Željko Reiner - Academia.edu (original) (raw)

Papers by Željko Reiner

Lijec̆nic̆ki vjesnik

Sa`etak. Premda jo{ nije potpuno jasno dokazano jesu li povi{eni trigliceridi izravno aterogeni i... more Sa`etak. Premda jo{ nije potpuno jasno dokazano jesu li povi{eni trigliceridi izravno aterogeni ili nisu, rezultati mnogih istra`ivanja upu}uju na to da su oni nedvojbeno va`an ~imbenik rizika i/ili biljeg koronarne bolesti srca (KBS). Stoga u osoba koje imaju velik rizik od KBS-a treba lije~iti hipertrigliceridemiju. Povi{eni su trigliceridi ~esto udru`eni sa sni`enom koncentracijom HDL-kolesterola, osobito u bolesnika s dijabetesom tipa 2 i/ili metaboli~kim sindromom koji imaju velik rizik od KBS-a. Takav se poreme}aj lipida naziva aterogena dislipidemija i ima sve ve}u prevalenciju. Lije~enje hipertrigliceridemije ponajprije se mora temeljiti na intenzivnoj promjeni nezdravog na~ina `ivota (smanjenje tjelesne te`ine u debelih, smanjenje unosa alkohola te {e}era, fruktoze i transmasnih kiselina, redovita aerobna tjelesna aktivnost) ~ime se trigliceridi mogu sniziti za ~ak do 50%. Osobe s velikim rizikom od KBS-a koje ne mogu promjenom na~ina `ivota dovoljno smanjiti hipertrigliceridemiju moraju se lije~iti lijekovima. U ovom ~asu od lijekova za taj poreme}aj imamo fibrate, nijacin i pripravke omega 3-masnih kiselina koji su registrirani kao lijekovi. Ako je istodobno povi{en i LDL-kolesterol, bolesnici trebaju uzimati kombiniranu terapiju. Na temelju rezultata najnovijih istra`ivanja takvim se bolesnicima preporu~uje uzimanje statina uz fenofibrat i/ili omega 3-masne kiseline.

Pharmaceuticals

Dyslipidaemia is a well-known risk factor for the development of cardiovascular disease, a leadin... more Dyslipidaemia is a well-known risk factor for the development of cardiovascular disease, a leading cause of morbidity and mortality in developed countries. As a consequence, the medical community has been dealing with this problem for decades, and traditional statin therapy remains the cornerstone therapeutic approach. However, clinical trials have observed remarkable results for a few agents effective in the treatment of elevated serum lipid levels. Ezetimibe showed good but limited results when used in combination with statins. Bempedoic acid has been thoroughly studied in multiple clinical trials, with a reduction in LDL cholesterol by approximately 15%. The first approved monoclonal antibodies for the treatment of dyslipidaemia, PCSK9 inhibitors, are currently used as second-line treatment for patients with unregulated lipid levels on statin or statin combination therapy. A new siRNA molecule, inclisiran, demonstrates great potential, particularly concerning compliance, as it is...

European Journal of Preventive Cardiology, 2020

Aims Statins are pivotal to the secondary prevention of major adverse cardiovascular events, but ... more Aims Statins are pivotal to the secondary prevention of major adverse cardiovascular events, but some patients are statin-intolerant. We examined the effects of the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab on the risk of major adverse cardiovascular events according to the intensity of background statin treatment. Methods and results The ODYSSEY OUTCOMES trial compared alirocumab with placebo in 18,924 patients with acute coronary syndrome and dyslipidaemia despite intensive or maximum-tolerated statin treatment (including no statin if intolerance was documented). The primary outcome (major adverse cardiovascular events) comprised coronary heart disease death, non-fatal myocardial infarction, ischaemic stroke, or unstable angina. Median follow-up was 2.8 years. Baseline statin treatment was high-intensity (88.8%), low/moderate-intensity (8.7%) or none (2.4%). Median baseline low-density lipoprotein cholesterol was 86, 89 and 139 mg/dL (P < 0.001)...

