Chemical Pathology 19 - Lipid Update

Question 1

What is the statistical mortality benefit of adding a thiazide diuretic to outstanding BP medications, following an MI?

Answer 1

Worth it, as 2 in 100 will be prevented from a further MI in the next 5 years

Question 2

What is the statistical mortality benefit of adding a PCSK9 inhibitor to outstanding BP medications, following an MI?

Answer 2

Decreases incidence of non-fatal MI, but does not reduce death

Question 3

Give an example of a PCSK9 inhibitor medication, and how it works

Answer 3

Evolocumab

Regulates LDL-receptor recycling to reduce cholesterol

Question 4

What did the UKPDS study show?

Answer 4

That it takes 15 years for good glucose control to show a benefit

Question 5

What did the Advance study show?

Answer 5

Slightly less intense intervention into glucose control actually reduce death compared to super-intense intervention

Question 6

What did the Accord study show?

Answer 6

If you take someone who already has knackered coronary arteries and suddenly tighten glucose control, motality actually increases

Question 7

What did the DCCT show?

Answer 7

Good control in type 1 diabetes improves outcome

Question 8

What makes SGLT2 inhibitors such a fabulous drug class according to Meeran?

Answer 8

Reduce HbA1c, BP, weight, type 2 diabetes incidence and cardiovascular disease, with immediate effect!

Question 9

What is the broad mechanism of action of SGLT2 inhibitors?

Answer 9

They cause glycosuria

Question 10

Give an example of a GLP-1 analogue drug

Answer 10

Semaglutide

Question 11

What is the mechanism of action of the ‘gliptin’ drugs?

Answer 11

DPP4 inhibitors