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Articles by Jeffrey T. Kuvin
Total Records ( 2 ) for Jeffrey T. Kuvin
  Haseeb Jafri , Alawi A. Alsheikh-Ali , Paula Mooney , Carey D. Kimmelstiel , Richard H. Karas and Jeffrey T. Kuvin
 

Background

The importance of the number of circulating low-density lipoprotein (LDL) cholesterol particles, in addition to total LDL level, has been increasingly recognized. The effects of extended-release niacin (ERN) on LDL particle numbers have not been studied.

Objective

To evaluate ERN's effects on LDL particle numbers.

Methods

Fifty-four patients with stable coronary artery disease (CAD) and well-controlled LDL levels were randomly assigned to 3 months of ERN (1 g/day) or placebo in addition to their baseline medications. Lipoprotein particle number was analyzed by proton nuclear magnetic resonance spectroscopy at baseline and after 3 months.

Results

Compared to baseline, the addition of ERN had no significant effect on total LDL cholesterol levels; however, ERN decreased the number of medium and small LDL particles (P < .005). After 3 months, ERN decreased the number of medium and small LDL particles compared to placebo-treated patients (P < .05). ERN raised HDL cholesterol levels by 2.7%, significantly increased the number of large HDL particles (P < .001), and decreased the number of small HDL particles (P = .027) compared to placebo. There were no significant changes in lipid values or particle numbers in the placebo-treated patients. In patients with stable coronary artery disease and well-controlled LDL cholesterol levels, ERN reduced the number of circulating particles of the more atherogenic subtypes of LDL, despite having no effect on total LDL cholesterol levels. ERN also favorably altered the number of HDL particles.

Conclusion

ERN-induced alterations in lipoprotein particle numbers may contribute to its anti-atherosclerotic effects, and these effects may not be evident from the standard lipid profile.

  Erika M. Felix-Getzik , Jeffrey T. Kuvin and Richard H. Karas
 

Background

Low levels of high-density lipoprotein cholesterol (HDL-C) are an independent risk factor for coronary artery disease. For this study, nonoptimal HDL-C is defined as less than 40 mg/dL for male patients and less than 50 mg/dL for female patients. Even when low-density lipoprotein cholesterol (LDL-C) and non-HDL-C goals are met, significant risk for subsequent cardiovascular events remains in patients with acute coronary syndrome (ACS).

Objective

This study is a prospective, observational study to determine the prevalence of low HDL-C levels in 250 consecutive patients presenting with ACS who have well-controlled LDL-C levels.

Methods

This was an institutional review board-approved, prospective, observational study in which we evaluated consecutive patients admitted to the adult general cardiology service with a diagnosis of ACS.

Results

One hundred nine (44%) patients had LDL-C levels less than 100 mg/dL on admission. Of those patients, 90 (83%) had a nonoptimal HDL-C. Interestingly, a majority of patients, 94 (86%), had non-HDL-C levels at target. At discharge, approximately one half of eligible patients were started on therapy to increase their HDL-C levels.

Conclusion

In conclusion, nonoptimal HDL-C levels are highly prevalent in patients presenting with ACS and reasonably controlled LDL-C and non-HDL-C levels.

 
 
 
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