Medicus, Jan 26, 2001

smanjenje unosa energije smanjuje endogenu sintezu kolesterola (1). Tako smanjenje tjelesne teaei... more smanjenje unosa energije smanjuje endogenu sintezu kolesterola (1). Tako smanjenje tjelesne teaeine za 1 kilogram uzrokuje sniaeenje ukupnog kolesterola za 0,05 mmol/l, LDL-kolesterola za 0,02 mmol/l, triglicerida za 0,015 mmol/l, a povisuje HDL-kolesterol za 0,009 mmol/l nakon πto se tjelesna teaeina uravnoteaei (2).

Kardiologia Polska, 2015

He has held many positions in the European Society of Cardiology (ESC) and European Atheroscleros... more He has held many positions in the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) and was a member of the World Heart Organisation Executive Board in Geneva, where he was representing Europe. He is a member of the editorial boards of several journals (JACC, Nature Rev Cardiol, etc.) and is a reviewer for a number of journals (Lancet, Eur Heart J, etc.). Besides publishing many papers and books, he is first author of the ESC/EAS European guidelines for the management of dyslipidaemias and one of the authors of the last two Joint European guidelines on cardiovascular disease prevention. Professor Reiner's research has focused on lipidology and preventive cardiology.

The American Journal of Clinical Nutrition, 2009

Peroxisome proliferator-activated receptor c (PPARc) is a clinically validated target for treatme... more Peroxisome proliferator-activated receptor c (PPARc) is a clinically validated target for treatment of insulin resistance. PPARc activation by full agonists such as thiazolidinediones has shown potent and durable glucose-lowering activity in patients with type 2 diabetes without the concern for hypoglycemia or gastrointestinal toxicities associated with some other medications used to treat this disease. However, thiazolidinediones are linked to safety and tolerability issues such as weight gain, fluid retention, edema, congestive heart failure, and bone fracture. Distinctive properties of PPARc provide the opportunity for selective modulation of the receptor such that desirable therapeutic effects may be attained without the unwanted effects of full activation. PPARc is a nuclear receptor that forms a complex with coreceptor RXR and a cell type-and cell statespecific array of coregulators to control gene transcription. PPARc affinity for these components, and hence transcriptional response, is determined by the conformational changes induced by ligand binding within a complex pocket with multiple interaction points. This molecular mechanism thereby offers the opportunity for selective modulation. A desirable selective PPARc modulator profile would include high-affinity interaction with the PPARc-binding pocket in a manner that leads to retention of the insulin-sensitizing activity that is characteristic of full agonists as well as mitigation of the effects leading to increased adiposity, fluid retention, congestive heart failure, and bone fracture. Examples of endogenous and synthetic selective PPARc modulator (SPPARM) ligands have been identified. SPPARM drug candidates are being tested clinically and provide support for this strategy.

Journal of Clinical Medicine, 2022

Statins are competitive inhibitors of hydroxymethylglutaryl-CoA (HMG-CoA) reductase and have been... more Statins are competitive inhibitors of hydroxymethylglutaryl-CoA (HMG-CoA) reductase and have been used to treat elevated low-density lipoprotein cholesterol (LDL-C) for almost four decades. Antioxidant and anti-inflammatory properties which are independent of the lipid-lowering effects of statins, i.e., their pleiotropic effects, might be beneficial in the prevention or treatment of many diseases. This review discusses the antioxidant effects of statins achieved by modulating the nuclear factor erythroid 2 related factor 2/ heme oxygenase-1 (Nrf2/HO-1) pathway in different organs and diseases. Nrf2 and other proteins involved in the Nrf2/HO-1 signaling pathway have a crucial role in cellular responses to oxidative stress, which is a risk factor for ASCVD. Statins can significantly increase the DNA-binding activity of Nrf2 and induce the expression of its target genes, such as HO-1 and glutathione peroxidase) GPx, (thus protecting the cells against oxidative stress. Antioxidant and a...

