Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
-
G Ital Cardiol (Rome) · May 2014
Review[PCSK9 inhibitors and dyslipidemias: an update on clinical evidence].
Elevated plasma LDL cholesterol (LDL-C) levels are associated with cardiovascular diseases and statin therapy was proven to decrease LDL-C and reduce cardiovascular death. However, in patients at high cardiovascular risk, achievement of optimal LDL-C levels is challenging, and therefore additional strategies for further loweing LDL-C levels are under development. Recently, silencing of apolipoprotein B gene and MTP inhibition have been approved for the treatment of patients with familial hypercholesterolemia, and there is great interest in the inhibition of proprotein convertase subtilisin/kexin 9 (PCSK9). ⋯ Monoclonal antibodies against PCSK9 represent so far the most advanced approach in clinical development, with alirocumab, evolocumab and bococizumab under advanced clinical development. Recent data from the first phase III studies show LDL-C reduction in monotherapy and on top of statins. Long-term studies on cardiovascular endpoints are ongoing and the results will be crucial to translate the benefit of this promising approach into clinical practice.
-
G Ital Cardiol (Rome) · May 2014
[Primary percutaneous coronary intervention and therapeutic hypothermia in comatose survivors after out-of-hospital cardiac arrest complicating acute myocardial infarction: a single-center experience].
Therapeutic hypothermia (TH) is associated with improved neurologic outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). There are currently limited data on the outcomes of patients presenting with resuscitated OHCA in the setting of acute myocardial infarction. The aim of this study was to assess the outcomes of comatose survivors of OHCA complicating acute myocardial infarction treated with primary percutaneous coronary intervention (PCI) and TH. ⋯ TH in conjunction with primary PCI is feasible and associated with acceptable outcome in the majority of comatose survivors of OHCA complicating acute myocardial infarction, especially if CPR-to-ROSC time was <20 min. Randomized studies are needed to better assess the superiority of TH and primary PCI vs primary PCI alone in this complex subset of OHCA patients.