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Articles by Vijay Nambi
Total Records ( 4 ) for Vijay Nambi
  Venkat Polsani , Christie M. Ballantyne , Peter H. Jones , Vijay Nambi , Salim S. Virani and Daniele Zoch
  not available
  Salim S. Virani , Mahboob Alam , Christie M. Ballantyne , McArthur A. Elayda , Vei-Vei Lee , Vijay Nambi , Wei Pan , Venkatesh Polsani and James M. Wilson
  not available
  Venkateshwar R. Polsani , Vijay Nambi , Salim S. Virani , Daniele Zoch , Eric Y. Yang , Peter H. Jones and Christie M. Ballantyne
 

Background

Although there is clinical evidence for the safety and efficacy of single-drug therapy and some two-drug combinations for the treatment of hypertriglyceridemia, information is limited on the use of more than 2 drugs.

Objective

We evaluated the efficacy and safety of multidrug regimens (≥3 agents) in the management of hypertriglyceridemia.

Methods

The study included 40 individuals in an academic lipid referral clinic with mean follow-up of 1.98 years and an average use of 3.5 medications.

Results

During the study, mean body mass index decreased significantly (P=.0127), from 29.2 kg/m2 to 28.7 kg/m2, and mean hemoglobin A1C showed a trend towards decreasing (P=.06), from 7.9% to 7.2% in patients with diabetes (n=17). All lipid parameters decreased significantly: total cholesterol level decreased significantly from (mean±SD) 334.3±282.9 mg/dL to 183.8±54.8 mg/dL (P=.001, mean reduction of 45%), mean (± SD) triglyceride level decreased significantly from 1900.9±4576.8 mg/dL to 300.7±372.2 mg/dL (P=.02), median (range) triglyceride level decreased from 599 (242-28,550) mg/dL to 301 (40-1960) mg/dL (P < .001, mean reduction of 50%), and mean (± SD) non-high-density lipoprotein cholesterol decreased significantly from 189.9±131.6 mg/dL to 138.4±49.1 mg/dL (P=.014, mean reduction of 27%). There were no serious adverse effects (rhabdomyolysis or increased liver function tests >3 times upper limit of normal).

Conclusion

In a 2-year follow-up of 40 individuals on multidrug therapy (average of 3.5 drugs) for severe hypertriglyceridemia, combination therapy was efficacious and well tolerated.

  Smita I. Negi , Lynne Steinberg , Venkateshwar R. Polsani , Saqib A. Gowani , Vijay Nambi , Varinder Kumar , Victor Marinescu , Peter H. Jones , Laura A. Petersen , Christie M. Ballantyne and Salim S. Virani
 

Background

Non-high density lipoprotein cholesterol (non-HDL-C) goal attainment per Adult Treatment Panel III (ATP III) guidelines remains low.

Objective

To understand gaps in knowledge and practices of physicians-in-training (internal medicine, family medicine, cardiology, endocrinology) towards non-HDL-C.

Methods

A survey based on a conceptual model to assess the trainee's knowledge, attitudes, and practice regarding non-HDL-C was developed and administered to physicians-in-training (n = 655) at 26 training programs in the United States. Responses of those in internal medicine and family medicine (residents-in-training; n = 418) were compared with those in cardiology and endocrinology (fellows-in-training; n = 124).

Results

Response rate was 83.7%. Fifty-three percent of residents and 31% of fellows-in-training had not read the ATP III guidelines (P < .001). Thirty-three percent of the residents and 35% fellows-in-training could not calculate non-HDL-C from a standard lipid panel (P = .7). Sixty-seven percent of the residents and 52% of fellows were not aware of treatment goals for non-HDL-C (P = .004 for comparison between residents and fellows). Both residents and fellows reported infrequent calculation of non-HDL-C levels in patients with elevated triglycerides (≥200 mg/dL; 32.5% vs 35.4%, respectively, P = .6). Lack of familiarity with ATP III guidelines, lack of knowledge regarding importance of non-HDL-C, lack of institutional mandate to calculate non-HDL-C, and lack of emphasis on non-HDL-C by teaching staff were reported as barriers to non-HDL-C use in routine clinical practice.

Conclusions

At least one-third of physicians-in-training could not calculate non-HDL-C from a standard lipid panel, and a large number were not aware of ATP III treatment goals pertaining to non-HDL-C. This area represents one for improvement if non-HDL-C is to be retained as a treatment target in the forthcoming ATP-IV guidelines.

 
 
 
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