European Heart Journal, 2022

Aims Statin intolerance (SI) represents a significant public health problem for which precise est... more Aims Statin intolerance (SI) represents a significant public health problem for which precise estimates of prevalence are needed. Statin intolerance remains an important clinical challenge, and it is associated with an increased risk of cardiovascular events. This meta-analysis estimates the overall prevalence of SI, the prevalence according to different diagnostic criteria and in different disease settings, and identifies possible risk factors/conditions that might increase the risk of SI. Methods and results We searched several databases up to 31 May 2021, for studies that reported the prevalence of SI. The primary endpoint was overall prevalence and prevalence according to a range of diagnostic criteria [National Lipid Association (NLA), International Lipid Expert Panel (ILEP), and European Atherosclerosis Society (EAS)] and in different disease settings. The secondary endpoint was to identify possible risk factors for SI. A random-effects model was applied to estimate the overal...

Journal of Clinical Medicine, 2021

Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid... more Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid disorders characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth and a significantly higher risk of developing premature atherosclerotic cardiovascular disease. The majority of the current pediatric guidelines for clinical management of children and adolescents with FH does not consider the impact of genetic variations as well as characteristics of vascular phenotype as assessed by recently developed non-invasive imaging techniques. We propose a combined integrated approach of cardiovascular (CV) risk assessment and clinical management of children with FH incorporating current risk assessment profile (LDL-C levels, traditional CV risk factors and familial history) with genetic and non-invasive vascular phenotyping. Based on the existing data on vascular phenotype status, this panel recommends that all children with FH and cIMT ≥0.5 mm should receive lipi...

European Heart Journal, 2021

Patient Forum The content of these European Society of Cardiology (ESC) Guidelines has been publi... more Patient Forum The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC (journals.permissions@oup.com). Disclaimer: The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

Atherosclerosis, 2019

☆ The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC)... more ☆ The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). The disclosure forms of all experts involved in the development of these Guidelines are available on the ESC website www.escardio.org/guidelines.

Atherosclerosis Supplements, 2019

Atherosclerosis, 2019

Statistical analysis centre (D. De Bacquer h , G. De Backer h), Central laboratory (L. Raman ax ,... more Statistical analysis centre (D. De Bacquer h , G. De Backer h), Central laboratory (L. Raman ax , J. Sundvall ax), Study centres, organisations, investigators and other research personnel (National Coordinators in each country are indicated by asterisk (D. DeSmedt * bd , J.

Cor et Vasa, 2010

Souhrnný přehled Residual Risk Reduction Initiative, R 3 i* Navzdory současným standardům léčby z... more Souhrnný přehled Residual Risk Reduction Initiative, R 3 i* Navzdory současným standardům léčby zaměřené na dosažení cílových hodnot LDL cholesterolu, krevního tlaku a glykemie mají pacienti s dyslipidemií vysoké reziduální riziko vzniku vaskulárních příhod. Aterogenní dyslipidemie, zejména vyšší hodnota triglyceridů a nízká koncentrace HDL cholesterolu, se často vyskytuje spolu s vyšší koncentrací apolipoproteinu B a non-HDL cholesterolu u pacientů s diagnostikovanými kardiovaskulárními onemocněními, diabetes mellitus 2. typu, obezitou nebo metabolickým syndromem a je spojena s reziduálním makrovaskulárním a mikrovaskulárním rizikem. Residual Risk Reduction Initiative (R 3 i) byla založena proto, aby se touto důležitou problematikou zabývala. Cílem tohoto souhrnného přehledu je vyzdvihnout skutečnost, že se aterogenní dyslipidemie podílí na reziduálním makrovaskulárním riziku a mikrovaskulárních komplikacích, a doporučit léčebnou intervenci vedoucí ke snížení tohoto rizika, podpořenou důkazy a odborným konsensem. Důležitým prvním krokem je úprava životního stylu. Často je mimo to nutná také farmakoterapie. Přidání niacinu, fi brátu nebo ω-3 mastných kyselin k terapii statiny zlepšuje všechny lipidové rizikové faktory. Klinické studie hodnotí, zda mají tyto strategie lepší klinický přínos než léčba statiny. Závěrem lze říci, že iniciativa R 3 i zdůrazňuje potřebu ovlivnit vysokou míru reziduálního vaskulárního rizika u pacientů s dyslipidemií, kteří jsou léčeni prostřednictvím úpravy životního stylu anebo farmakoterapií v souladu se současnými standardy léčby.

European Journal of Preventive Cardiology, 2019

Aims The aim of this study was to determine whether the Joint European Societies guidelines on se... more Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhib...

