DIAGNOSIS AND MANAGEMENT OF DYSLIPIDEMIA

TABLE OF CONTENTS

Introduction

10

 

 

Nomogram to convert plasma cholesterol values from mg/dl to mmol/L

12

Nomogram to convert plasma triglycerides values from mg/dl to mmol/L

13

 

 

Chapter I. Cholesterol and lipoproteins

14

Major steps of cholesterol biosynthesis

15

Classification of plasma lipoproteins

16

General structure of lipoproteins

18

Structure of low-density lipoproteins (LDL)

19

Lipoprotein pathways: exogenous

20

Lipoprotein lipase and triglyceride-rich lipoproteins

21

Lipoprotein pathways: endogenous

22

 

 

Chapter II. Cholesterol, lipoproteins and atherosclerosis

24

Natural history of atherosclerotic disease

28

Gross morphology of atherosclerotic lesions

29

Nomenclature and sequence of atherosclerotic lesions

30

Plaque structure

32

Pathophysiological role of plaque rupture

35

Histologic section of a thrombosed coronary artery

37

Angiographic picture of a thrombosed coronary artery

38

Endothelial injury resulting in coronary thrombosis

39

 

 

Chapter III. Plasma lipoprotein analysis

40

Factors influencing plasma lipoprotein level

41

Classification based on total cholesterol and high density lipoprotein (HDL)-cholesterol       

42

Risk factors for coronary artery disease (CAD)

43

Primary CAD prevention in adults based on total cholesterol and HDL-cholesterol

45

Clinical importance of LDL measurement

46

Classification based on LDL-cholesterol

47

Primary CAD prevention in adults based on LDL-cholesterol

48

Secondary CAD prevention in adults based on LDL-cholesterol

49

Classification of triglyceride plasma levels

50

Therapeutic classification of hyperlipidemia

51

Selected causes of secondary hyperlipidemia

52

 

 

Chapter IV. Management of hyperlipidemia

53

When to initiate dietary therapy?

56

Dietary theory of high blood cholesterol

57

General considerations regarding lipid-lowering diet

58

Desirable body weight

61

When to prescribe lipid-lowering drugs?

62

Lipid-lowering agents

63

Bile acid sequestrants

64

Nicotinic acid

66

HMG-CoA reductase inhibitors (statins)

69

Fibrates

72

Probucol

74

Combination therapy of dyslipidemia

76

Drug selection in dyslipidemia

77

 

 

Chapter V. Efficacy of lipid-lowering therapy

78

West of Scotland Study

80

4S

82

CCAIT

84

PLAC I

86

REGRESS

88

ACAPS

90

PLAC II

92

 

 

Clinical macroresults of angiographic microchanges (instead of afterward)

94

 

 

Bibliography

96

 

 

List of slides

104

    © V. Kryzhanivsky, 1995

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