Ivan Pećin

University of Zagreb

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Bojan Jelaković

University of Zagreb

ŽR

Željko Reiner

University Hospital Centre Zagreb

Mario Laganović

Klinička bolnica Merkur

Jelena Kos

University Hospital Centre Zagreb

Sandra Karanović

University Hospital Centre Zagreb

Vedran Premužić

University Hospital Centre Zagreb

ŽD

Živka Dika

University Hospital Centre Zagreb

Ana Jelaković

University of Rijeka

Mirjana Fuček

University Hospital Centre Zagreb

Ivana Vuković Lela

University of Zagreb

Cooperative Institutions

University of Zagreb

195

University Hospital Centre Zagreb

191

Duke Medical Center

Inserm

Hrvatski zavod za javno zdravstvo

Sisters of Charity Hospital

College of Slavonski Brod

University of Colorado Denver

Brigham and Women's Hospital

Université Paris Cité

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Predictive value of leptin and adiponectin-to- leptin ratio for hypertension and insulin resistance in subjects with low cardiovascular risk

Vanja Ivković Jelena Kos Sandra Karanović Ivana Vuković Lela Vedran Premužić

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The Landscape of Mucopolysaccharidosis in Southern and Eastern European Countries: A Survey from 19 Specialistic Centers.

Research Square (Research Square) (2021)

Anna Tylki‐Szymańska Zsuzsanna Almássy Violetta Anastasiadou Daniela Avdjieva-Tzavella Ingeborg Barišić

Abstract Background: Mucopolysaccharidoses (MPS) are a group of lysosomal storage disorders caused by defects in genes coding for different lysosomal enzymes which degrade glycosaminoglycans. Impaired lysosomal degradation causes cell dysfunction leading to progressive multiorgan involvement, disabling consequences and poor life expectancy. Enzyme replacement therapy (ERT) is now available for most MPS types, offering beneficial effects on disease progression and improving quality of life of patients. The landscape of MPS in Europe is not completely described and studies on availability of treatment show that ERT is not adequately implemented, particularly in Southern and Eastern Europe. In this study we performed a survey analysis in main specialist centers in Southern and Eastern European countries, to outline the landscape of disease management in the region and understand ERT implementation, with particular reference to MPS IVA. Results : 19 experts from 14 Southern and Eastern European countries in total responded to the survey. Results outlined a picture of MPS management in the region, with a high number of MPS patients managed in the centers and a high level of care. MPS II was the most prevalent followed by MPS IVA, with a particular high number of adult patients. The study particularly focused on management and treatment of MPS IVA patients. Adherence to current European Guidelines for follow-up of MPS IVA patients is generally adequate, although some important assessments are reported as difficult due to the lack of MPS skilled specialists. Availability of ERT in Southern and Eastern European countries is generally in line with other European regions, even though regulatory, organizational and reimbursement constrains are demanding. Conclusions: The landscape of MPS in Southern and Eastern European countries is generally comparable to that of other European regions on the epidemiology, treatment accessibility and follow up difficulties. However, issues limiting ERT availability and reimbursement should be simplified, to start treatment as early as possible and make it available for more patients. Besides, educational programs dedicated to specialists should be implemented, particularly for pediatricians, clinical geneticists, surgeons, anesthesiologists and neurologists.

Lysosomal Storage Disorders

Mucopolysaccharidosis type II

Mucopolysaccharidosis

Lysosomal storage disease

10.21203/rs.3.rs-1071210/v1

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AKI - human studies

Nephrology Dialysis Transplantation (2013)

Sim Kutlay İlhan Kurultak Gökhan Nergızoğlu Ş. Ertürk Oktay Karatan

10.1093/ndt/gft129

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[Arterial hypertension in Croatia. Results of EH-UH study].

PubMed (2007)

Bojan Jelaković Tajana Željković-Vrkić Ivan Pećin Živka Dika Aleksandar Jovanović

Arterial hypertension (AH) is the most important independent risk factor of cardiovascular diseases. The prevalence of AH is higher than it was several decades before, and in Europe it is approximately 40%. A higher prevalence of AH has been reported in Europe than in the United States and Canada. According to the results of epidemiology of arterial hypertension in Croatia study (EH-UH), the prevalence of AH in Croatia is 37.5%. Women are more aware, they were treated more often, and blood pressure control was more frequently achieved than in men. However, body mass index and socioeconomic factors have a greater influence on blood pressure values and prevalence of AH in women. A low level of health education and inappropriate treatment are the most important reasons for the poor blood pressure control observed. Measures of primary prevention should be performed continuously and adjusted to special population subgroups. As an increase of obesity and hypertension was observed in school children, these measures should start at that age.

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2024 Recommendations on the Optimal Use of Lipid-Lowering Therapy in Established Atherosclerotic Cardiovascular Disease and Following Acute Coronary Syndromes: A Position Paper of the International Lipid Expert Panel (ILEP)

Drugs (2024)

Maciej Banach Željko Reiner Stanisław Surma Gani Bajraktari Agata Bielecka‐Dąbrowa