Lijec̆nic̆ki vjesnik

Sa`etak. Premda jo{ nije potpuno jasno dokazano jesu li povi{eni trigliceridi izravno aterogeni i... more Sa`etak. Premda jo{ nije potpuno jasno dokazano jesu li povi{eni trigliceridi izravno aterogeni ili nisu, rezultati mnogih istra`ivanja upu}uju na to da su oni nedvojbeno va`an ~imbenik rizika i/ili biljeg koronarne bolesti srca (KBS). Stoga u osoba koje imaju velik rizik od KBS-a treba lije~iti hipertrigliceridemiju. Povi{eni su trigliceridi ~esto udru`eni sa sni`enom koncentracijom HDL-kolesterola, osobito u bolesnika s dijabetesom tipa 2 i/ili metaboli~kim sindromom koji imaju velik rizik od KBS-a. Takav se poreme}aj lipida naziva aterogena dislipidemija i ima sve ve}u prevalenciju. Lije~enje hipertrigliceridemije ponajprije se mora temeljiti na intenzivnoj promjeni nezdravog na~ina `ivota (smanjenje tjelesne te`ine u debelih, smanjenje unosa alkohola te {e}era, fruktoze i transmasnih kiselina, redovita aerobna tjelesna aktivnost) ~ime se trigliceridi mogu sniziti za ~ak do 50%. Osobe s velikim rizikom od KBS-a koje ne mogu promjenom na~ina `ivota dovoljno smanjiti hipertrigliceridemiju moraju se lije~iti lijekovima. U ovom ~asu od lijekova za taj poreme}aj imamo fibrate, nijacin i pripravke omega 3-masnih kiselina koji su registrirani kao lijekovi. Ako je istodobno povi{en i LDL-kolesterol, bolesnici trebaju uzimati kombiniranu terapiju. Na temelju rezultata najnovijih istra`ivanja takvim se bolesnicima preporu~uje uzimanje statina uz fenofibrat i/ili omega 3-masne kiseline.

Pharmaceuticals

Dyslipidaemia is a well-known risk factor for the development of cardiovascular disease, a leadin... more Dyslipidaemia is a well-known risk factor for the development of cardiovascular disease, a leading cause of morbidity and mortality in developed countries. As a consequence, the medical community has been dealing with this problem for decades, and traditional statin therapy remains the cornerstone therapeutic approach. However, clinical trials have observed remarkable results for a few agents effective in the treatment of elevated serum lipid levels. Ezetimibe showed good but limited results when used in combination with statins. Bempedoic acid has been thoroughly studied in multiple clinical trials, with a reduction in LDL cholesterol by approximately 15%. The first approved monoclonal antibodies for the treatment of dyslipidaemia, PCSK9 inhibitors, are currently used as second-line treatment for patients with unregulated lipid levels on statin or statin combination therapy. A new siRNA molecule, inclisiran, demonstrates great potential, particularly concerning compliance, as it is...

European Journal of Preventive Cardiology, 2020

Aims Statins are pivotal to the secondary prevention of major adverse cardiovascular events, but ... more Aims Statins are pivotal to the secondary prevention of major adverse cardiovascular events, but some patients are statin-intolerant. We examined the effects of the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab on the risk of major adverse cardiovascular events according to the intensity of background statin treatment. Methods and results The ODYSSEY OUTCOMES trial compared alirocumab with placebo in 18,924 patients with acute coronary syndrome and dyslipidaemia despite intensive or maximum-tolerated statin treatment (including no statin if intolerance was documented). The primary outcome (major adverse cardiovascular events) comprised coronary heart disease death, non-fatal myocardial infarction, ischaemic stroke, or unstable angina. Median follow-up was 2.8 years. Baseline statin treatment was high-intensity (88.8%), low/moderate-intensity (8.7%) or none (2.4%). Median baseline low-density lipoprotein cholesterol was 86, 89 and 139 mg/dL (P < 0.001)...

