Preface
Preface
Contents
Contributors
Part I: Basic Science: Dyslipidemia and Stroke
1: Role of Dyslipidemia in Atherosclerosis
1.1 Introduction
1.1.1 Lipids in the Atherosclerotic Process
1.1.2 Atherosclerotic Plaque Progression and Acute Rupture
1.1.3 Atherosclerotic Cardiovascular Disease
1.1.4 Atherosclerotic Peripheral Artery Disease
1.2 Conclusion
References
2: Effects of Dyslipidemia on the Cerebral Vessels
2.1 Effect of Dyslipidemia on Large Artery
2.2 Effect of Dyslipidemia on Small Artery
2.3 Effect of Dyslipidemia on Capillary Bed
References
Part II: Clinical Significance of Dyslipidemia in Stroke
3: Impact of Dyslipidemia on Ischemic Stroke
3.1 Impact of LDL Cholesterol
3.1.1 Primary Prevention Trials
3.1.2 Secondary Prevention Trials
3.1.3 Future Therapeutic Directions
3.1.4 Conclusion
3.2 Impact of HDL Cholesterol
3.2.1 HDL: An Antiatherogenic Lipoprotein?
3.2.2 Low HDL Cholesterol
3.2.3 Primary Prevention Trials
3.2.4 Secondary Prevention Trials
3.2.5 Conclusion
3.3 Association of Hypertriglyceridemia with Ischemic Stroke
3.3.1 Fasting Versus Non-fasting TGs
3.3.2 Clinical Evidence for Lowering of TGs on CVD Outcomes
3.3.3 Management of Hypertriglyderidemia
3.4 Association of Other Lipids with Ischemic Stroke
3.4.1 Human Genetics of Lp(a)
3.4.2 Clinical Evidence Related to Lp(a)
3.4.3 Management of High Levels of Lp(a)
References
4: Dyslipidemia and Hemorrhagic Stroke
4.1 Impact of Total Cholesterol
4.2 Impact of Low-Density Lipoprotein Cholesterol
4.3 Impact of Triglyceride
4.4 Impact of HDL Cholesterol
4.5 Postulated Pathophysiology of Hemorrhagic Stroke with Low Cholesterol Level
4.6 Lipid-Lowering Treatment and Hemorrhagic Stroke
4.6.1 Lipid-Lowering Treatment and Risk of ICH
4.6.2 Statin Treatment in Patients with ICH
4.7 Conclusion
References
5: Clinical Biomarkers of Dyslipidemia
5.1 Apolipoproteins
5.2 Lipid Peroxidation
5.3 Metabolomics
5.4 Lipidomics
References
Part III: Treatment of Dyslipidemia in Stroke Patients
6: Therapeutic Lifestyle Modification
6.1 Dietary Modification in Dyslipidemia
6.1.1 Energy
6.1.2 Fats and Carbohydrates
6.1.3 Dietary Pattern
6.1.4 Alcohol
6.1.5 Other Foods Patients Are Curious about
6.2 Physical Activity in Dyslipidemia
6.2.1 Effects of Physical Activity on HDL-C
6.2.2 Effects of Physical Activity on TG
6.2.3 Effects of Physical Activity on LDL-C
6.2.4 Mechanism behind the Effects of Physical Activity on Lipid Profile
6.2.5 Physical Activity Suggestion for Stroke Prevention
6.3 Smoking Cessation in Dyslipidemia
6.3.1 Cigarette Smoking and Lipid Profiles
6.3.2 Changes in Lipid Profiles upon Smoking Cessation
6.3.3 Other Forms of Cigarette Smoke Exposure: Passive Smoking and Electronic Cigarettes
References
7: Statins
7.1 History of Statin
7.2 Mechanism of Action
7.3 Types of each Statin
7.3.1 Pharmacological Properties of Statin
7.3.2 Efficacy of each Statin on Lipid Profile
7.3.3 Side Effects of Statins
7.4 Pleiotropic Effects of Statin on Cardiovascular Outcomes
7.4.1 Mechanism of Action of Pleiotropic Effects
7.4.2 Pleiotropic Effects of Statins on Atherosclerosis
7.4.3 Pleiotropic Effects on Cardiovascular Outcomes
7.5 Implication of Statin on Stroke Trials
7.5.1 Effects of Prestroke Statins
7.5.2 Effects of Post-Stroke Statins
7.5.3 Effects of Statins in Patients with Thrombolysis
References
8: Ezetimibe
8.1 History of Ezetimibe
8.2 Mechanisms of Action
8.3 Information for the Practical Use of Ezetimibe
8.3.1 Brief Review of Pharmacokinetics
8.3.2 Special Subgroups
8.3.3 DrugâDrug Interactions
8.3.4 Safety
8.4 Implications in Stroke Patients
8.4.1 Monotherapy
8.4.2 Combination Therapy
8.4.3 Guidelines
8.5 Conclusion
References
9: Fibrate and Niacin
9.1 History of Fibrate and Niacin
