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2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult - 2009 recommendations.

https://arctichealth.org/en/permalink/ahliterature148105
Source
Can J Cardiol. 2009 Oct;25(10):567-79
Publication Type
Article
Date
Oct-2009
Author
Jacques Genest
Ruth McPherson
Jiri Frohlich
Todd Anderson
Norm Campbell
André Carpentier
Patrick Couture
Robert Dufour
George Fodor
Gordon A Francis
Steven Grover
Milan Gupta
Robert A Hegele
David C Lau
Lawrence Leiter
Gary F Lewis
Eva Lonn
G B John Mancini
Dominic Ng
Glen J Pearson
Allan Sniderman
James A Stone
Ehud Ur
Author Affiliation
McGill University Health Centre, Montreal, Canada. jacques.genest@muhc.mcgill.ca
Source
Can J Cardiol. 2009 Oct;25(10):567-79
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cardiovascular Diseases - etiology - prevention & control
Congresses as topic
Diagnostic Techniques, Cardiovascular
Dyslipidemias - complications - diagnosis - drug therapy
Humans
Hypolipidemic Agents - therapeutic use
Practice Guidelines as Topic - standards
Risk Assessment - methods
Societies, Medical
Abstract
The present article represents the 2009 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult.
Notes
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PubMed ID
19812802 View in PubMed
Less detail

The analysis by Manuel and colleagues creates controversy with headlines, not data.

https://arctichealth.org/en/permalink/ahliterature175310
Source
CMAJ. 2005 Apr 12;172(8):1033-4; discussion 1037
Publication Type
Article
Date
Apr-12-2005
Author
Jacques Genest
Ruth McPherson
Jiri Frohlich
George Fodor
Author Affiliation
Division of Cardiology, Royal Victoria Hospital, McGill University, Montréal, Que. jacques.genest@muhc.mcgill.ca
Source
CMAJ. 2005 Apr 12;172(8):1033-4; discussion 1037
Date
Apr-12-2005
Language
English
Publication Type
Article
Keywords
Canada
Cholesterol, LDL - blood
Coronary Disease - mortality - prevention & control
Health Expenditures
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - drug therapy
Hypolipidemic Agents - therapeutic use
Practice Guidelines as Topic
Risk factors
Notes
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Comment On: CMAJ. 2005 Apr 12;172(8):1027-3115824409
PubMed ID
15824410 View in PubMed
Less detail

Cardiometabolic risk in Canada: a detailed analysis and position paper by the cardiometabolic risk working group.

https://arctichealth.org/en/permalink/ahliterature135666
Source
Can J Cardiol. 2011 Mar-Apr;27(2):e1-e33
Publication Type
Article
Author
Lawrence A Leiter
David H Fitchett
Richard E Gilbert
Milan Gupta
G B John Mancini
Philip A McFarlane
Robert Ross
Hwee Teoh
Subodh Verma
Sonia Anand
Kathryn Camelon
Chi-Ming Chow
Jafna L Cox
Jean-Pierre Després
Jacques Genest
Stewart B Harris
David C W Lau
Richard Lewanczuk
Peter P Liu
Eva M Lonn
Ruth McPherson
Paul Poirier
Shafiq Qaadri
Rémi Rabasa-Lhoret
Simon W Rabkin
Arya M Sharma
Andrew W Steele
James A Stone
Jean-Claude Tardif
Sheldon Tobe
Ehud Ur
Author Affiliation
Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Source
Can J Cardiol. 2011 Mar-Apr;27(2):e1-e33
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cardiovascular Diseases - epidemiology - etiology - therapy
Diabetes Mellitus, Type 2 - epidemiology - etiology - prevention & control
Humans
Metabolic Syndrome X - complications - epidemiology - therapy
Practice Guidelines as Topic
Risk factors
Abstract
The concepts of "cardiometabolic risk," "metabolic syndrome," and "risk stratification" overlap and relate to the atherogenic process and development of type 2 diabetes. There is confusion about what these terms mean and how they can best be used to improve our understanding of cardiovascular disease treatment and prevention. With the objectives of clarifying these concepts and presenting practical strategies to identify and reduce cardiovascular risk in multiethnic patient populations, the Cardiometabolic Working Group reviewed the evidence related to emerging cardiovascular risk factors and Canadian guideline recommendations in order to present a detailed analysis and consolidated approach to the identification and management of cardiometabolic risk. The concepts related to cardiometabolic risk, pathophysiology, and strategies for identification and management (including health behaviours, pharmacotherapy, and surgery) in the multiethnic Canadian population are presented. "Global cardiometabolic risk" is proposed as an umbrella term for a comprehensive list of existing and emerging factors that predict cardiovascular disease and/or type 2 diabetes. Health behaviour interventions (weight loss, physical activity, diet, smoking cessation) in people identified at high cardiometabolic risk are of critical importance given the emerging crisis of obesity and the consequent epidemic of type 2 diabetes. Vascular protective measures (health behaviours for all patients and pharmacotherapy in appropriate patients) are essential to reduce cardiometabolic risk, and there is growing consensus that a multidisciplinary approach is needed to adequately address cardiometabolic risk factors. Health care professionals must also consider risk factors related to ethnicity in order to appropriately evaluate everyone in their diverse patient populations.
PubMed ID
21459257 View in PubMed
Less detail

