Conclusion: Impaired HDL functionality in South Asians may be a contributing factor to their high CVD risk. (C) 2016 The Italian Society of Diabetology, the Italian Society for the Study of... Show moreConclusion: Impaired HDL functionality in South Asians may be a contributing factor to their high CVD risk. (C) 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved. Show less
Nordestgaard, B.G.; Langsted, A.; Mora, S.; Kolovou, G.; Baum, H.; Bruckert, E.; ... ; European Federation Clinical Chem 2016
Conclusion We recommend that non-fasting blood samples be routinely used for the assessment of plasma lipid profiles. Laboratory reports should flag abnormal values on the basis of desirable... Show moreConclusion We recommend that non-fasting blood samples be routinely used for the assessment of plasma lipid profiles. Laboratory reports should flag abnormal values on the basis of desirable concentration cut-points. Non-fasting and fasting measurements should be complementary but not mutually exclusive. Show less
The main objective of this thesis was to unravel relationships between obesity, insulin resistance, hyperglycemia, and atherosclerosis. It is well-established that patients with type 2... Show more The main objective of this thesis was to unravel relationships between obesity, insulin resistance, hyperglycemia, and atherosclerosis. It is well-established that patients with type 2 diabetes have a 2- to 3-fold increased risk of cardiovascular disease. We investigated whether insulin resistance and hyperglycemia are associated with atherosclerosis and incident cardiovascular disease before the onset of type 2 diabetes. Obesity can be considered as a common cause of both insulin resistance and atherosclerosis. Therefore, we investigated to what extent associations between insulin resistance, hyperglycemia and atherosclerosis were explained by body fat. We further aimed to study the specific role of visceral fat in the development of insulin resistance and atherosclerosis, and directly assessed abdominal subcutaneous and visceral adipose tissue depots. Show less
In this thesis we observe that prescription rates of lipid-lowering drugs and antithrombotic medication in secondary prevention in old age are low. According to focus-group discussions with general... Show moreIn this thesis we observe that prescription rates of lipid-lowering drugs and antithrombotic medication in secondary prevention in old age are low. According to focus-group discussions with general practitioners highly individualized care with the ultimate aim to improve quality of life, might largely explain these low prescription rates; however, improvements might be expected from structured follow up, and tailored, age-specific guidelines, reflecting the heterogeneity of clinical practice. In very old age we observed that the severity of the cardiovascular disease history is associated with unfavourable prognosis, not only with regard to (recurrent) cardiovascular disease/mortality, but also with regard to future disability and cognitive decline. Of four newer cardiovascular risk markers N-terminal pro B-type natriuretic peptide (NT-proBNP) was the strongest predictor of cardiovascular events/mortality in secondary cardiovascular prevention in very old age. NT-proBNP was also associated with cognitive and functional decline. Finally NT-proBNP predicted treatment effect of pravastatin. In order to improve patient care in older age, the following actions are recommended: vigorous ICPC coding and pro-active follow-up of all older patients with a history of cardiovascular disease. Finally, optimisation of secondary cardiovascular prevention is advised by individualised risk prediction and consciously weighing all pros and cons of preventive treatment. Show less
