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The Triglyceride Enigma: a Biomarker of Risk Or a Therapeutic Target?

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The Triglyceride Enigma: a Biomarker of Risk Or a Therapeutic Target? Official Publication of the National Lipid Association LipidSpin The Triglyceride Enigma: A Biomarker of Risk or a Therapeutic Target? Also in this issue: Lowering Triglycerides with Omega-3 Fatty Acids Disorders of the Triglyceride–HDL Axis in Insulin Resistance This issue sponsored by the Southwest Lipid Association Volume 12 Issue 4 Fall 2014 visit www.lipid.org REGISTER NOW NATIONAL LIPID ASSOCIATION SCIENTIFIC SESSIONS Palmer House Hotel Chicago, IL Hosted by the Midwest Lipid Association Scientific Sessions June 11–14, 2015 Professional Development Courses June 10–11, 2015 lipid.org/sessions Cutting-Edge Topics Each day of the conference, thought leaders will present cases and discuss the latest research, guidelines, controversies and clinical strategies on topics including: Featured Speakers • Recent Guidelines and Treatment Recommendations • Philip J. Barter, MD, PhD • Novel Targets and Emerging Therapies • Robert H. Eckel, MD • Treatment Strategies for High Risk Populations • W. Timothy Garvey, MD • Risk Assessment, Statin Safety, and Patient Adherence • Donald M. Lloyd-Jones, MD • Management Strategies for Obesity, Hypertension and Diabetes • Paul M. Ridker, MD • Special Interest Workshops on Pediatric Dyslipidemia, Women’s • Neil J. Stone, MD Issues and Complex Cases • George L. Bakris, MD • Keith C. Ferdinand, MD Professional Development Prior to the sessions, attend courses to develop your professional skills, prepare for certication in Clinical Lipidology, and integrate evidence into your clinical decisions: CME Credit Provided by National Lipid Association • Lipid Academy This activity has been approved for AMA PRA Category 1 Credit™. Full accreditation information is available at www.lipid.org/sessions • Masters in Lipidology In This Issue: Fall 2014 (Volume 12, Issue 4) Editors 2 From the NLA President JAMES A. UNDERBERG, MD, MS, FACPM, FACP, FNLA* Making Waves Clinical Assistant Professor of Medicine —Terry A. Jacobson, MD, FACP, FNLA NYU School of Medicine & NYU Center for Prevention of Cardiovascular Disease Director Bellevue Hospital Lipid Clinic 5 From the SWLA President Look for the NLA Community logo to discuss New York, NY Make Your Voice Heard articles online at www.lipid.org ROBERT A. WILD, MD, PhD, MPH, FNLA* —Krishnaswami Vijayaraghavan, MD, FACC, FNLA Clinical Epidemiology and Biostatistics and Clinical Lipidology Professor Oklahoma University Health Sciences Center 6 Letter from the LipidSpin Editors 23 Case Study Oklahoma City, OK Guidelines: What Are They? What Can Type III Hyperlipidemia Unmasked by Managing Editor They Do? What Can They Not Do? Biliary Cirrhosis MELISSA HEYBOER —Robert A. Wild, MD, MPH, PhD, FNLA —Amita Matura, MD National Lipid Association —Lisa Forman, MD, MSCE —James M. Falko, MD, FNLA Executive Director 7 Clinical Feature CHRISTOPHER R. SEYMOUR, MBA National Lipid Association The Triglyceride Enigma Chapter Update —Krishnaswami Vijayaraghavan, MD, FACC, FNLA 26 Contributing Editor —Thomas Haffey, DO, FACC, FACOI, FNLA Challenges and Opportunities in KEVIN C. MAKI, PhD, CLS, FNLA Increasing SWLA Membership —Kari Uusinarkaus, MD, FAAFP, FNLA Associate Editor for Patient Education 12 Guest Editorial —Krishnaswami Vijayaraghavan, MD, FACC, FNLA VANESSA L. MILNE, MS, NP, CLS Cardiac Vascular Nurse and Family Nurse Practitioner Current ACC/AHA Guidelines in Bellevue Hospital Lipid Clinic Regards to Hypertriglyceridemia Member Spotlight New York, NY —Rajasree Pai Ramachandra Pai, MD 28 Thomas Haffey, DO, FACC, FACOI, LipidSpin is published quarterly by the FNLA National Lipid Association 14 EBM Tools for Practice 6816 Southpoint Parkway, Suite 1000 Triglyceride and Atherogenic Jacksonville, FL 32216 30 Education, News and Notes Phone: 904-998-0854 | Fax: 904-998-0855 Dyslipidemia in Adolescence —Piers Rupert R. Blackett, MD, FNLA Copyright ©2013 by the NLA. —Catherine McNeal, MD, PhD, FNLA Events Calendar All rights reserved. 31 —Don P. Wilson, MD, FNLA Visit us on the web at www.lipid.org. 32 Foundation Update 16 Lipid Luminations The National Lipid Association makes every effort to provide accurate information in the LipidSpin at the Whither Fibrates? 33 References time of publication; however, circumstances may alter —Scott Shurmur, MD, FNLA certain details, such as dates or locations of events. Any changes will be denoted as soon as possible. 