The risk for significant creatine kinase elevation with statins.

Background: The HMG-CoA reductase inhibitors (statins) are effective for reducing long-term cardiovascular morbidity and mortality in both primary and secondary prevention. The most serious adverse reaction is significant elevation of creatine kinase (CK) leading to rhabdomyolysis. The incidence of CK elevation is low in randomized, controlled trials.

Statin adherence and mortality in patients enrolled in a secondary prevention program.

Objectives: To determine statin adherence rates in patients enrolled in a cardiovascular secondary disease prevention program and to evaluate the impact of adherence on subsequent clinical events.

Methods: Patients who had an incident cardiac event between January 1, 2000, and December 31, 2005, and began statin therapy within 90 days of that event were identified and followed until death, a recurrent nonfatal cardiac event, or December 31, 2006. Analysis was conducted in 2007 and 2008.

Pharmacologic risk factor management in peripheral arterial disease: a vade mecum for vascular surgeons.

There is broad and compelling evidence for risk factor reduction to limit cardiovascular morbidity and mortality in patients with peripheral arterial disease. Indeed, vascular surgeons have placed a call to arms to ensure this takes place. Despite this fact, some wariness exists on the part of many vascular surgeons to initiate these strategies, functionally abnegating their responsibilities in this regard.

The triglyceride-lowering effects of a modest dose of docosahexaenoic acid alone versus in combination with low dose eicosapentaenoic acid in patients with coronary artery disease and elevated triglycerides.

Background: Hypertriglyceridemia is a risk factor for coronary artery disease (CAD). The American Heart Association recommends 1000 mg of omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), daily for cardioprotection and higher doses for triglyceride-lowering in patients with CAD.

Methods: This was a prospective, randomized, double-blind study comparing DHA to DHA + EPA in patients with CAD and triglycerides greater than 200 mg/dL.

Effect of a clinical pharmacy service on lipid control in patients with peripheral arterial disease.

Objective: Our group and others have previously established that patients with peripheral artery disease (PAD) are significantly undertreated with respect to overall cardiovascular risk factor management, despite national guidelines to the contrary. In an effort to maximize risk factor control in our patients with PAD, we established a pharmacist-managed, physician-monitored algorithmic approach to the outpatient management of lipids in patients with PAD. The purpose of this study was to determine the effect of this service on lipid screening and control in patients with PAD.

Atherosclerotic risk factor control in patients with peripheral arterial disease.

Background: The presence of peripheral arterial disease (PAD), even in the absence of overt coronary artery disease (CAD), confers the same relative risk of death from a cardiovascular cause as in patients with a previous cardiovascular event. Current guidelines recommend atherosclerotic risk factor-reduction strategies in PAD patients identical to those in patients with a recent coronary event. The purpose of this study was to determine the status of atherosclerotic risk factor control in patients with PAD.