Hyperlipidemias: Paraskevas KI

Paraskevas KI, Bessias N, Papas TT, Gekas CD, Andrikopoulos V, Mikhailidis DP. · No affiliation provided · Angiology. · Pubmed #18505745 No free full text.

Abstract: Established vascular risk factors (ie, smoking, hypertension, diabetes mellitus, and dyslipidemia) play an important role in the development of vascular disease. Emerging evidence suggests that some of these risk factors may have a more intense effect on specific arterial beds, a finding that holds implications for a prognostic role for certain types of vascular disease.

Paraskevas KI. · Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK. · Int Urol Nephrol. · Pubmed #18066677 No free full text.

Abstract: Lipid abnormalities, and especially hypertriglyceridaemia, are a prominent feature of peritoneal dialysis (PD) patients. The results from several studies have shown that statins are effective and safe lipid-lowering agents in these individuals. Besides lipid lowering, current evidence suggests that these agents exert multiple beneficial effects on PD patients. Statins may maintain residual kidney function by altering the response of the kidneys to dyslipidaemia and, thus, slow the progression of renal failure in PD patients. Also, statins may reduce the incidence of cardiovascular events, as well as morbidity and mortality rates in this high-risk group. However, despite the multiple beneficial effects, PD patients receive suboptimal statin treatment. Apart from the German Dialysis and Diabetes (4D) study, no other prospective, randomised controlled trial has investigated the effects of statin treatment on dialysis patients. The results of large-scale, multi-centre randomised controlled studies (such as AURORA and SHARP) are expected to define the role of statin therapy in this high-risk population.

Athyros VG, Kakafika AI, Papageorgiou AA, Paraskevas KI, Tziomalos K, Anagnostis P, Pagourelias E, Koumaras C, Karagiannis A, Mikhailidis DP. · Atherosclerosis and Metabolic Syndrome Units, Second Propedeutic Department of Internal Medicine, Aristotelian University, Hippocration Hospital, Thessaloniki, Greece. · Curr Med Res Opin. · Pubmed #18430270 No free full text.

Abstract: BACKGROUND: Reducing low-density lipoprotein cholesterol (LDL-C) levels to National Cholesterol Expert Panel (NCEP) goal is recommended. However, sex-specific effects may influence benefit. METHODS AND RESULTS: In this post hoc analysis of the GREek Atorvastatin and Coronary heart disease (CHD) Evaluation [GREACE] study we investigated the extent in vascular event reduction by statin treatment according to sex. From a total of 1600 patients with stable CHD, 624/176 and 632/168 were men/women on atorvastatin or on usual care, respectively. During 3-year follow-up, comparison of atorvastatin treatment with usual care demonstrated a relative risk reduction (RRR) of the primary end point (all vascular events) of 54% in women (hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.24-0.87, p=0.003) and of 50% in men (HR 0.50, 95% CI 0.32-0.70, p<0.001). The fall in LDL-C levels played the key role in end point reduction in both sexes. However, in men there was an additional benefit related to the atorvastatin-induced increase in high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR), while in women end points were related to a substantial triglycerides (TG) reduction. CONCLUSIONS: Treatment with atorvastatin to the NCEP LDL-C goal compared with 'usual care' significantly reduced CHD morbidity and mortality in both men and women. Both men and women benefited from statin treatment possibly with different mechanisms making a contribution over and above LDL-C reduction.

Paraskevas KI, Mikhailidis DP, Liapis CD. · Department of Clinical Biochemistry and Academic Department of Surgery, Royal Free Hospital, London, United Kingdom. · Angiology. · Pubmed #17626988 No free full text.

Abstract: The aim of this article is to investigate the association between internal carotid artery occlusion (ICAO) and the presence of atherosclerotic disease and vascular risk factors. The clinical characteristics and risk factors of 120 patients presenting with ICAO were retrospectively reviewed. All patients (n = 120) had at least 1 of the 4 vascular risk factor (diabetes, smoking, hypercholesterolemia, and hypertension); 2, 3, or all 4 risk factors were present in 14 to 82 of the patients (11.7% to 68.3%), 10 to 39 of the patients (8.3% to 32.5%), and 9 of the patients (7.5%), respectively. A total of 84 patients (70%) with ICAO had disease in at least 1 additional vascular bed (aorta, coronary or lower limb arteries). In addition to ICAO, vascular disease was present in 2 and all 3 of these arterial beds in 42 (35%) and 9 (7.5%) patients, respectively. Furthermore, stenosis or occlusion of the ipsilateral or contralateral vertebral arteries was recorded in 19 of 120 patients (15.8%). Regarding the contralateral carotid artery, 1 patient had bilateral ICAO. One patient had contralateral common carotid artery occlusion, and 1 patient was excluded from the analysis because of surgery to the contralateral carotid artery. Of the remaining 117 patients, 34 (29.0%) had less than 50% contralateral carotid artery stenosis. Thirty-two patients (27.4%) had 50% to 69%, and 51 (43.6%) had 70% to 99% stenosis. Ultrasonographic imaging of the carotid plaque of the contralateral carotid artery revealed that 52 of the 120 arteries (43.3%) were uniformly or predominantly echolucent (types I and II, respectively). Fifty-nine (49.2%) were predominantly or uniformly echogenic (types III and IV), and 9 (7.5%) could not be classified. A similar distribution of echomorphology was observed on the occluded side. ICAO is associated with widespread atherosclerotic disease and a high prevalence of vascular risk factors. Detection of ICAO should prompt the investigation of other arterial beds and treatment of risk factors.

Paraskevas KI. · No affiliation provided · J Vasc Surg. · Pubmed #18727983 No free full text.

This publication has no abstract.