Potpourri 2020 LipidSpin Articles | National Lipid Association Online

JOSEPH J. SASEEN, PHARMD, CLS, FNLA	From the NLA President: Important Goals, Visions for the Coming Year I would like to welcome everyone to the Potpourri Edition of LipidSpin – brought to you this year as a joint effort between the Northeast and Southeast Lipid Associations. This is the first LipidSpin edition that I have the good fortune of introducing to you as President of the National Lipid Association. I consider this opportunity a great honor, and hope to spend this year building upon the strong foundation established by my predecessors as well as creating substantial pathways... more
EDWARD GOLDENBERG, MD, FACC, FACP, FNLA	From the NELA President: You Are Not Alone As an intern, in 1972, what I feared most was caring for an acute myocardial infarction (MI). Prior to the coronary care unit (CCU), developed in Kansas in the 1960’s, the mortality of an acute MI was 30% and subsequently dropped to 15% because of effective treatment of arrhythmias. Otherwise treatment was oxygen, morphine, listening to the patient, and providing support for the family. There were no effective diuretics for the treatment of congestive heart failure (CHF), so morphine, oxygen... more
THOMAS R. WHITE, MD, FNLA	From the SELA President: A New Enemy, an Age-Old Mission As I write this, it is nearly impossible to address anything related to health care and medicine without mentioning COVID19. Indeed, this pandemic has effected changes most of us never imagined. Lives have been lost. Families have suffered. Unemployment is rampant. The tension between restoring the economy and respecting the virus is palpable. There remains much uncertainty. Meanwhile, our SELA chapter has been working diligently with NELA under the leadership of Dr. Ed Goldenberg to... more
KAYE-EILEEN WILLARD, MD, FNLA	Editor’s Corner: Beating Isolation Through Collective Innovation “In the long history of humankind (and of animal kind too) those who learned to collaborate and improvise most effectively have prevailed” ~ Charles R. Darwin I often peruse the comments of historical figures for whom I have admiration in order to ‘center myself’ and better lead my colleagues. This quote from Darwin struck me as ideal for our present COVID-19 ‘era’ during which we are asked to lead through challenging, sometimes unprecedented... more
SASHA DE JESUS, MD GUY L. MINTZ, MD, FACP, FACC, FASPC, FNLA	Clinical Feature: Maximizing Patient-Clinician Engagement: Shared Decision-Making Cardiovascular disease (CVD) is the leading cause of death worldwide, accounting for nearly 18 million deaths in 2017 with 859,125 of those occurring in the United States – a number higher than death from all forms of cancer combined.(1) Unfortunately, this global number is anticipated to rise to over 22 million by 2030. About one third of American adults have some form of CVD, with costs of the management of these conditions surpassing $351 billion between 2014 and 2015.(1) ... more
REED MSZAR, MPH DIPIKA J. GOPAL, MD JENNIFER LEWEY, MD, MPH RICHARD L. NEMIROFF, MD DANIEL E. SOFFER, MD, FNLA	EBM Tools for Practice: Finding Familial Hypercholesterolemia in the Perinatal Period Familial hypercholesterolemia (FH) is an autosomal codominant genetic disorder of lipoprotein metabolism associated with disproportionately high levels of lowdensity lipoprotein cholesterol (LDL-C) and an increased risk of developing premature atherosclerotic cardiovascular disease (ASCVD) and valvular aortic stenosis.(1,2) Heterozygous FH (HeFH) affects all races and ethnicities and is prevalent in approximately 1 in 220 individuals, though an estimated 90% of those affected are presently... more
KEVIN FOREY, MD, MBA EUGENIA GIANOS, MD, FACC, FASE, FNLA	Lipid Luminations: Renewed Justification for Triglyceride-Lowering Therapy: Insight from REDUCE-IT and Previous Fibrate Trials An accumulating body of evidence has implicated hypertriglyceridemia as a treatable risk factor for the prevention of atherosclerotic cardiovascular diseases (ASCVD).(1) Most notably, the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) provided renewed and convincing justification for triglyceride-lowering therapy in at-risk individuals with optimally controlled low-density lipoprotein (LDLC) levels.(2) The results of this landmark study have built upon... more
