Pub Date : 2026-01-01DOI: 10.1016/j.artere.2025.500817
Alessandra Franze’ , Emma Plana , Nuria Jiménez-Hernández , Alejandro Artacho , Javier Pons , Andrés Moya , Alex Mira , F. Xavier López-Labrador , Manuel Miralles
<div><h3>Introduction</h3><div>The potential involvement of pathogens in the development of atherosclerosis has been studied for decades. Some previous studies have successfully identified the presence of pathogens in the atheromatous plaque. However, many of these determinations are aimed at detecting the presence of a particular species. The use of omics technologies allows for the analysis of the complete microbial profile of a given sample. In the specific case of atheromatous plaque, the study of the bacterial load composition would help to clarify the possible relationship between infection and atherosclerosis and identify whether there is a bacterial profile associated with unstable plaques and, therefore, with the consequent risk of ischemic events.</div></div><div><h3>Methodology</h3><div>We analyzed cross-sectional fragments of carotid atheromatous plaque (N<!--> <!-->=<!--> <!-->57) and serum (N<!--> <!-->=<!--> <!-->54) from patients with recent neurological symptoms and asymptomatic patients (control group). Nucleic acids were extracted from the samples by enzymatic digestion and homogenization, with additional treatment with type I collagenase in the case of plaques. Bacterial ribosomal RNA (16S-rRNA gene) was amplified and subjected to massive sequencing using the Illumina Miseq platform. The bioinformatic analysis, to identify the taxonomic composition, and biostatistical analysis, to determine the significant taxa, of the 16S-rRNA was performed in the R environment. As contamination control, bacterial species ratios ≥10 with respect to negative controls were considered significant.</div></div><div><h3>Results</h3><div>The presence of bacterial 16S-rRNA was very low in both types of samples. The bacterial composition in terms of α diversity and β diversity differed between plaque and serum; however, we did not observe significant differences between samples from symptomatic and asymptomatic patients. The most abundant phylum and genus in plaque were <em>Firmicute</em>s and <em>Staphylococcus</em>, respectively. For Staphylococcus, we found 100% similarity homology of the 16S-rRNA with 3 species (<em>S. epidermidis</em>, <em>S. caprae</em>, and <em>S. capitis</em>). In serum, the most abundant phyla were <em>Firmicutes</em> and <em>Proteobacteria</em>, with <em>Streptococcus</em> being the dominant genus, for which we found 100% homology of the 16S-rRNA with 20 species of oral streptococci.</div></div><div><h3>Conclusions</h3><div>We have successfully applied massive sequencing techniques to determine the presence and relative abundance of bacterial species in atheromatous plaques and serum of patients undergoing carotid endarterectomy. We have not observed significant differences between symptomatic and asymptomatic patients regarding the main genera, so we cannot establish a direct connection between bacterial composition and atheromatous plaque vulnerability. However, a possible association between atherosclerosis and the presen
{"title":"Application of high-throughput sequencing to the study of the main bacterial populations in carotid stenosis","authors":"Alessandra Franze’ , Emma Plana , Nuria Jiménez-Hernández , Alejandro Artacho , Javier Pons , Andrés Moya , Alex Mira , F. Xavier López-Labrador , Manuel Miralles","doi":"10.1016/j.artere.2025.500817","DOIUrl":"10.1016/j.artere.2025.500817","url":null,"abstract":"<div><h3>Introduction</h3><div>The potential involvement of pathogens in the development of atherosclerosis has been studied for decades. Some previous studies have successfully identified the presence of pathogens in the atheromatous plaque. However, many of these determinations are aimed at detecting the presence of a particular species. The use of omics technologies allows for the analysis of the complete microbial profile of a given sample. In the specific case of atheromatous plaque, the study of the bacterial load composition would help to clarify the possible relationship between infection and atherosclerosis and identify whether there is a bacterial profile associated with unstable plaques and, therefore, with the consequent risk of ischemic events.</div></div><div><h3>Methodology</h3><div>We analyzed cross-sectional fragments of carotid atheromatous plaque (N<!--> <!-->=<!--> <!-->57) and serum (N<!--> <!-->=<!--> <!-->54) from patients with recent neurological symptoms and asymptomatic patients (control group). Nucleic acids were extracted from the samples by enzymatic digestion and homogenization, with additional treatment with type I collagenase in the case of plaques. Bacterial ribosomal RNA (16S-rRNA gene) was amplified and subjected to massive sequencing using the Illumina Miseq platform. The bioinformatic analysis, to identify the taxonomic composition, and biostatistical analysis, to determine the significant taxa, of the 16S-rRNA was performed in the R environment. As contamination control, bacterial species ratios ≥10 with respect to negative controls were considered significant.