Distribution and medical impact of loss-of-function variants in the Finnish founder population.

https://arctichealth.org/en/permalink/ahliterature260438
Source
PLoS Genet. 2014 Jul;10(7):e1004494
Publication Type
Article
Date
Jul-2014
Author
Elaine T Lim
Peter Würtz
Aki S Havulinna
Priit Palta
Taru Tukiainen
Karola Rehnström
Tõnu Esko
Reedik Mägi
Michael Inouye
Tuuli Lappalainen
Yingleong Chan
Rany M Salem
Monkol Lek
Jason Flannick
Xueling Sim
Alisa Manning
Claes Ladenvall
Suzannah Bumpstead
Eija Hämäläinen
Kristiina Aalto
Mikael Maksimow
Marko Salmi
Stefan Blankenberg
Diego Ardissino
Svati Shah
Benjamin Horne
Ruth McPherson
Gerald K Hovingh
Muredach P Reilly
Hugh Watkins
Anuj Goel
Martin Farrall
Domenico Girelli
Alex P Reiner
Nathan O Stitziel
Sekar Kathiresan
Stacey Gabriel
Jeffrey C Barrett
Terho Lehtimäki
Markku Laakso
Leif Groop
Jaakko Kaprio
Markus Perola
Mark I McCarthy
Michael Boehnke
David M Altshuler
Cecilia M Lindgren
Joel N Hirschhorn
Andres Metspalu
Nelson B Freimer
Tanja Zeller
Sirpa Jalkanen
Seppo Koskinen
Olli Raitakari
Richard Durbin
Daniel G MacArthur
Veikko Salomaa
Samuli Ripatti
Mark J Daly
Aarno Palotie
Source
PLoS Genet. 2014 Jul;10(7):e1004494
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
European Continental Ancestry Group
Exome - genetics
Female
Finland
Founder Effect
Gene Frequency
Genetic Diseases, Inborn
Genetic Drift
Genetic Variation
Genetics, Population
Genome-Wide Association Study
Humans
Male
Phenotype
Abstract
Exome sequencing studies in complex diseases are challenged by the allelic heterogeneity, large number and modest effect sizes of associated variants on disease risk and the presence of large numbers of neutral variants, even in phenotypically relevant genes. Isolated populations with recent bottlenecks offer advantages for studying rare variants in complex diseases as they have deleterious variants that are present at higher frequencies as well as a substantial reduction in rare neutral variation. To explore the potential of the Finnish founder population for studying low-frequency (0.5-5%) variants in complex diseases, we compared exome sequence data on 3,000 Finns to the same number of non-Finnish Europeans and discovered that, despite having fewer variable sites overall, the average Finn has more low-frequency loss-of-function variants and complete gene knockouts. We then used several well-characterized Finnish population cohorts to study the phenotypic effects of 83 enriched loss-of-function variants across 60 phenotypes in 36,262 Finns. Using a deep set of quantitative traits collected on these cohorts, we show 5 associations (p
Notes
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Comment In: Nat Rev Genet. 2014 Oct;15(10):644-525139190
PubMed ID
25078778 View in PubMed
Less detail

