DECEMBER 2012, VOL 1, NO 3
Value-Based Care Cardiometabolic Health
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F R O M T H E P U B L I S H E R S O F A M E R I CA N H E A LT H & D R U G B E N E F I T S
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CVD Pipeline: Novel Approaches to Modifying Lipids/Lipoproteins
Heart disease the leading cause of death in diabetic patients
A total of 16 new drug classes are in development
By Wayne Kuznar
By Mary Mosley
Photo © Jim Dowdalls/Photo Researchers, Inc
Interventions for Cardiovascular Risk Reduction in Type 2 Diabetes Must Be Multifactorial Boston, MA—Optimal cardiovascular (CV) risk reduction in patients with diabetes must be multifactorial, stated James R. Gavin III, MD, PhD, Clinical Professor of Medicine, Emory University, Atlanta, GA, at the 2012 Cardiometabolic Health Congress. A great deal is known about CV disease (CVD) in diabetes, yet its prevention remains a paradox. No matter how well its risks are mitigated, the rates of CVD in the presence of diabetes remain higher than in its absence “in ways that simply make no sense,” Dr Gavin said. Coronary heart disease (CHD) is the leading cause of death in patients with diabetes. Although there are a host of emerging risk factors for CHD that ulti-
Munich, Germany—A total of 16 novel classes of drugs are under development for the management of lipoprotein metabolism toward the prevention of cardiovascular disease (CVD), according to John J.P. Kastelein, MD, PhD, Academic Medical Center, University of Amsterdam, the Netherlands. Dr Kastelein reviewed several of these approaches at the 2012 European Society of Cardiology (ESC) Congress. New Approaches to LDL-C Reduction Apolipoprotein (apo)-B mRNA antisense drugs, microsomal triglyceride transfer protein (MTP) inhibitors, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are promising new approaches to reducing low-density lipoprotein cholesterol (LDL-C), according to Dr Kastelein.
ApoB mRNA Antisense Drugs Mipomersen (Kynamro; Genzyme/Sanofi, Isis Pharmaceuticals) is an apoB mRNA antisense drug that has been studied in a trial Continued on page 11
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Belly Fat Triples CV and All-Cause GLP-1 Agonism Holds Promise Mortality, Even with Normal Weight for Preventing Macrovascular
Disease in Type 2 Diabetes
By Mary Mosley Munich, Germany—The risk of cardiovascular (CV) and all-cause death is nearly 3 times higher in persons with normal weight who nevertheless have excess belly fat than in people who are overweight or obese with a high waist-to-hip ratio (WHR), according to new data presented by Karine Sahakyan, MD, PhD, MPH, a cardiologist at the Mayo Clinic, Rochester, MN, at the 2012 European
Society of Cardiology Congress. The study data came from a large, nationwide, representative sample of the US population, “so we’re pretty confident about the results of this study,” said Dr Sahakyan. Normal-Weight Central Obesity Is Deadly Nearly half (47.8%) of the people with a normal body mass index (BMI) Continued on page 13
By Wayne Kuznar Boston, MA—No glucose-lowering regimen has been shown to reduce macrovascular complications, such as myocardial infarction (MI) or stroke, but glucagon-like peptide (GLP)-1 agonism appears to have favorable effects on many surrogate markers for cardio-
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INSIDE CARDIOMETABOLIC HEALTH . . . . .6 Controlling 4 risk factors cuts CHD rate in diabetes by 50% Data reveal potential cardioprotective role for DPP-4 inhibitors CVD MANAGEMENT . . . . . . . . . . . . . . .8 Third definition of MI presented at ESC PHS II: CV events in men not reduced with multivitamins EMERGING THERAPIES . . . . . . . . .10 Serelaxin reduces dyspnea in acute heart failure LCZ696 promising in heart failure with preserved EF
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vascular disease (CVD), according to presenters at the 2012 Cardiometabolic Health Congress. Although hyperglycemic states increase cardiovascular (CV) risk in a continuous manner, definitive evidence that glucose control decreases
OBESITY/OVERWEIGHT . . . . . . . . . .13 Behavioral interventions can result in weight loss HYPERTENSION . . . . . . . . . . . . . . . . .14 Three new prognostic markers in hypertension LIPID MANAGEMENT . . . . . . . . . . .15 Lipid therapy update DRUG UPDATES . . . . . . . . . . .18, 22 Belviq: New weight-loss Rx for overweight or obese patients Qsymia: Combination oral therapy for obese or overweight patients