9.2 Mechanism of Action
9.3 Types of Agents
9.4 Implication of Dyslipidemia Medication on Stroke Trials
9.5 Conclusion
References
10: Fish Oils
10.1 History of Fish Oils
10.2 Mechanism of Action
10.2.1 Triglyceride
10.2.2 Heart Rate and Blood Pressure
10.2.3 Platelet Function
10.2.4 Inflammation
10.2.5 Vascular Endothelium
10.3 Types of Fish Oils
10.4 Implication of Fish Oils on Stroke Trials
10.4.1 Fish Oils on Stroke Trials
10.4.2 Conclusion
References
11: PCSK9 Inhibiting Monoclonal Antibodies
11.1 Biology of PCSK9
11.2 Pharmacology of Monoclonal Antibodies Against PCSK9
11.2.1 Alirocumab
11.2.1.1 Indications
11.2.1.2 Mechanism
11.2.1.3 Dose/Administration, Absorption, Distribution, Metabolism, and Clearance, Interactions
11.2.1.4 Efficacy
11.2.1.5 Adverse Reactions
11.2.1.6 Cost
11.2.2 Evolocumab
11.2.2.1 Indications
11.2.2.2 Mechanism
11.2.2.3 Dose/Administration, Absorption, Distribution, Metabolism and Clearance, Interactions
11.2.2.4 Efficacy
11.2.2.5 Adverse Reactions
11.2.2.6 Cognitive Function
11.2.2.7 Cost
11.3 Current Guidelines on PCSK-9 in Patients with ASCVD
11.4 Conclusion
References
12: PCSK9 Inhibiting siRNA
12.1 Phase 1 and 2 Clinical Studies
12.2 Phase III Studies
12.3 What Side Effects or Other Symptoms Should Clinicians Watch for?
12.4 Will Inclisiran Enhance LDL-C Goal/Threshold Attainment?
12.5 What About Outcome Data?
12.6 Comparison to Other PCSK 9 Therapies
12.7 Summary
References
13: Understanding of Clinical Practice Guidelines for Dyslipidemia
13.1 History of the Clinical Practice Guidelines
13.2 NCEP-ATP III Guidelines
13.3 ACC/AHA Guidelines
13.4 ESC/EAS Guidelines
13.5 Conclusions
References
Part IV: Management of Dyslipidemia in Clinical Practice of Stroke
14: Practical Management of Dyslipidemia in Stroke Patients
14.1 Use of Lipid-Lowering Agents in Patients Who have Experienced a Stroke
14.2 Effects of Hyperlipidemia and Statin Use in Patients with Various Stroke Subtypes
14.3 Effects of Lipid-Lowering Agents in Patients with Various Stroke Subtypes
14.4 Summary
References
15: Practical Dyslipidemia Management in Stroke-Specific Situations
15.1 Clinical Practice Guidelines and Landmark Trials for the Management of Dyslipidemia in Patients with Stroke
15.2 Role of Early Lipid-Lowering Therapy During Acute Stroke Period
15.3 Management of Dyslipidemia in Atrial Fibrillation-Associated Stroke
15.4 Management of Dyslipidemia in Hemorrhagic Stroke
15.5 Conclusions
References
16: Dyslipidemia in Women: Etiology and Management
16.1 Prevalence of Dyslipidemia in Women
16.1.1 CHD Risk Factors in Women
16.1.2 Diabetes Mellitus
16.2 Different Response to Therapy in Women
16.2.1 Statins: Primary Prevention
16.2.2 Meta-analyses of Primary Prevention Statin Trials
16.2.3 Statins: Secondary Prevention
16.2.4 Meta-analysis of Secondary Prevention Statin Trials
16.3 Lipid Management in Pregnancy
16.4 Lipid Management in Postmenopausal Women
16.4.1 Menopause and Dyslipidemia
16.4.2 Patient Screening
16.4.3 Nonpharmacologic Therapy
16.5 Pharmacologic Therapy
16.5.1 Statins
16.5.2 PSCK-9 Inhibitors
16.5.3 Cholesterol Absorption Inhibitors
16.5.4 Fibrates
16.5.5 Omega-3 Fatty Acids
16.6 Conclusions
References
17: Safety Considerations of Pharmacological Treatment
17.1 Drug Interaction Among Lipid-Lowering Agents
17.1.1 Statin
17.1.2 Ezetimibe
17.1.3 Fibrate
17.1.4 Niacin
17.1.5 Fish Oils
17.1.6 PCSK9 Inhibitors
17.2 Adverse Drug Reactions
17.2.1 Statin
17.2.2 Ezetimibe
17.2.3 Fibrate
17.2.4 Niacin
17.2.5 Fish Oils
17.2.6 PCSK9 Inhibitors
17.3 Statin-Induced Diabetes
17.3.1 High-Risk Population for Incident Diabetes After Statin Therapy
17.3.2 Suggested Mechanisms for Glucose Alterations
17.4 Cognitive Impairment
References