35 Triglycerides Infographic The NLA invites members and guest authors to 18 Specialty Corner provide scientific and medical opinion, which do not necessarily reflect the policy of the Association. Disorders of the Triglyceride–HDL 36 NLA Recommendations Infographic Axis in Insulin Resistance —Joseph L. Lillo, DO, FNLA, CPI 37 Patient Tear Sheet 21 Practical Pearls Lowering Triglycerides with Omega-3 *indicates ABCL Diplomate status Fatty Acids —Donald G. Lamprecht, PharmD, BCPS, FNLA, CLS —Lisa J. Schwellenbach, PharmD, BCPS Official Publication of the National Lipid Association 1 From the NLA President: Making Waves TERRY A. JACOBSON, MD, FACP, FNLA National Lipid Association President Professor of Medicine, Emory University Atlanta, GA Director, Lipid Clinic and Cardiovascular Risk Reduction Program Diplomate, American Board of Clinical Lipidology campaign was due in large part to the resources for clinicians including: participation from members who took Recommendations tab in the Clinical Discuss this article at • www.lipid.org/lipidspin our survey on triglyceride, knowledge, Lipidology Resource Center on management, and practices. One thing lipidjournal.com we learned from our survey is that there “Knowing is not enough; we must apply. is still a large gap in the use and reporting • ReachMD podcasts with NLA Willing is not enough; we must do.” of non-HDL-C by clinical laboratories. experts – Johann Wolfgang von Goethe Future, educational campaigns on high • Infographic from the NLA triglycerides will need to focus more on Being a part of the National Lipid Recommendations that emphasize standardizing the reporting of non-HDL-C Association is about more than just the importance of setting and encouraging providers to use non- raising awareness about lipid disorders cholesterol management (available HDL-C in patient management. Aiding — it’s about effecting change within our on page 36) the triglyceride educational campaign communities and across the country. has been the Foundation of the NLA, • Lipid Insights Virtual Journal Club, who played a large role in the creation of a 60-minute CME Webcast, on the One of the ways the NLA has succeeded patient education tools and resources. You Recommendations in doing this is through national campaigns can read more about the success of the geared toward promoting our organization “What’s Your Number?” campaign in the • Slide deck on the Recommendations and bringing attention to topics of great Foundation Update by Anne C. Goldberg, which you can use for presentations interest to healthcare providers and their MD, FNLA, on page 32. patients. Since the last edition of the You can find all these tools and more LipidSpin, the NLA has launched two of on the NLA website at lipid.org/ The second big initiative from the NLA these successful campaigns. recommendations. In addition, Part 2 of leadership was the release of the Executive these Recommendations are scheduled to Summary of the NLA Recommendations To coincide with National Cholesterol be published by the time of the national for Patient-Centered Management of Education Month in September, the NLA meeting in June 2015. Dyslipidemia – Part 1 in the September/ launched and promoted a triglyceride October issue of the Journal of Clinical campaign in order to raise awareness With the creation of the NLA Lipidology. Along with the release of the about the significant role triglycerides Recommendations for the Patient-Centered Executive Summary in the Journal, was the play in patients’ lives. The success of this Management of Dyslipidemia, the creation of several other useful tools and 2 LipidSpin leadership of the NLA felt strongly that educational meetings. We look forward to Looking back, the 2014 Fall Clinical it was time for the NLA to act. Although member participation in disseminating the Lipid Update in Indianapolis was a huge issuing general lipid recommendations NLA Recommendations and are requesting success. Congratulations to the Northeast has always been part of the NLA strategic any suggestions on how to get us our and Midwest Chapters for hosting such a plan, the release of the 2013 AHA ACC message out. As to paraphrase the poet popular event. If you were not able attend Guideline on the Treatment of Blood Johann Wolfgang von Goethe, “Knowing is the meeting, you can access meeting Cholesterol in Adults accelerated the not enough; we must apply. Willing is not highlights by visiting lipid.org/education/ process. We are very excited about the enough; we must do.” highlights. new NLA Recommendations and how they can help supplement the current Campaigns like these are the lifeblood of If you haven’t already, make sure you’ve AHA/ACC guidelines and also help to the NLA and we cannot thank you enough saved the date for the NLA’s upcoming “fill in the gaps.” So far we have received for helping make them so successful. meetings. The 2015 Spring Clinical very positive feedback by the provider Whether it’s being an author on a major Lipid Update — sponsored by the community. NLA paper or sharing a post on Facebook, Pacific and Southwest Chapters — will your continued commitment to the NLA is take place Feb. 27– March 1, 2015, in In
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