL-18) were determined in never-treated homozygous FH Moroccan patients (n=4) and compared to those of heterozygous FH subjects (n=7) and of healthy control subjects (n=5).

Comparison of efficacy and safety assessment of fluvastatin in patients <65 years versus > or =65 years of age.

This pooled analysis of 30 completed clinical trials assessed the efficacy and safety of fluvastatin in patients <65 (n = 8,037) and patients > or =65 years of age (n = 3,717). The results demonstrated that in patients > or =65 years of age, lipid changes with fluvastatin therapy are equivalent to or slightly better than those observed in patients <65 years of age. Treatment with fluvastatin produced a significantly lower incidence of major cardiovascular clinical end points (major adverse cardiac events [MACEs]) and an increase in the time to a first MACE in the older population.

Effect of levothyroxine replacement therapy on coagulation and fibrinolysis in severe hypothyroidism.

Objective: We previously demonstrated that patients suffering from moderate hypothyroidism were at increased risk of thrombosis contrasting with the bleeding tendency of those presenting severe hypothyroidism. The latter state is associated with hemostatic anomalies including von Willebrand type 1 disease and increased fibrinolytic capacity. With the exception of von Willebrand type 1 disease, reversibility of hemostatic changes is not established after levothyroxine replacement therapy.

Sampling variability of liver biopsy in nonalcoholic fatty liver disease.

Background & Aims: In nonalcoholic fatty liver disease (NAFLD), the distinction between steatosis and steatohepatitis (NASH) and the assessment of the severity of the disease rely on liver histology alone. The aim of this study was to assess the sampling error of liver biopsy and its impact on the diagnosis and staging of NASH.

Methods: Fifty-one patients with NAFLD underwent percutaneous liver biopsy with 2 samples collected.

Blood lipid and lipoprotein levels: relationships with educational level and region of residence in the French SU.VI.MAX study.

Background: Blood lipid profile of French men and women obtained from the general population is not well known. Furthermore, the association between these lipids, as a function of other potential risk factors for cardiovascular disease, and sociodemographic factors such as age, educational level, and region of residence is not well studied in large samples in Europe.

Methods: Data on French healthy volunteers, aged between 40 and 65 years for men (n = 5141) and 35 and 65 years for women (n = 7876) were obtained from the "Supplementation en Vitamines et Mineraux Antioxydants" (SU.

[Role of LDL in cardiovascular diseases. New data and new recommendations].

The management of hypercholesterolemia has rapidly progressed with the large clinical trials mainly on statins. Over the past 15 years, it has been demonstrated that the principle target was LDL-cholesterol and that treatment with statins decreased cardiovascular morbidity and global mortality. The studies have progressively targeted patients with increasingly lower cholesterol levels but always at high risk.

Renal disease in cardiovascular disorders: an underrecognized problem.

Chronic renal disease is generally appreciated as a major and rapidly growing health problem. In the United States alone, as many as 19.5 million people may have markers of early renal disease, and more than 660,000 people are expected to require renal replacement therapy by the year 2010.

[The interest of cholesterol levels in young children. Study in a population of 4,697 children aged 4].

Introduction: There is a need to dispose of normal cholesterol levels in young children. In view of the paucity of such data in France, we analysed the results of screening conducted in children.

Method: We analysed the cholesterol levels of 4697 children, with a mean age of 4.

[Health locus of control and cholesterol representations. Results of the FRACTION survey].

Unlabelled: The concept of the health locus of control (HLC) proved fruitful in predicting individual health behavior, in particular a person's ability to actively comply with a preventive approach. It is interesting to apply such a concept to the field of cardiovascular risk, where too many people still disregard to various degrees measures designed to control hypercholesterolemia. Now, hypercholesterolemia is recognized as a major modifiable risk factor for cardiovascular disease.