THOMAS R. WHITE, MD, FNLA DHARMESH PATEL, MD, FACC, MBBS (London), FACP, FASPC, FNLA	Practical Pearls: The Young Active Asymptomatic Patient With Very High LDL-C We present a clinical case and offer Practical Pearls from primary care/Lipid Specialist and cardiology for management of a common scenario, reinforcing the importance of a clinician-patient discussion. Key points: Severe hypercholesterolemia (LDL-C ≥ 190 mg/dL) is a high-risk condition warrants high-intensity statin warrants outreach to family members (cascade screening) to test their lipid profile (+/- FH genotyping) and Lp(a)... more
SHILPA SINGH, DO STEPHEN MENG, MD	Case Study: Lipoprotein(a) and its Role in Cardiovascular Risk Here we describe a case study of a 50- year-old physically active male wit h no significant past medical history wh o presented initially with fatigue an d shortness of breath while playing tenni s and was found to have new findings of an inferior wall MI on EKG. He wa s referred to Cardiology for a nuclea r stress study which showed a moderat e sized, severe fixed inferior wall defect. He had well-preserved functional exercis e capacity during the study. His lipid panel exhibited an LDL of... more
LUKE HAMILTON, MS BENJAMIN JACK DON P. WILSON, MD, FNLA	Specialty Corner: Effects of Low Cholesterol on Adrenal Function Cholesterol is an essential component of human cell biology, responsible for numerous diverse and important physiologic functions. In addition to maintenance of cell membranes, cholesterol is a key substrate for production of vitamin D, and thyroid and steroid hormones. Previous studies hypothesized adrenal insufficiency may occur in individuals with LDL/HDL deficiency, although little data is available. Given its importance in maintaining proper cellular function and maintenance, vital... more
JENNIFER TUNOA, PHARMD JOSEPH J. SASEEN, PHARMD, CLS, FNLA	Guest Editorial: Clinicians Should Monitor LDL-C After Starting Lipid-Lowering Therapy Multiple randomized controlled trials have demonstrated significant reductions in major cardiovascular (CV) events and mortality with statin therapy.(1) These data have supported the “LDL-C treatment strategy,” in which CV event risk reduction is directly proportionate to the extent of LDL-C lowering.(2) Because the majority of these trials studied fixed-dose statin regimens, this approach became the foundation of initial treatment recommendations within the 2013 ACC/AHA Guideline on the... more
CAROLINE deRICHEMOND, CRNP, CLS, FNLA	NELA Chapter Update: Effect of COVID-19 on the Daily Practice of Medicine I knew that Saturday when my pager went off with a “high priority” message, COVID-19 was here. In less than 24 hours, our regional chair restructured all that we do; four days hospital rounds, four days telemedicine, no outreach, work at one campus, days off requiring checking messages for updates of protocols, daily dashboard and system-wide town hall meetings. We were placed into teams to minimize exposure ultimately “to avoid all of us getting the virus at once.” That Monday I had... more
THOMAS R. WHITE, MD, FNLA	SELA Chapter Update: SELA Stays Productive During Unpredictable Year This year, SELA was excited to collaborate with the Foundation of the NLA to provide financial support to Health First Community Health Center to conduct LDL-C, Triglyceride, and A1C screenings in rural and un/underinsured populations in Kentucky. Patients were provided with educational resources and those who presented with elevated levels received counseling from the onsite clinician working with the phlebotomist. Due to COVID-19, all screenings are currently on hold until it is safe to... more
DEAN KARALIS, MD, FNLA* GREGORY POKRYWKA, MD, NCMP, FNLA* MARY KATHERINE CHEELEY, PharmD, BCPS, CLS, FNLA TRACY SEVERSON, RD	Member Spotlight: Overcoming the Challenges of COVID-19