</div></div><div><h3>Results</h3><div>The presence of bacterial 16S-rRNA was very low in both types of samples. The bacterial composition in terms of α diversity and β diversity differed between plaque and serum; however, we did not observe significant differences between samples from symptomatic and asymptomatic patients. The most abundant phylum and genus in plaque were <em>Firmicute</em>s and <em>Staphylococcus</em>, respectively. For Staphylococcus, we found 100% similarity homology of the 16S-rRNA with 3 species (<em>S. epidermidis</em>, <em>S. caprae</em>, and <em>S. capitis</em>). In serum, the most abundant phyla were <em>Firmicutes</em> and <em>Proteobacteria</em>, with <em>Streptococcus</em> being the dominant genus, for which we found 100% homology of the 16S-rRNA with 20 species of oral streptococci.</div></div><div><h3>Conclusions</h3><div>We have successfully applied massive sequencing techniques to determine the presence and relative abundance of bacterial species in atheromatous plaques and serum of patients undergoing carotid endarterectomy. We have not observed significant differences between symptomatic and asymptomatic patients regarding the main genera, so we cannot establish a direct connection between bacterial composition and atheromatous plaque vulnerability. However, a possible association between atherosclerosis and the presen","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 1","pages":"Article 500817"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.artere.2025.500770
Patricio Lopez-Jaramillo , Gladys Lizarazo , Raúl Torres , Fausto Posso , Jose P. Lopez-Lopez , Maya Caicedo , Fernando Vargas-Mendoza
Cardiovascular diseases (CVD) are the main cause of death globally, especially in low- and middle-income countries (LMICs), where the largest number of inhabitants on the planet are concentrated. Air pollution inside and outside the home by microparticles 2·5 (PM2·5) has become an important risk factor for the presence of CVD and other chronic non-communicable diseases, particularly in LMICs. The use of solid fuels as an energy source for cooking food and heating inside the home has negative effects not only on human health but also on the health of the planet, as it contributes to deforestation and the consequent effect on climate change. In this narrative review we update how air pollution inside the home from cooking food with firewood and charcoal impacts the risk of CVD, the factors that determine the use of these polluting fuels, and the actions necessary for the massive transition toward the use of non-polluting energy, highlighting the development of university research to offer a stove that uses green hydrogen as a non-polluting energy source.
{"title":"Cardiovascular effects of household air pollution on cardiovascular diseases incidence","authors":"Patricio Lopez-Jaramillo , Gladys Lizarazo , Raúl Torres , Fausto Posso , Jose P. Lopez-Lopez , Maya Caicedo , Fernando Vargas-Mendoza","doi":"10.1016/j.artere.2025.500770","DOIUrl":"10.1016/j.artere.2025.500770","url":null,"abstract":"<div><div><span>Cardiovascular diseases (CVD) are the main cause of death globally, especially in low- and middle-income countries (LMICs), where the largest number of inhabitants on the planet are concentrated. Air pollution inside and outside the home by microparticles 2·5 (PM2·5) has become an important </span>risk factor<span> for the presence of CVD and other chronic non-communicable diseases, particularly in LMICs. The use of solid fuels as an energy source for cooking food and heating inside the home has negative effects not only on human health but also on the health of the planet, as it contributes to deforestation<span> and the consequent effect on climate change. In this narrative review we update how air pollution inside the home from cooking food with firewood and charcoal impacts the risk of CVD, the factors that determine the use of these polluting fuels, and the actions necessary for the massive transition toward the use of non-polluting energy, highlighting the development of university research to offer a stove that uses green hydrogen as a non-polluting energy source.</span></span></div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 1","pages":"Article 500770"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.artere.2025.500821
Pedro Javier Tárraga Marcos , Ángel Arturo López-González , Emilio Martínez-Almoyna Rifá , Hernán Paublini Oliveira , Cristina Martorell Sánchez , Pedro Juan Tárraga López , José Ignacio Ramírez-Manent
The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.