Gene dosage of the common variant 9p21 predicts severity of coronary artery disease.

https://arctichealth.org/en/permalink/ahliterature141832
Source
J Am Coll Cardiol. 2010 Aug 3;56(6):479-86
Publication Type
Article
Date
Aug-3-2010
Author
Sonny Dandona
Alexandre F R Stewart
Li Chen
Kathryn Williams
Derek So
Ed O'Brien
Christopher Glover
Michel Lemay
Olivia Assogba
Lan Vo
Yan Qing Wang
Marino Labinaz
George A Wells
Ruth McPherson
Robert Roberts
Author Affiliation
John and Jennifer Ruddy Canadian Cardiovascular Genetics Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada.
Source
J Am Coll Cardiol. 2010 Aug 3;56(6):479-86
Date
Aug-3-2010
Language
English
Publication Type
Article
Keywords
Age Factors
Age of Onset
Aged
Chromosomes, Human, Pair 9 - genetics
Coronary Angiography
Coronary Artery Disease - epidemiology - genetics - radiography
Cross-Sectional Studies
Electrocardiography
Female
Follow-Up Studies
Gene Dosage
Genetic Predisposition to Disease - epidemiology
Genetic Variation
Genotype
Humans
Male
Middle Aged
Ontario - epidemiology
Prevalence
Retrospective Studies
Risk Assessment - methods
Risk factors
Severity of Illness Index
Abstract
The purpose of this study was to test the hypothesis that 9p21 gene dosage determines the severity of coronary artery disease (CAD).
The 9p21 locus is the first common genetic variant to associate with risk of CAD and/or myocardial infarction in multiple studies.
A cross-sectional study examined nondiabetic patients with CAD defined by coronary angiography to have at least 1 epicardial stenosis >50%. In all, 950 patients with early onset CAD (age 56.1 +/- 9.6 years) and an independent sample of 764 patients with late onset CAD (age 70.0 +/- 8.0 years) were enrolled from the cardiac catheterization laboratories at the University of Ottawa Heart Institute from April 15, 2006, to August 15, 2008, and genotyped for the single nucleotide polymorphism rs1333049 9p21 risk variant. Angiographers were blinded to genotype. The association between 9p21 risk genotype and the proportion of patients with 3-vessel disease, 1-vessel disease, left main trunk disease, and coronary artery bypass graft surgery was tested, as was its association with the modified Gensini and Duke coronary scoring indexes.
Among younger CAD cases, 3-vessel disease demonstrated a strong, direct association with 9p21 gene dosage (p = 4.26 x 10(-4)). Conversely, 1-vessel disease demonstrated a strong inverse association with increasing gene dosage (p = 2.41 x 10(-5)). In the replication sample, gene dosage also predicted 3-vessel disease (p = 6.51 x 10(-6)). Left main trunk disease and coronary artery bypass graft surgery demonstrated a direct strong association with gene dosage (p = 3.66 x 10(-4)) and (p = 2.42 x 10(-2)), respectively. Gene dosage demonstrated a strong, direct association with both the modified Gensini (p
Notes
Comment In: J Am Coll Cardiol. 2011 Mar 29;57(13):1497-8; author reply 1498-921435522
Comment In: J Am Coll Cardiol. 2010 Aug 3;56(6):487-920670759
PubMed ID
20670758 View in PubMed
Less detail

Identification and management of cardiometabolic risk in Canada: a position paper by the cardiometabolic risk working group (executive summary).