Medicus, Jan 26, 2001

smanjenje unosa energije smanjuje endogenu sintezu kolesterola (1). Tako smanjenje tjelesne teaei... more smanjenje unosa energije smanjuje endogenu sintezu kolesterola (1). Tako smanjenje tjelesne teaeine za 1 kilogram uzrokuje sniaeenje ukupnog kolesterola za 0,05 mmol/l, LDL-kolesterola za 0,02 mmol/l, triglicerida za 0,015 mmol/l, a povisuje HDL-kolesterol za 0,009 mmol/l nakon πto se tjelesna teaeina uravnoteaei (2).

Kardiologia Polska, 2015

He has held many positions in the European Society of Cardiology (ESC) and European Atheroscleros... more He has held many positions in the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) and was a member of the World Heart Organisation Executive Board in Geneva, where he was representing Europe. He is a member of the editorial boards of several journals (JACC, Nature Rev Cardiol, etc.) and is a reviewer for a number of journals (Lancet, Eur Heart J, etc.). Besides publishing many papers and books, he is first author of the ESC/EAS European guidelines for the management of dyslipidaemias and one of the authors of the last two Joint European guidelines on cardiovascular disease prevention. Professor Reiner's research has focused on lipidology and preventive cardiology.

The American Journal of Clinical Nutrition, 2009

Peroxisome proliferator-activated receptor c (PPARc) is a clinically validated target for treatme... more Peroxisome proliferator-activated receptor c (PPARc) is a clinically validated target for treatment of insulin resistance. PPARc activation by full agonists such as thiazolidinediones has shown potent and durable glucose-lowering activity in patients with type 2 diabetes without the concern for hypoglycemia or gastrointestinal toxicities associated with some other medications used to treat this disease. However, thiazolidinediones are linked to safety and tolerability issues such as weight gain, fluid retention, edema, congestive heart failure, and bone fracture. Distinctive properties of PPARc provide the opportunity for selective modulation of the receptor such that desirable therapeutic effects may be attained without the unwanted effects of full activation. PPARc is a nuclear receptor that forms a complex with coreceptor RXR and a cell type-and cell statespecific array of coregulators to control gene transcription. PPARc affinity for these components, and hence transcriptional response, is determined by the conformational changes induced by ligand binding within a complex pocket with multiple interaction points. This molecular mechanism thereby offers the opportunity for selective modulation. A desirable selective PPARc modulator profile would include high-affinity interaction with the PPARc-binding pocket in a manner that leads to retention of the insulin-sensitizing activity that is characteristic of full agonists as well as mitigation of the effects leading to increased adiposity, fluid retention, congestive heart failure, and bone fracture. Examples of endogenous and synthetic selective PPARc modulator (SPPARM) ligands have been identified. SPPARM drug candidates are being tested clinically and provide support for this strategy.

Journal of Clinical Medicine, 2022

Statins are competitive inhibitors of hydroxymethylglutaryl-CoA (HMG-CoA) reductase and have been... more Statins are competitive inhibitors of hydroxymethylglutaryl-CoA (HMG-CoA) reductase and have been used to treat elevated low-density lipoprotein cholesterol (LDL-C) for almost four decades. Antioxidant and anti-inflammatory properties which are independent of the lipid-lowering effects of statins, i.e., their pleiotropic effects, might be beneficial in the prevention or treatment of many diseases. This review discusses the antioxidant effects of statins achieved by modulating the nuclear factor erythroid 2 related factor 2/ heme oxygenase-1 (Nrf2/HO-1) pathway in different organs and diseases. Nrf2 and other proteins involved in the Nrf2/HO-1 signaling pathway have a crucial role in cellular responses to oxidative stress, which is a risk factor for ASCVD. Statins can significantly increase the DNA-binding activity of Nrf2 and induce the expression of its target genes, such as HO-1 and glutathione peroxidase) GPx, (thus protecting the cells against oxidative stress. Antioxidant and a...

European Heart Journal, 2022

Aims Statin intolerance (SI) represents a significant public health problem for which precise est... more Aims Statin intolerance (SI) represents a significant public health problem for which precise estimates of prevalence are needed. Statin intolerance remains an important clinical challenge, and it is associated with an increased risk of cardiovascular events. This meta-analysis estimates the overall prevalence of SI, the prevalence according to different diagnostic criteria and in different disease settings, and identifies possible risk factors/conditions that might increase the risk of SI. Methods and results We searched several databases up to 31 May 2021, for studies that reported the prevalence of SI. The primary endpoint was overall prevalence and prevalence according to a range of diagnostic criteria [National Lipid Association (NLA), International Lipid Expert Panel (ILEP), and European Atherosclerosis Society (EAS)] and in different disease settings. The secondary endpoint was to identify possible risk factors for SI. A random-effects model was applied to estimate the overal...