{"title":"Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables","authors":"Pedro Javier Tárraga Marcos , Ángel Arturo López-González , Emilio Martínez-Almoyna Rifá , Hernán Paublini Oliveira , Cristina Martorell Sánchez , Pedro Juan Tárraga López , José Ignacio Ramírez-Manent","doi":"10.1016/j.artere.2025.500821","DOIUrl":"10.1016/j.artere.2025.500821","url":null,"abstract":"<div><div>The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 1","pages":"Article 500821"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.artere.2025.500890
Johanna Vicuña
{"title":"Importance of cardiovascular and atherogenic risk in health care professionals","authors":"Johanna Vicuña","doi":"10.1016/j.artere.2025.500890","DOIUrl":"10.1016/j.artere.2025.500890","url":null,"abstract":"","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 1","pages":"Article 500890"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.artere.2025.500800
Jiali Xu , Nana Deng , Zhouyue Zhang , Mingming Deng , Gang Luo
Objective
Post-acute pancreatitis diabetes mellitus (PPDM-A) is a type of diabetes linked to pancreatic exocrine dysfunction, which increases the risk of pancreatic cancer and mortality. Hyperlipidemia, or high blood lipid levels, is the third leading cause of acute pancreatitis (AP) and is associated with a higher diabetes risk. However, the link between lipid-lowering treatments and PPDM-A is unclear. This study aims to explore this relationship.
Methods
A cohort of 223 patients diagnosed with AP and hyperlipidemia was categorized into PPDM-A and non-PPDM-A groups. Binary logistic regression was utilized to analyze the correlation between fibrate therapy and PPDM-A incidence. Mendelian randomization (MR) was used to determine whether there was a causal relationship between triglyceride levels and diabetes.
Results
Elevated blood glucose levels (GLU) (OR = 1.360, p < 0.001), female (OR = 0.091, p = 0.030), severity of AP [moderately severe AP (MASP) (OR = 5.585, p = 0.019)], recurrent acute pancreatitis (RAP) (OR = 6.399, p = 0.007), and fibrate use (OR = 0.109, p = 0.001) emerged as independent influencing factors of PPDM-A. MR evidence suggests a causal relationship between triglyceride levels and diabetes risk (OR = 1.088, p < 0.001), with a two-step MR showing that pancreatitis partially mediates this effect with a mediated proportion of 1.55% (p = 0.048).
Conclusion
Fibrates demonstrate the potential to lower the risk of PPDM-A among individuals with AP and hypertriglyceridemia. Furthermore, the effect of triglyceride levels on diabetes risk was partly mediated by pancreatitis.
目的急性胰腺炎后糖尿病（PPDM-A）是一种与胰腺外分泌功能障碍相关的糖尿病，其增加了胰腺癌和死亡率的风险。高脂血症是导致急性胰腺炎（AP）的第三大原因，并与较高的糖尿病风险相关。然而，降脂治疗与PPDM-A之间的联系尚不清楚。本研究旨在探讨这种关系。方法将223例AP合并高脂血症患者分为PPDM-A组和非PPDM-A组。采用二元logistic回归分析贝特治疗与PPDM-A发病率的相关性。孟德尔随机化（MR）用于确定甘油三酯水平与糖尿病之间是否存在因果关系。结果血糖水平升高（GLU） （OR = 1.360, p < 0.001）、女性（OR = 0.091, p = 0.030）、AP严重程度[中重度AP (MASP)] （OR = 5.585, p = 0.019）、复发性急性胰腺炎（RAP） （OR = 6.399, p = 0.007）、使用fibrate （OR = 0.109, p = 0.001）是PPDM-A的独立影响因素。磁共振证据表明甘油三酯水平与糖尿病风险之间存在因果关系（OR = 1.088, p < 0.001），两步磁共振显示胰腺炎部分介导了这种影响，介导比例为1.55% （p = 0.048）。结论贝特类药物具有降低AP和高甘油三酯血症患者PPDM-A风险的潜力。此外，甘油三酯水平对糖尿病风险的影响部分是由胰腺炎介导的。
{"title":"Exploring the link between fibrates therapy and diabetes mellitus following primary acute pancreatitis with hypertriglyceridemia","authors":"Jiali Xu , Nana Deng , Zhouyue Zhang , Mingming Deng , Gang Luo","doi":"10.1016/j.artere.2025.500800","DOIUrl":"10.1016/j.artere.2025.500800","url":null,"abstract":"<div><h3>Objective</h3><div>Post-acute pancreatitis diabetes mellitus (PPDM-A) is a type of diabetes linked to pancreatic exocrine dysfunction, which increases the risk of pancreatic cancer and mortality. Hyperlipidemia, or high blood lipid levels, is the third leading cause of acute pancreatitis (AP) and is associated with a higher diabetes risk. However, the link between lipid-lowering treatments and PPDM-A is unclear. This study aims to explore this relationship.