Atherosclerotic cardiovascular disease (ASCVD) and consequent acute coronary syndromes (ACS) are substantial contributors to morbidity and mortality across Europe. Fortunately, as much as two thirds of this disease's burden is modifiable, in particular by lipid-lowering therapy (LLT). Current guidelines are based on the sound premise that, with respect to low-density lipoprotein cholesterol (LDL-C), "lower is better for longer", and recent data have strongly emphasised the need for also "the earlier the better". In addition to statins, which have been available for several decades, ezetimibe, bempedoic acid (also as fixed dose combinations), and modulators of proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors and inclisiran) are additionally very effective approaches to LLT, especially for those at very high and extremely high cardiovascular risk. In real life, however, clinical practice goals are still not met in a substantial proportion of patients (even in 70%). However, with the options we have available, we should render lipid disorders a rare disease. In April 2021, the International Lipid Expert Panel (ILEP) published its first position paper on the optimal use of LLT in post-ACS patients, which complemented the existing guidelines on the management of lipids in patients following ACS, which defined a group of "extremely high-risk" individuals and outlined scenarios where upfront combination therapy should be considered to improve access and adherence to LLT and, consequently, the therapy's effectiveness. These updated recommendations build on the previous work, considering developments in the evidential underpinning of combination LLT, ongoing education on the role of lipid disorder therapy, and changes in the availability of lipid-lowering drugs. Our aim is to provide a guide to address this unmet clinical need, to provide clear practical advice, whilst acknowledging the need for patient-centred care, and accounting for often large differences in the availability of LLTs between countries.

Pharmacotherapy

Position paper

Atherosclerotic cardiovascular disease

Position (finance)

10.1007/s40265-024-02105-5

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World hypertension Day 2009 in Croatia and CRASH report. Awareness about danger hidden in salt

Jelena Kos Živka Dika Ines Drenjančević Beth E. Heinrich Mario Ivanuša

Day to day

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The Metabolic Syndrome in a Continental Rural Part of Croatia

Ivana Vuković Marica Miletić‐Medved Ivan Pećin Ante Cvitković Dubravka Čvoriščec

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Achievement of ESC/EAS LDL-C treatment goals after an acute coronary syndrome with statin and alirocumab

European Journal of Preventive Cardiology (2022)

Ulf Landmesser Jennifer McGinniss Philippe Gabríel Steg Deepak L. Bhatt Vera Bittner

Abstract Aims European guidelines set low-density lipoprotein cholesterol (LDL-C) treatment goals <1.4 mmol/L after acute coronary syndrome (ACS), and <1.0 mmol/L for patients with recurrent cardiovascular events ≤2 years. Many ACS patients do not achieve these goals on statin alone. We examined actual goal achievement with alirocumab and projected achievement with ezetimibe, either added to optimized statin therapy. Methods and results The ODYSSEY OUTCOMES trial (NCT01663402) compared alirocumab with placebo in 18 924 patients with recent ACS and hyperlipidaemia despite high-intensity or maximum-tolerated statin therapy. This subanalysis comprised 17 589 patients with LDL-C ≥1.4 mmol/L at baseline who did not receive ezetimibe treatment. High-intensity statin treatment was used in 88.8%. Median (interquartile range) baseline LDL-C was 2.3 (1.9−2.7) mmol/L. With alirocumab, 94.6% of patients achieved LDL-C <1.4 mmol/L at ≥1 post-baseline measurement vs. 17.3% with placebo. Among 2236 patients with a previous cardiovascular event within 2 years (before the qualifying ACS), 85.2% vs. 3.5%, respectively, achieved LDL-C <1.0 mmol/L. Among patients not treated with ezetimibe, we projected that its use would have achieved LDL-C <1.4 and <1.0 mmol/L in 10.6 and 0%, respectively, at baseline (assuming 18 ± 3% reduction of LDL-C). Conclusion Among patients with recent ACS and LDL-C ≥1.4 mmol/L despite optimized statin therapy, the addition of alirocumab allowed 94.6% to achieve the 2019 European guideline LDL-C goal <1.4 mmol/L, and 85.2% of those with recurrent cardiovascular events to achieve <1.0 mmol/L. In contrast, the addition of ezetimibe to optimized statin therapy was projected to achieve LDL-C <1.4 mmol/L in only 10.6% of patients at baseline.

Alirocumab

Ezetimibe

Interquartile range

10.1093/eurjpc/zwac107

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Citations (10)

Thigh abscess as an extension of psoas abscess: the first manifestation of perforated appendiceal adenocarcinoma: case report

Wiener klinische Wochenschrift (2014)

Igor Petrović Ivan Pećin Maja Prutki Goran Augustin Ana Nedić

Exploratory laparotomy

Presentation (obstetrics)

10.1007/s00508-014-0651-0

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Mutation detection in Croatian patients with Familial Hypercholesterolemia

Annals of Human Genetics (2012)

Ivan Pećin Ros Whittall Marta Futema Jadranka Sertić Željko Reiner

Summary Familial hypercholesterolemia (FH) is caused by mutations in the genes for LDLR, APOB or PCSK9 , and identification of the causative mutation provides definitive diagnosis so that the patient can be treated, their relatives tested and, therefore, premature heart disease prevented. DNA of eight unrelated individuals with clinically diagnosed FH were analyzed using a High‐Resolution Melting method (HRM) for the LDLR gene (coding region, promoter and intron/exon boundaries), the APOB gene (part exon 26) and the PCSK9 gene (exon7). Variations found were sequenced and the effect on function of confirmed variants examined using predictive algorithms. Gross deletions and insertions were analysed using MLPA. Three novel LDLR variants were found, p.(S470C), p.(C698R) and c.2312–2A>C. All were predicted to be pathogenic using predictive algorithms. Three previously reported disease‐causing mutations were identified (p.(G20R), p.(N272T) and p.(S286R); the latter was also carried by a hypercholesterolaemic relative. One patient carried the pathogenic APOB variant p.(R3527Q). No large LDLR deletions nor insertions were found, neither were any PCSK9 variants identified. HRM is a sensitive method for screening for mutations. While the causative mutation has been identified in 88% of these clinically defined FH patients, there appears to be a high degree of allelic heterogeneity in Croatian patients.

PCSK9

10.1111/j.1469-1809.2012.00735.x

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Citations (13)