https://arctichealth.org/en/permalink/ahliterature135665
Source
Can J Cardiol. 2011 Mar-Apr;27(2):124-31
Publication Type
Article
Author
Lawrence A Leiter
David H Fitchett
Richard E Gilbert
Milan Gupta
G B John Mancini
Philip A McFarlane
Robert Ross
Hwee Teoh
Subodh Verma
Sonia Anand
Kathryn Camelon
Chi-Ming Chow
Jafna L Cox
Jean-Pierre Després
Jacques Genest
Stewart B Harris
David C W Lau
Richard Lewanczuk
Peter P Liu
Eva M Lonn
Ruth McPherson
Paul Poirier
Shafiq Qaadri
Rémi Rabasa-Lhoret
Simon W Rabkin
Arya M Sharma
Andrew W Steele
James A Stone
Jean-Claude Tardif
Sheldon Tobe
Ehud Ur
Author Affiliation
St. Michael's Hospital, Toronto, Ontario, Canada. LeiterL@smh.ca
Source
Can J Cardiol. 2011 Mar-Apr;27(2):124-31
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cardiovascular Diseases - epidemiology - etiology - prevention & control
Diabetes Mellitus, Type 2 - complications - epidemiology - therapy
Humans
Incidence
Metabolic Syndrome X - complications - epidemiology - therapy
Obesity - complications - epidemiology - therapy
Practice Guidelines as Topic
Risk Assessment - methods
Risk factors
Abstract
With the objectives of clarifying the concepts related to "cardiometabolic risk," "metabolic syndrome" and "risk stratification" and presenting practical strategies to identify and reduce cardiovascular risk in multiethnic patient populations, the Cardiometabolic Working Group presents an executive summary of a detailed analysis and position paper that offers a comprehensive and consolidated approach to the identification and management of cardiometabolic risk. The above concepts overlap and relate to the atherogenic process and development of type 2 diabetes. However, there is confusion about what these terms mean and how they can best be used to improve our understanding of cardiovascular disease treatment and prevention. The concepts related to cardiometabolic risk, pathophysiology, and strategies for identification and management (including health behaviours, pharmacotherapy, and surgery) in the multiethnic Canadian population are presented. "Global cardiometabolic risk" is proposed as an umbrella term for a comprehensive list of existing and emerging factors that predict cardiovascular disease and/or type 2 diabetes. Health behaviour interventions (weight loss, physical activity, diet, smoking cessation) in people identified at high cardiometabolic risk are of critical importance given the emerging crisis of obesity and the consequent epidemic of type 2 diabetes. Vascular protective measures (health behaviours for all patients and pharmacotherapy in appropriate patients) are essential to reduce cardiometabolic risk, and there is growing consensus that a multidisciplinary approach is needed to adequately address cardiometabolic risk factors. Health care professionals must also consider ethnicity-related risk factors in order to appropriately evaluate all individuals in their diverse patient populations.
PubMed ID
21459258 View in PubMed
Less detail

Limitations of statin monotherapy for the treatment of dyslipidemia: a projection based on the Canadian lipid study--observational.

https://arctichealth.org/en/permalink/ahliterature152683
Source
Curr Med Res Opin. 2009 Jan;25(1):47-55
Publication Type
Article
Date
Jan-2009
Author
Martin Sénécal
George Fodor
Claude Gagné
Jacques Genest
Marc-André Lavoie
Ruth McPherson
Michael Marentette
Rolf J Sebaldt
Author Affiliation
Health economics and outcomes research, Merck Frosst Canada Ltd., Montreal, Canada. martin_senecal@merck.com
Source
Curr Med Res Opin. 2009 Jan;25(1):47-55
Date
Jan-2009
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cholesterol, LDL - blood
Coronary Artery Disease - complications
Cross-Sectional Studies
Dyslipidemias - complications - drug therapy
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Middle Aged
Abstract
Several randomized controlled trials indicate that a low density lipoprotein cholesterol (LDL-C) target or =2.0 mmol/L. Depending on the statin that was used, it was projected that between 28.2% and 62.7% of high CAD-risk patients would not attain an LDL-C of
PubMed ID
19210138 View in PubMed
Less detail

Prevalence of dyslipidemia in statin-treated patients in Canada: results of the DYSlipidemia International Study (DYSIS).

