Questions and Answers (1) View all
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Answer added in Diabetology33 Would early intervention with an ACE inhibitor be beneficial to diabetic cystopathy ?By Sara Pritchard · University of HertfordshireWalter Riesen · Universität BernProbabaly not. ACE Ihnibitors act on hypertension not on elevated glucose levels, so I doubt whether they would have an effect. At least there are no... [more]Probabaly not. ACE Ihnibitors act on hypertension not on elevated glucose levels, so I doubt whether they would have an effect. At least there are no data so farFollowing
Publications (49) View all
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Article: [New european guidelines for dyslipidemia].
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ABSTRACT: Lifestyle changes should be considered before anything else in patients with dyslipidemia according to the new guidelines on dyslipidemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). The guidelines recommend the SCORE system (Systematic Coronary Risk Estimation) to classify cardiovascular risk into four categories (very high, high, medium or low risk) as the basis for treatment decisions. HDL cholesterol, which is inversely proportional to cardiovascular risk, is included to the total risk estimation. In addition to calculating absolute risk, the guidelines contain a table with the relative risk, which could be useful in young patients with a low absolute risk, but high risk compared to individuals of the same age group.Revue médicale suisse 03/2012; 8(331):525-6, 528-30. -
SourceAvailable from: Walter F Riesen
Article: Diagnostic accuracy of point-of-care testing for acute coronary syndromes, heart failure and thromboembolic events in primary care: a cluster-randomised controlled trial.
Yuki Tomonaga, Felix Gutzwiller, Thomas F Lüscher, Walter F Riesen, Markus Hug, Albert Diemand, Matthias Schwenkglenks, Thomas D Szucs[show abstract] [hide abstract]
ABSTRACT: Evidence of the clinical benefit of 3-in-1 point-of-care testing (POCT) for cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP) and D-dimer in cardiovascular risk stratification at primary care level for diagnosing acute coronary syndromes (ACS), heart failure (HF) and thromboembolic events (TE) is very limited. The aim of this study is to analyse the diagnostic accuracy of POCT in primary care. Prospective multicentre controlled trial cluster-randomised to POCT-assisted diagnosis and conventional diagnosis (controls). Men and women presenting in 68 primary care practices in Zurich County (Switzerland) with chest pain or symptoms of dyspnoea or TE were consecutively included after baseline consultation and working diagnosis. A follow-up visit including confirmed diagnosis was performed to determine the accuracy of the working diagnosis, and comparison of working diagnosis accuracy between the two groups. The 218 POCT patients and 151 conventional diagnosis controls were mostly similar in characteristics, symptoms and pre-existing diagnoses, but differed in working diagnosis frequencies. However, the follow-up visit showed no statistical intergroup difference in confirmed diagnosis frequencies. Working diagnoses overall were significantly more correct in the POCT group (75.7% vs 59.6%, p = 0.002), as were the working diagnoses of ACS/HF/TE (69.8% vs 45.2%, p = 0.002). All three biomarker tests showed good sensitivity and specificity. POCT confers substantial benefit in primary care by correctly diagnosing significantly more patients. DRKS: DRKS00000709.BMC Family Practice 03/2011; 12:12. · 1.80 Impact Factor -
Article: Commentary to factors predicting cardiovascular events in statin-treated diabetic and non-diabetic patients with coronary atherosclerosis.
Walter F RiesenAtherosclerosis 11/2009; 208(2):332-3. · 3.79 Impact Factor -
Article: Impact of enhanced compliance initiatives on the efficacy of rosuvastatin in reducing low density lipoprotein cholesterol levels in patients with primary hypercholesterolaemia.
