Cholesterol emboli syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nasrin Nikravangolsefid, MD-MPH [2]

Overview

Some pharmacologic medical therapies that can be effective for cholesterol emboli syndrome include statins, corticosteroids, colchicine, cyclophosphamide and IL1 antagonists.

Medical Therapy

There is no definitive treatment for cholesterol emboli syndrome; the mainstay of therapy is supportive care.
Pharmacologic medical therapies that can be effective for cholesterol emboli syndrome include ^[1]
- Statins
  - Statins can stabilize the atherosclerotic plaques. ^[2]
  - Statins reduce inflammation. ^[3]
  - Statins reduce the risk of developing ESRD and dialysis requirement. ^[4]
- Corticosteroids ^[5] ^[6] ^[7]
  - high dose of corticosteroids has been shown effective but not in the long term.
- Colchicine ^[8] ^[9]
- Cyclophosphamide
- IL1 antagonists might be effective due to their anti-inflammatory effects.

References

↑ Ozkok, Abdullah (2019). “
Cholesterol-embolization syndrome: current perspectives
“. Vascular Health and Risk Management. Volume 15: 209–220. doi:10.2147/VHRM.S175150. ISSN 1178-2048.
↑ Akdim, Fatima; van Leuven, Sander; P. Kastelein, John; G. Stroes, Erik (2007). “Pleiotropic Effects of Statins: Stabilization of the Vulnerable Atherosclerotic Plaque?”. Current Pharmaceutical Design. 13 (10): 1003–1012. doi:10.2174/138161207780487548. ISSN 1381-6128.
↑ Tousoulis, Dimitris; Psarros, Costas; Demosthenous, Michael; Patel, Rikhil; Antoniades, Charalambos; Stefanadis, Christodoulos (2014). “Innate and Adaptive Inflammation as a Therapeutic Target in Vascular Disease”. Journal of the American College of Cardiology. 63 (23): 2491–2502. doi:10.1016/j.jacc.2014.01.054. ISSN 0735-1097.
↑ Woolfson, Robin G; Lachmann, Helen (1998). “Improvement in renal cholesterol emboli syndrome after simvastatin”. The Lancet. 351 (9112): 1331–1332. doi:10.1016/S0140-6736(05)79058-9. ISSN 0140-6736.
↑ “Cholesterol crystal embolization (CCE): Improvement of renal function with high-dose corticosteroid treatment Desai M, Ram R, Prayaga A, Dakshinamurty K V – Saudi J Kidney Dis Transpl”.
↑ Stabellini N, Cerretani D, Russo G, Rizzioli E, Gilli P (2002). “[Renal atheroembolic disease: evaluation of the efficacy of corticosteroid therapy]”. G Ital Nefrol (in Italian). 19 (1): 18–21. PMID 12165941.
↑ Yücel, A. E.; Kart-Köseoglu, H.; Demirhan, B.; Özdemir, F. N. (2005). “Cholesterol crystal embolization mimicking vasculitis: success with corticosteroid and cyclophosphamide therapy in two cases”. Rheumatology International. 26 (5): 454–460. doi:10.1007/s00296-005-0012-4. ISSN 0172-8172.
↑ . doi:10.1016/j.atherosclerosis.2017.12.02. Missing or empty |title= (help)
↑ Robertson, Stacy; Martínez, Gonzalo J.; Payet, Cloe A.; Barraclough, Jennifer Y.; Celermajer, David S.; Bursill, Christina; Patel, Sanjay (2016). “Colchicine therapy in acute coronary syndrome patients acts on caspase-1 to suppress NLRP3 inflammasome monocyte activation”. Clinical Science. 130 (14): 1237–1246. doi:10.1042/CS20160090. ISSN 0143-5221.

Template:WikiDoc Sources

[Ozkok2019-1] Ozkok, Abdullah (2019). “
Cholesterol-embolization syndrome: current perspectives
“. Vascular Health and Risk Management. Volume 15: 209–220. doi:10.2147/VHRM.S175150. ISSN 1178-2048.

[Akdimvan_Leuven2007-2] Akdim, Fatima; van Leuven, Sander; P. Kastelein, John; G. Stroes, Erik (2007). “Pleiotropic Effects of Statins: Stabilization of the Vulnerable Atherosclerotic Plaque?”. Current Pharmaceutical Design. 13 (10): 1003–1012. doi:10.2174/138161207780487548. ISSN 1381-6128.

[TousoulisPsarros2014-3] Tousoulis, Dimitris; Psarros, Costas; Demosthenous, Michael; Patel, Rikhil; Antoniades, Charalambos; Stefanadis, Christodoulos (2014). “Innate and Adaptive Inflammation as a Therapeutic Target in Vascular Disease”. Journal of the American College of Cardiology. 63 (23): 2491–2502. doi:10.1016/j.jacc.2014.01.054. ISSN 0735-1097.

[WoolfsonLachmann1998-4] Woolfson, Robin G; Lachmann, Helen (1998). “Improvement in renal cholesterol emboli syndrome after simvastatin”. The Lancet. 351 (9112): 1331–1332. doi:10.1016/S0140-6736(05)79058-9. ISSN 0140-6736.

[urlCholesterol_crystal_embolization_(CCE):_Improvement_of_renal_function_with_high-dose_corticosteroid_treatment_Desai_M,_Ram_R,_Prayaga_A,_Dakshinamurty_K_V_-_Saudi_J_Kidney_Dis_Transpl-5] “Cholesterol crystal embolization (CCE): Improvement of renal function with high-dose corticosteroid treatment Desai M, Ram R, Prayaga A, Dakshinamurty K V – Saudi J Kidney Dis Transpl”.

[pmid12165941-6] Stabellini N, Cerretani D, Russo G, Rizzioli E, Gilli P (2002). “[Renal atheroembolic disease: evaluation of the efficacy of corticosteroid therapy]”. G Ital Nefrol (in Italian). 19 (1): 18–21. PMID 12165941.

[YücelKart-Köseoglu2005-7] Yücel, A. E.; Kart-Köseoglu, H.; Demirhan, B.; Özdemir, F. N. (2005). “Cholesterol crystal embolization mimicking vasculitis: success with corticosteroid and cyclophosphamide therapy in two cases”. Rheumatology International. 26 (5): 454–460. doi:10.1007/s00296-005-0012-4. ISSN 0172-8172.

[8] . doi:10.1016/j.atherosclerosis.2017.12.02. Missing or empty |title= (help)

[RobertsonMartínez2016-9] Robertson, Stacy; Martínez, Gonzalo J.; Payet, Cloe A.; Barraclough, Jennifer Y.; Celermajer, David S.; Bursill, Christina; Patel, Sanjay (2016). “Colchicine therapy in acute coronary syndrome patients acts on caspase-1 to suppress NLRP3 inflammasome monocyte activation”. Clinical Science. 130 (14): 1237–1246. doi:10.1042/CS20160090. ISSN 0143-5221.

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