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• Impact of vascular biology in treatment of cardiovascular disease Section II: Lipid management

The VBWG Core Curriculum 2003 slide lecture compendium, Impact of vascular biology in treatment of cardiovascular disease, provides updates on new science and mechanisms of disease, plus implications of recent clinical trials.

Areas of focus:

This slide/lecture program focuses on lipid management and its role in treatment of atherosclerosis. The material covers:

  • Recent important epidemiological findings
  • Updated scientific knowledge on the molecular mechanisms of atherosclerosis
  • New clinical trial evidence for aggressive lipid management
  • The critical role of lipid management in the care of the diabetic patient



03LIPIDS001.pdf (0.5MB)03LIPIDS001.pdf (0.5MB)

A: Epidemiology update

Download 03LIPIDS001.ppt (5 slides - 0.9MB)

A:  Epidemiology update 1 in 4 adults have diabetes or the metabolic syndrome Higher prevalence of CV risk factors in adults with vs without diabetes Level of kidney function: An independent risk factor for CV disease Increased prevalence of dyslipidemia in patients with vs without chronic

B: Basic science update:

Download 03LIPIDS002.ppt (16 slides - 2.9MB)

B: Basic science update: Formation of small, dense LDL particles Lipid entry into the vascular wall Importance of LDL modification in foam cell formation OxLDL correlates with subclinical atherosclerosis and inflammatory activity Role of vascular smooth muscle cells in early lesion formation Key cytokines marking inflammatory activity Formation of advanced lesions Plaque rupture Increased pro-inflammatory cytokines in unstable vs stable angina Plaque instability beyond the culprit lesion New therapeutic goal: Plaque stabilization Potential therapeutic strategies to stabilize plaque Potential plaque stabilizing effects of cholesterol lowering Beneficial effects of statins on endothelial function Nasal vaccination with HSP decreases lesion size and inflammation

C: Clinical trials update:

Download 03LIPIDS003.ppt (29 slides - 10.1MB)

C: Clinical trials update: Lipid effects of statin during acute phase of UA/NSTEMI LDL lowering: Important anti-inflammatory mechanism of statins Statins reduce thermal gradient between lesions and angiographically Anti-inflammatory effects of statins prior to or at time of stenting Evidence for pro-atherogenic role for receptor CD40 and its ligand (CD40L) Statins reduce level of soluble CD40L LIPS: Benefits of statin in patients following PCI FLORIDA trial Possible explanations for neutral effect of fluvastatin in FLORIDA trial Benefit of aggressive vs moderate lipid management in ACS ARBITER: Differing effects of aggressive vs moderate lipid lowering Differing effects of statins and antithrombotic therapy on embolic events MIRACL: Nonfatal stroke reduction with intensive statin therapy in Statins and stroke reduction: Evidence for cholesterol-independent effects GREACE: Risk reductions in CV morbidity and mortality Reduction in CV events with statin following noncardiac vascular surgery OxLDL correlates with post-transplant endothelial dysfunction Evidence for statin benefit on post-transplant clinical outcome Innate and adaptive immunity Statins inhibit IFN-g–induced MHC II expression ALLHAT-LLT: Design ALLHAT-LLT: Effects of statin or usual care on outcomes Relationship between risk reduction and change in cholesterol vs control Benefits of aggressive vs moderate lipid lowering in patients with stable CAD Statins lower BP and improve arterial compliance in untreated ISH Statins provide additional BP reduction in treated hypertensives Statins improve exercise performance in patients with PAD Low adherence with statin therapy in primary and secondary prevention

D: Lipid management in the patient with diabetes

Download 03LIPIDS004.ppt (6 slides - 1.1MB)

D: Lipid management in the patient with diabetes Elevated CV risk in diabetes Potential mechanisms of elevated risk in diabetes Exaggerated intimal hyperplasia in diabetics following stenting Event rates (statin vs placebo) in diabetic cohorts of randomized trials Proposed lipid-lowering algorithm in hypertensive diabetic patients
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Published by Medical Education Consultants, Inc. (MEDCON), on behalf of the University of Florida College of Medicine.

The editorial content of this program does not necessarily reflect the views or recommendations of the University of Florida College of Medicine or AstraZeneca, Aventis Pharmaceuticals Inc, King Pharmaceuticals, Pfizer Inc, Wyeth Pharmaceuticals, or the publisher. The reader is advised to consult the full prescribing information of each product prior to use.

This program was prepared and produced by Medical Education Consultants, Inc, Westport, Connecticut, on behalf of the University of Florida College of Medicine through an unrestricted educational grant provided by AstraZeneca, Aventis Pharmaceuticals Inc, King Pharmaceuticals, Pfizer Inc, and Wyeth Pharmaceuticals.

©2003 Medical Education Consultants, Inc. (MEDCON). All rights reserved.

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