TSELEPIS

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The Framingham Study: Relationship Between Cholesterol

and CHD Risk

The Framingham Study: The Framingham Study: Relationship Between Cholesterol Relationship Between Cholesterol

andand CHDCHD RiskRisk

Castelli WP. Am J Med. 1984;76:4-12

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Serum total cholesterol, mg/dL (mmol/L)

Meta-analysis of 38 primary and secondary intervention trials

Benefits of Cholesterol LoweringBenefits of Cholesterol LoweringBenefits of Cholesterol Lowering

% in cholesterol reduction

Total mortality (p=0.004)

CHD mortality (p=0.012)

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Gould AL et al. Circulation. 1998;97:946-952

Platelet Adhesion and Aggregation

Platelet Thrombus Formation

Activation of the coagulation cascade

Mackman N. J Clin Invest. 2012; 122: 2331-36

Occlusion of an artery in the brain results in an ischaemic stroke, one of the most severe complications of atrial fibrillation (AF).

Role of Endothelium in Coagulation

The Fibrinolytic System

Marn F, et al. Thrombosis Research 109 (2003) 233

240

FH

Elisaf M, Tselepis AD. Platelets 10: 124, 1999

LDL

FH

Elisaf M, Tselepis AD. Platelets 10: 124, 1999

LDL

LDL

LDL

LDL

Relou IAM, et al. CMLS, Cell Mol Life Sci. 60: 961, 2003

Effect of CM and VLDL remnants on platelets

De Man FH, et al. Atherosclerosis. 2000;152:407-414

Platelet activation in Hypertriglyceridemic patients

Mochizuki M, et al. Thromb Res. 1996;81:583-593

CMVLDL

LDLLp(a)

Lp(a)

Badimon L. Ann. N.Y. Acad. Sci. 1254 (2012) 1832

HDL anti-atherothrombotic effects

HDL

Calabresi L, et al. ATVB. 23: 1724, 2003

Ex Vivo Platelet Function is Attenuated by RecHDL in patients with 2DM

Calkin AC, et al. Circulation. 2009;120:2095-2104

Thrombus formation is attenuated by rHDL in patients with T2DM

Calkin AC, et al. Circulation. 2009;120:2095-2104

Properties of

Dense LDL

Elevation of plasma sdLDL concentration in patients with STEMI

Chan H-C, et al. Blood. 2013;122(22):3632-3641

sdLDL-induced platelet aggregation and adhesion


sdLDL-mediated Endothelial Cell dysfunction


oxLDL

Relou IAM, et al. CMLS, Cell Mol Life Sci. 60: 961, 2003

oxLDLoxLDL

oxLDL

Yang S-H, et al. Thromb Res. 132 (2013) 702711

Morphological changes in the platelets induced by ox-LDL

Skrlin S, et al. Semin Cardiothorac Vasc Anesth. 2010; 14: 283

The mechanism of action of statins

Violi F, et al. Circulation. 2013;127:251-257

Statins as antiplatelet drugs

Violi F, et al. Circulation. 2013;127:251-257

Statins as anticoagulant drugs

Silverstein RL. J Clin Invest. 2012;122:481484

Statins Reduce Atherothrombosis

Potential beneficial effects of statins during and after PCI

Angeli F, et al. Ther Adv Cardiovasc Dis 2012; 6: 163

Main characteristics of the randomized clinical trials comparing early statin therapy with placebo or

usual care in patients with ACS



Impact of statin therapy on all-cause mortality in randomized clinical trials comparing early statin therapy

with placebo or usual care in patients with ACS

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Platelet aggregation

Modified from Mitsios, JV et al. Circulation. 2004;109:1335Modified from Mitsios, JV et al. Circulation. 2004;109:1335--13381338

Pharmacodynamic Studies That Evaluated the possible Clopidogrel-Atorvastatin Interaction

Clinical

studies that evaluated the possible Clopidogrel-Atorvastatin Interaction

Bates

ER. J Am

Coll

Cardiol

2011;57:125163

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