https://arctichealth.org/en/permalink/ahliterature139312
Source
Can J Cardiol. 2010 Nov;26(9):e330-5
Publication Type
Article
Date
Nov-2010
Author
Shaun G Goodman
Anatoly Langer
Natacha R Bastien
Ruth McPherson
Gordon A Francis
Jacques J Genest
Lawrence A Leiter
Author Affiliation
St Michael's Hospital and University of Toronto, Toronto, Ontario. goodmans@smh.toronto.on.ca
Source
Can J Cardiol. 2010 Nov;26(9):e330-5
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Aged
Canada - epidemiology
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Cross-Sectional Studies
Drug Therapy, Combination
Dyslipidemias - blood - drug therapy - epidemiology
Evidence-Based Medicine
Female
Fluorobenzenes - therapeutic use
Heptanoic Acids - therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Middle Aged
Practice Guidelines as Topic
Prevalence
Pyrimidines - therapeutic use
Pyrroles - therapeutic use
Risk factors
Sulfonamides - therapeutic use
Abstract
Despite clear guideline recommendations, there is a growing body of evidence that there is suboptimal use of lipid-lowering treatment in Canadians.
To assess the prevalence and types of persistent lipid abnormalities in Canadian patients receiving statin therapy.
The present cross-sectional study recruited 2436 outpatients 45 years of age or older who were treated with statins by 232 physicians from 10 provinces; all underwent clinical examination and had their latest fasting lipid values while on statin therapy recorded.
The median patient age was 66 years (interquartile range [IQR] 58 to 74 years), 60% were men and 80% were in the high 10-year risk category. The median low-density lipoprotein cholesterol level was 2.0 mmol/L (IQR 1.6 mmol/L to 2.5 mmol/L) and the median total cholesterol/high-density lipoprotein cholesterol ratio was 3.4 mmol/L (IQR 2.8 mmol/L to 4.1 mmol/L). However, based on the 2006 Canadian Cardiovascular Society recommendations, 37% of all patients did not have a low-density lipoprotein cholesterol level at goal or intervention target level, including 45% of high-risk category patients. The majority of patients received atorvastatin (50%) or rosuvastatin (37%) but primarily at low-to-medium doses, and a minority (14%) received additional lipid-modifying therapies.
The present observational study highlights the need for more intensive treatment of lipid abnormalities, particularly among high-risk patients. Recognizing several important limitations related to the observational nature of the study, the findings suggest the possibility that, in addition to optimizing adherence, there remains an important need to titrate current statin therapy to higher doses and potentially use a combination of lipid-modifying treatments (once the statin dose has been truly maximized) to further bridge the gap between evidence-based medicine and current Canadian practice.
Notes
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PubMed ID
21076724 View in PubMed
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Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease: summary of the 2003 update.

https://arctichealth.org/en/permalink/ahliterature183108
Source
CMAJ. 2003 Oct 28;169(9):921-4
Publication Type
Article
Date
Oct-28-2003
Author
Jacques Genest
Jiri Frohlich
George Fodor
Ruth McPherson
Author Affiliation
Royal Victoria Hospital, McGill University, Montréal, Que. jacques.genest@muhc.mcgill.ca
Source
CMAJ. 2003 Oct 28;169(9):921-4
Date
Oct-28-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
C-Reactive Protein - metabolism
Canada - epidemiology
Cardiovascular Diseases - etiology - prevention & control
Female
Humans
Hyperlipidemias - complications - therapy
Hypertension - complications
Hypolipidemic Agents - therapeutic use
Male
Middle Aged
Obesity - complications - epidemiology
Practice Guidelines as Topic
Risk factors
Notes
Cites: CMAJ. 2000 May 16;162(10):1441-710834048
Cites: Circulation. 1999 Sep 28;100(13):1481-9210500053
Cites: Lancet. 2002 Jul 6;360(9326):7-2212114036
Cites: JAMA. 2001 Apr 4;285(13):1711-811277825
Comment In: CMAJ. 2004 Jul 20;171(2):118; author reply 118-915262868
Comment In: CMAJ. 2004 Jul 20;171(2):118; author reply 118-915262866
Comment In: CMAJ. 2005 Nov 8;173(10):1210; author reply 121016275979
Comment In: CMAJ. 2005 Nov 8;173(10):1207; author reply 121016275976
Comment On: CMAJ. 2000 May 16;162(10):1441-710834048
Erratum In: CMAJ. 2003 Nov 25;169(11):1149
PubMed ID
14581310 View in PubMed
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