Vol. 14 Issue 1 LipidSpin Articles | National Lipid Association Online

CARL E. ORRINGER, MD, FACC, FNLA	From the NLA President: The Importance of Collaboration How many of you have taken the time to read, from front to back, the recent National Lipid Association (NLA) Recommendations for Patient-Centered Management of Dyslipidemia, Parts 1 and 2? Don’t be embarrassed, because I can’t see how few of you raised your hands. I had the good fortune to co-author this document with a host of outstanding academic leaders in the field of clinical lipidology. As I reflect on the creation of these documents and think of the many hours that we all... more
THOMAS A. HAFFEY, DO, FACC, FACOI, FNLA	From the SWLA President: Guidelines + Guidance Lines “If you would not be forgotten as soon as you are dead and rotten, either write things worth reading or do things worth the writing.” – Benjamin Franklin The National Lipid Association is the premier organization dedicated to advancing our knowledge about the optimal approach to diagnosing and treating patients with lipid disorders. Any success of the organization is directly related to the diverse nature of our members. The NLA membership crosses multiple medical... more
DANIEL E. SOFFER, MD, FNLA	Letter from the LipidSpin Editors: How I Learned to Stop Worrying and Learned to Love the Guidelines I’ve been through many stages with the guidelines. I really think I love them now. Let me tell you why. I began my internal medicine residency in 1994, and the first time I ever heard that there was such a thing as guidelines, was at residents’ clinic in my first year where I was treating a man following hospitalization for non-cardiac chest pain. I asked my attending to explain how a doctor decides when to use cholesterol medicine. We had results from 4S and WOSCOPS, but statins... more
M. EUGENE SHERMAN, MD, FACC	Clinical Feature: Why Advocacy is Important to a Medical Specialty Organization In the strictest sense, “advocacy” is defined as the act or process of supporting a cause. With that as the basis of our discussion, why is advocacy important to a medical specialty organization such as the National Lipid Association (NLA)? The NLA’s mission statement includes comments on professionalism and public service and this service relates to patient outcomes, with specific reference to reducing death and disability related to lipid disorders. Therefore, it is both reasonable... more
JANET S. WRIGHT, MD, FACC	Guest Editorial: Bringing the Nation Together to Save a Million Hearts by 2017 Every 39 seconds, a U.S. adult dies from cardiovascular disease (CVD),¹ the nation’s top killer and a leading cause of disability for Americans both young and old. We spend about 1 out of 6 healthcare dollars on this disease each year — an estimated nearly $320 billion in healthcare expenses and lost productivity.¹ But those human and economic costs could be lower if we expanded our national actions in prevention. About half of U.S. adults (46.5 percent)... more
KARI UUSINARKAUS, MD, FAAFP, FNLA JOEL C. MARRS, PharmD, FCCP, FASHP, BCPS-AQ Cardiology, BCACP, FNLA	EBM Tools for Practice: Beyond the Guidelines: Application of Trial Data to Individual Patients by Focusing on Explanatory vs. Pragmatic Trials This edition of the LipidSpin is devoted to guidelines vs. guidance. We all strive to practice evidence-based medicine (EBM) and our understanding of science has moved forward at a quick pace. Multiple journals come out every week with new articles that advance medicine’s knowledge base. Large, randomized controlled trials (RCTs) get headlines when a positive or negative result is found. However, in the everyday practice of seeing patients and making treatment decisions, how... more
MICHAEL S. KELLY, PharmD KARI L. OLSON, PharmD, FCCP, BCPS-AQ Cardiology	Lipid Luminations: New Evidence For Non-Statin Lipid-Lowering Medications The American College of Cardiology/American Heart Association (ACC/AHA) Blood Cholesterol Guideline recommends high-intensity statin therapy for high-risk patients to reduce the risk of major adverse cardiovascular events (MACE).¹Despite treatment with high-intensity statins, patients continue to experience MACE. Additionally, some patients have a less-than-anticipated response to, or are unable to, tolerate high-intensity statins. Whether additional non-statin lipid-... more
JOSEPH L. LILLO, DO, CPI, FNLA	Specialty Corner: A Guide for Clinicians to Escape the Tyranny of Guidelines In keeping with the theme of this issue of the LipidSpin, this Specialty Corner is devoted to advice for the practicing clinician who has to make daily decisions on how best to protect his/her patients from cardiovascular disease. It seems since the 2013 publication of the American College of Cardiology/ American Heart Association (ACC/AHA) guidelines, we have been engaged in countless discussions about them, either for or against, and all of the reasons to support each view... more
DONALD G. LAMPRECHT, PharmD, BCPS, FNLA BRITTANY A. TODD, PharmD, BCPS	Practical Pearls: The Clinical Implications of Statins in Combination with CYP3A4 Inducers Clinical question: In statin-treated patients who also require strong CYP3A4 inducers, does statin therapy need to be preemptively modified to account for decreased systemic exposure secondary to increased metabolism? Recent guidelines endorse the use of appropriate-intensity statin therapy to match an individual’s risk for atherosclerotic cardiovascular disease (ASCVD).^1,2 The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines for... more
ELIZABETH J. JACKSON, ACNS-BC, FNLA EDWARD CHAFIZADEH, MD ANTOINE PHAM, DO	Case Study: Autoimmune-Mediated Necrotizing Myositis Due to Statin Therapy Muscle symptoms in patients on statin therapy are prevalent and offer a complicated differential for providers to entertain. Symptoms range from relatively mild aches and pains to severe and debilitating weakness and pain. Statins are taken by more than 25 million patients across the globe and have been clearly associated with such complaints. The range of muscle complaints attributed to statin use extends from myalgia — a subjective complaint without creatine kinase (CK) elevation (the most... more
THOMAS A. HAFFEY, DO, FACC, FACOI, FNLA	Chapter Update: Goals for the New Year The Southwest Chapter of the National Lipid Association (SWLA) established three primary goals we planned to achieve at the NLA Scientific Sessions last June in Chicago. Education: Promotion of lipid journal clubs in all of the states in the chapter Introduction to the legislative arena: Improving patient’s health through political advocacy Completion of the SWLA LipidSpin: Part education, part inspiration Education... more
ELIZABETH J. JACKSON, ACNS-BC, FNLA	Member Spotlight: Elizabeth J. Jackson, ACNS-BC, FNLA A passionate supporter of the National Lipid Association (NLA) and an advocate of clinical lipidology, Elizabeth (Beth) Jackson is a woman of many talents. Jackson works as a clinical nurse specialist and clinical lipid specialist with Edward R. Chafizadeh, MD, at CardioTexas in Austin, Texas. Some states do not work with clinical nurse specialists in the same capacity, but Jackson’s role is an advanced practice provider specializing in cardiology and lipidology. Jackson sees both inpatients... more
ANNE C. GOLDBERG, MD, FNLA	Foundation Update Happy New Year from the Foundation of the National Lipid Association! We are hard at work ensuring that 2016 is as much of a success as 2015. Part of that success stems from the many fundraising events sponsored by the Foundation. We are pleased to announce the first Foundation event of the year, which will take place during the Spring Clinical Lipid Update (CLU) in San Diego March 18–20. You can join the foundation on the evening of March 19, for a murder mystery comedy dinner show... more