Journal of Clinical Medicine, 2021

Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid... more Heterozygous familial hypercholesterolaemia (FH) is among the most common genetic metabolic lipid disorders characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth and a significantly higher risk of developing premature atherosclerotic cardiovascular disease. The majority of the current pediatric guidelines for clinical management of children and adolescents with FH does not consider the impact of genetic variations as well as characteristics of vascular phenotype as assessed by recently developed non-invasive imaging techniques. We propose a combined integrated approach of cardiovascular (CV) risk assessment and clinical management of children with FH incorporating current risk assessment profile (LDL-C levels, traditional CV risk factors and familial history) with genetic and non-invasive vascular phenotyping. Based on the existing data on vascular phenotype status, this panel recommends that all children with FH and cIMT ≥0.5 mm should receive lipi...

European Heart Journal, 2021

Patient Forum The content of these European Society of Cardiology (ESC) Guidelines has been publi... more Patient Forum The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC (journals.permissions@oup.com). Disclaimer: The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

Atherosclerosis, 2019

☆ The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC)... more ☆ The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). The disclosure forms of all experts involved in the development of these Guidelines are available on the ESC website www.escardio.org/guidelines.

Atherosclerosis Supplements, 2019

Atherosclerosis, 2019

Statistical analysis centre (D. De Bacquer h , G. De Backer h), Central laboratory (L. Raman ax ,... more Statistical analysis centre (D. De Bacquer h , G. De Backer h), Central laboratory (L. Raman ax , J. Sundvall ax), Study centres, organisations, investigators and other research personnel (National Coordinators in each country are indicated by asterisk (D. DeSmedt * bd , J.

Cor et Vasa, 2010

Souhrnný přehled Residual Risk Reduction Initiative, R 3 i* Navzdory současným standardům léčby z... more Souhrnný přehled Residual Risk Reduction Initiative, R 3 i* Navzdory současným standardům léčby zaměřené na dosažení cílových hodnot LDL cholesterolu, krevního tlaku a glykemie mají pacienti s dyslipidemií vysoké reziduální riziko vzniku vaskulárních příhod. Aterogenní dyslipidemie, zejména vyšší hodnota triglyceridů a nízká koncentrace HDL cholesterolu, se často vyskytuje spolu s vyšší koncentrací apolipoproteinu B a non-HDL cholesterolu u pacientů s diagnostikovanými kardiovaskulárními onemocněními, diabetes mellitus 2. typu, obezitou nebo metabolickým syndromem a je spojena s reziduálním makrovaskulárním a mikrovaskulárním rizikem. Residual Risk Reduction Initiative (R 3 i) byla založena proto, aby se touto důležitou problematikou zabývala. Cílem tohoto souhrnného přehledu je vyzdvihnout skutečnost, že se aterogenní dyslipidemie podílí na reziduálním makrovaskulárním riziku a mikrovaskulárních komplikacích, a doporučit léčebnou intervenci vedoucí ke snížení tohoto rizika, podpořenou důkazy a odborným konsensem. Důležitým prvním krokem je úprava životního stylu. Často je mimo to nutná také farmakoterapie. Přidání niacinu, fi brátu nebo ω-3 mastných kyselin k terapii statiny zlepšuje všechny lipidové rizikové faktory. Klinické studie hodnotí, zda mají tyto strategie lepší klinický přínos než léčba statiny. Závěrem lze říci, že iniciativa R 3 i zdůrazňuje potřebu ovlivnit vysokou míru reziduálního vaskulárního rizika u pacientů s dyslipidemií, kteří jsou léčeni prostřednictvím úpravy životního stylu anebo farmakoterapií v souladu se současnými standardy léčby.

European Journal of Preventive Cardiology, 2019

Aims The aim of this study was to determine whether the Joint European Societies guidelines on se... more Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhib...