Cleveland Clinic journal of medicine
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Cardiac and renal dysfunction often coexist, and one begets the other. The association is referred to as cardiorenal syndrome. One subtype, acute cardiorenal syndrome, is often described as a clinical scenario in which acute worsening of cardiac function leads to acute kidney injury. ⋯ Acute cardiorenal syndrome is common and often leads to emergency room visits and hospitalization. Our understanding of the hemodynamic mechanisms of acute cardiorenal syndrome is advancing. Correction of hypervolemia is the mainstay of therapy.
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Frailty and cardiovascular disease are highly interconnected and increase in prevalence with age. Identifying frailty allows for a personalized cardiovascular risk prescription and individualized management of hypertension, hyperlipidemia, diabetes, and lifestyle in the aging population.
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Statins therapy reduces atheroma in proportion to the reduction of low-density lipoprotein cholesterol (LDL-C). Proprotein convertase subtilisin--kexin type 9 (PCSK9) inhibitors are a new class of injectable human monoclonal antibodies shown to lower LDL-C when added to statin therapy. ⋯ Treatment with statins plus evolocumab achieved mean LDL-C levels of 36.6 mg/dL, produced atheroma regression with a mean change in percent of atheroma volume of about 1% (P < .001), and induced regression in a greater percentage of patients. The clinical benefits of LDL-C as low as 20 mg/dL shown in this trial warrant further investigation.