Spring 2017 LipidSpin Articles | National Lipid Association Online

Joyce L. Ross, MSN, CRNP, FPCNA, FNLA	From the NLA President: Times They Are A-Changin’ There are many new influences on how dyslipidemia is managed today. While this is exciting, as is common with change, there are cogs in the wheel of progress. Healthcare providers and patients are aware of barriers for implementing therapies that appear to be efficacious for optimal care. Multiple factors are involved with this issue. While our newest class of approved anti-dyslipidemia medication, PCSK9 inhibitors, appear to be safe and efficacious, evidence demonstrating that they... more
Rob S. Greenfield, MD, FACC, FAHA, FNLA	From the PLA President: Riding the Waves Once again, welcome to our region. From the endless smooth coastline of California to the pristine and rocky Oregon and Washington coasts. From the best snow in the world in Utah and Idaho to the big sky country of Montana. From Nevada and the last frontier of Alaska to the idyllic dreamscape of Hawaii. From the 4,900 miles that our region covers, we welcome you. The title of this issue elicits the image of a surfer navigating the waves with their sudden twists and turns. The surfer... more
DANIEL E. SOFFER, MD, FACP, FNLA	From the LipidSpin Editor: Clinical Lipidology — Heroic Tasks In Greek mythology Sisyphus was the king of Ephyra (now known as Corinth). He was punished for his self-aggrandizing craftiness and deceitfulness by being forced to roll an immense boulder up a hill, only to watch it come back to hit him, repeating this action for eternity.”1 It is a bit of an exaggeration to compare our task of prescribing proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors as equivalent or even similar to that of Sisyphus, but bear... more
PAUL D. ROSENBLIT, MD, PhD, FACE, FNLA YEHUDA HANDELSMAN, MD, FACP, FACE, FNLA	Clinical Feature: Targeting Atherogenic Cholesterol Goals for Patients that Meet the Criteria of ‘Extreme’ ASCVD Risk The Very High ASCVD Risk Category Atherosclerotic cardiovascular disease (ASCVD) risk assessment has long been simplified to only several major risk factors and only a few categories, ranging from low to very high, despite the spectrum and magnitudes of risk factors and striking cumulative effects.1 The intensity of treatment is patient risk dependent; higher absolute risk dictates more aggressive treatment.2–7 The very-high risk category evolved to include not only... more
VIET LE, MPAS, PA-C JOHN R. NELSON, MD, FACC, FASNC, FNLA	Guest Editorial: Eicosapentaenoic Acid: Pleiotrope Extraordinaire? The word “pleiotropy” is derived from the Greek word pleon, which means “more,” and tropos, which means “way” and refers to when a gene produces two or more unrelated pleiotropic traits. The term “statin pleiotropy” has been used to refer to mechanisms independent of cholesterollowering effects. Statins are indicated for both primary and secondary prevention of coronary heart disease. In a meta-analysis of data from 170,000 participants in 26 randomized trials, for each 38.... more
NATHAN D. WONG, PhD, FACC, FAHA, FASPC, FNLA	EBM Tools for Practice: The Lipid and Cardiovascular Disease Specialist and the Use of Basic Statistics: Reader Beware Medical literature is replete with the use of more complex statistics these days, and many of our practice guidelines require more and more rigorously conducted studies with sophisticated statistics to be considered. It is important that clinical lipid specialists and others in the field of preventive cardiology understand and be wary of some key issues in the interpretation of different studies. This primer reviews the basics on interpretation of statistical significance versus clinical... more
JESSICA A. DURHAM, ARNP	Lipid Luminations: The Nurse Practitioner’s Role as a Clinical Lipid Specialist Are you interested in preventive care? How about lifestyle focus, medical management, multi-specialty collaboration, an evidence-based approach, genetics and the related usage of technology? Then being credentialed as a clinical lipid specialist (CLS) should be in your future. After working on the East Coast for years as a registered nurse (RN) in an intensive care unit (ICU) setting and as a nurse practitioner (NP) for a cardiology service, I realized the inpatient setting was not... more
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GEETA SIKAND, MA, RDN, FAND, CDE, FNLA CAROL KIRKPATRICK, PhD, MPH, RDN, FNLA	Specialty Corner: Dietary Cholesterol: Does it Still Matter for Managing Dyslipidemia? Introduction Recent conflicting messages have left some practitioners wondering whether patients with dyslipidemia should limit dietary cholesterol. In 2015, the National Lipid Association (NLA) Recommendations for Patient-Centered Management of Dyslipidemia-Part 2 recommended <200 mg/day of dietary cholesterol for patients managing elevated levels of blood cholesterol.1 The 2015-2020 Dietary Guidelines for Americans (DGA) did not limit dietary cholesterol to 300... more
TERRANCE J. MORAN, MD, FACC, FAHA	Practical Pearls: Statins and Fibrates: A Re-Interpretation of the Data On April 18, 2016, the FDA announced retraction of prior approvals related to the combination of a statin with fenofibrate.1 This decision was prompted by the results of the ACCORD Lipid Trial, which failed to show reduction in cardiovascular events in diabetics when fenofibrate was routinely added to a statin.2 The question now is whether this failure applies to all patients or might there be a group that does benefit from a fibrate-statin combination? We will review the fibrate... more
MICHAEL D. SHAPIRO, DO, FACC, FASPC, FSCCT, FNLA ROB S. GREENFIELD, MD, FACC, FAHA, FNLA	Case Study: The Intolerance for Statin Intolerance A colleague recently asked us to comment on an interesting case. The patient was a 68-year-old woman hospitalized for abdominal pain and new-onset atrial fibrillation. She had a medical history significant for longstanding hypertension and non-obstructive coronary artery disease (CAD) by angiography one year prior to admission. Her home medications included simvastatin 20 mg daily and omeprazole 40 mg daily for dyspepsia. Her physical exam on admission revealed a blood pressure of 135/85... more
ROB S. GREENFIELD, MD, FACC, FAHA, FNLA	Chapter Update: News from the Pacific Lipid Association Although we are thousands of miles away from the National Lipid Association (NLA) headquarters and our time zone seems out of sync with scheduled committee meetings and conference calls, we appreciate the importance of working with and contributing to the NLA and strengthening not only our chapter, but the organization as a whole. Early awareness of the significance of clinical lipidology in our region, prior to the NLA, was made possible by the lipid symposia sponsored by such eminent... more
SONJA L. CONNOR, MS, RDN, LN, FAND	Member Spotlight: Sonja Connor, MS, RDN, LN Sonja Connor, MS, RDN, LN, began her journey with the National Lipid Association in the summer of 2009 and served on the Pacific Lipid Board from 2009–2010. When Sonja found out she was selected for the member spotlight she was elated and provided a very detailed glimpse into her life. Sonja’s contributions are geared to the advancement of lifestyle changes as her prime focus to combat coronary disease. Q: What triggered your interest in dietetics?... more
	Education and Meeting News and Notes Registration Open for the NLA Scientific Sessions Register for the National Lipid Association’s annual Scientific Sessions May 18–21, 2017, at the Philadelphia Marriott Downtown. Don’t miss featured sessions on: Genetic Scoring and Cardiovascular Risk, Treatment and Developing Therapies in FH, PCSK9 Outcomes Studies, and many more. Make sure to check lipid.org/sessions for complete agenda information... more