Walter F Riesen, Georg Noll, Roger Dariolo[show abstract] [hide abstract]
ABSTRACT: The effectiveness of lipid-lowering medication critically depends on the patients' compliance and the efficacy of the prescribed drug. The primary objective of this multicentre study was to compare the efficacy of rosuvastatin with or without access to compliance initiatives, in bringing patients to the Joint European Task Force's (1998) recommended low-density lipoprotein cholesterol (LDL-C) level goal (LDL-C, <3.0 mmol/L) at week 24. Secondary objectives were comparison of the number and percentage of patients achieving European goals (1998, 2003) for LDL-C and other lipid parameters. Patients with primary hypercholesterolaemia and a 10-year coronary heart disease risk of >20% received open label rosuvastatin treatment for 24 weeks with or without access to compliance enhancement tools. The initial daily dosage of 10 mg could be doubled at week 12. Compliance tools included: a) a starter pack for subjects containing a videotape, an educational leaflet, a passport/goal diary and details of the helpline and/or website; b) regular personalised letters to provide message reinforcement; c) a toll-free helpline and a website. The majority of patients (67%) achieved the 1998 European goal for LDL-C at week 24. 31% required an increase in dosage of rosuvastatin to 20 mg at week 12. Compliance enhancement tools did not increase the number of patients achieving either the 1998 or the 2003 European target for plasma lipids. Rosuvastatin was well tolerated during this study. The safety profile was comparable with other drugs of the same class. 63 patients in the 10 mg group and 58 in the 10 mg Plus group discontinued treatment. The main reasons for discontinuation were adverse events (39 patients in the 10 mg group; 35 patients in the 10 mg Plus group) and loss to follow-up (13 patients in the 10 mg group; 9 patients in the 10 mg Plus group). The two most frequently reported adverse events were myalgia (34 patients, 3% respectively) and back pain (23 patients, 2% respectively). The overall rate of temporary or permanent study discontinuation due to adverse events was 9% (n = 101) in patients receiving 10 mg rosuvastatin and 3% (n = 9) in patients titrated up to 20 mg rosuvastatin. Rosuvastatin was effective in lowering LDL-C values in patients with hypercholesterolaemia to the 1998 European target at week 24. However, compliance enhancement tools did not increase the number of patients achieving any European targets for plasma lipids.Swiss medical weekly: official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology 07/2008; 138(29-30):420-6. · 1.89 Impact Factor -
Article: Bevacizumab-associated hyperlipoproteinemia type IIb in a patient with advanced invasive-ductal breast cancer.
M Joerger, W F Riesen, B Thürlimann[show abstract] [hide abstract]
ABSTRACT: We report a case of bevacizumab-associated hyperlipoproteinemia in a patient with advanced breast cancer. A 57-year-old woman with advanced invasive-ductal breast cancer was administered bevacizumab from March 2008 to February 2009. Pretreatment laboratory showed borderline hypercholesterolemia (5.1 mmol/L, 197 mg/dL) and normal triglycerides (1.3 mmol/L, 115 mg/dL). Three months on treatment with bevacizumab, both serum cholesterol (11.9 mmol/L, 460 mg/dL) and triglycerides (7.4 mmol/L, 655 mg/dL) increased substantially, and remained well above the normal range for a period of bevacizumab treatment. From March 2008 to August 2008, the patient also received anticancer treatment with liposomal doxorubicin that was stopped early due to hand-foot syndrome. No concurrent hyperlipidemic drugs have been taken by the patient at the time of bevacizumab treatment. In February 2009, bevacizumab was stopped and the patient went on to receive paclitaxel for hepatic tumor progression. By December 2009, both serum triglycerides (1.3 mmol/L, 115 mg/dL) and cholesterol (3.2 mmol/L, 123 mg/dL) had normalized. This is the first published case of bevacizumab-associated hyperlipoproteinemia. By applying the Naranjo ADR probability scales, at least a possible relationship between hyperlipoproteinemia type IIb and bevacizumab in this patient is supported by the data (Naranjo score 4). No hyperlipidemic drugs were given concurrently with bevacizumab, and the serum cholesterol and triglycerides decreased quickly after bevacizumab was discontinued. This study describes a case of bevacizumab-associated hyperlipidemia. Patients receiving bevacizumab should have their cholesterol and triglycerides checked for potential worsening.Journal of Oncology Pharmacy Practice 09/2011; 17(3):292-4.