</div></div><div><h3>Methods</h3><div>A cohort of 223 patients diagnosed with AP and hyperlipidemia was categorized into PPDM-A and non-PPDM-A groups. Binary logistic regression was utilized to analyze the correlation between fibrate therapy and PPDM-A incidence. Mendelian randomization (MR) was used to determine whether there was a causal relationship between triglyceride levels and diabetes.</div></div><div><h3>Results</h3><div>Elevated blood glucose levels (GLU) (OR<!--> <!-->=<!--> <!-->1.360, <em>p</em> <!--><<!--> <!-->0.001), female (OR<!--> <!-->=<!--> <!-->0.091, <em>p</em> <!-->=<!--> <!-->0.030), severity of AP [moderately severe AP (MASP) (OR<!--> <!-->=<!--> <!-->5.585, <em>p</em> <!-->=<!--> <!-->0.019)], recurrent acute pancreatitis (RAP) (OR<!--> <!-->=<!--> <!-->6.399, <em>p</em> <!-->=<!--> <!-->0.007), and fibrate use (OR<!--> <!-->=<!--> <!-->0.109, <em>p</em> <!-->=<!--> <!-->0.001) emerged as independent influencing factors of PPDM-A. MR evidence suggests a causal relationship between triglyceride levels and diabetes risk (OR<!--> <!-->=<!--> <!-->1.088, <em>p</em> <!--><<!--> <!-->0.001), with a two-step MR showing that pancreatitis partially mediates this effect with a mediated proportion of 1.55% (<em>p</em> <!-->=<!--> <!-->0.048).</div></div><div><h3>Conclusion</h3><div>Fibrates demonstrate the potential to lower the risk of PPDM-A among individuals with AP and hypertriglyceridemia. Furthermore, the effect of triglyceride levels on diabetes risk was partly mediated by pancreatitis.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 1","pages":"Article 500800"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.artere.2025.500804
José Luis Díaz-Díaz , M. Eugenia Ameneiros , Rosa Argüeso Armesto , José María Mostaza Prieto , Xavier Pintó Sala , Avelino Rodríguez González , José Antonio Díaz-Peromingo , Alberto del Alamo Alonso , Pablo Fernández Catalina , Manuel Suárez Tembra , Carlos Alberto Názara Otero , Marta Pena Seijo , Javier Muñiz García , Teresa Rosalía Pérez-Castro , Antonio Pose Reino , Juan Pedro-Botet Montoya
Objectives
GALIPEMIAS is a study designed to determine the prevalence of familial dyslipidemias in the adult population of Galicia, evaluate the degree of lipid control according to the criteria of current clinical guidelines and analyze its association with atherosclerotic cardiovascular disease (ASCVD).
Methods
Cross-sectional study carried out in the general population over 18 years of age residing in Galicia and with a health card from the Galician Health Service (N = 1,000). The sample was selected by random cluster sampling. The prevalence of familial combined hyperlipidemia (FCH), hypercholesterolemia with dominant inheritance pattern (HC-DI) and familial hypertriglyceridemia (FHTG), as well as suspected familial dysbetalipoproteinemia (FDB) and the joint prevalence of familial dyslipidemias with dominant inheritance (FDL-DI) were analyzed. For the assessment of cardiovascular risk (CVR), the criteria of the 2021 European guidelines for cardiovascular prevention were followed. The LDL-C control target required according to the CVR level was defined according to the 2019 European ESC/EAS guidelines.
Results
The prevalence of FCH was 15.9% (95% CI: 13.6–18.4%), that of HC-DI 5.9% (95% CI: 4.5–7.6%), that of FHTG 1.7% (95% CI: 1.0–2.8%) and that of subjects with suspected FDB 0.9% (95% CI 0.4–1.6%). The joint prevalence of FDL-DI was 23.5% (95% CI: 20.8–26.3%), also present in 1 in 3 subjects with ASCVD. Overall, 60.5% of participants with FDL-DI had high or very high CV risk and 4.6% of them were on target for LDL-C control.
Conclusions
The presence of familial dyslipidemia with dominant inheritance is the majority among the adult population living in Galicia with dyslipidemia, with FCH being the most prevalent of them. These subjects are underdiagnosed, are generally at high or very high cardiovascular risk, hardly receive lipid-lowering treatment (1 in 3) and the degree of LDL-C control according to guidelines is very poor.
{"title":"Prevalence of familial dyslipidemias, degree of lipid control and relationship with atherosclerotic cardiovascular disease in the general population of Galicia. GALIPEMIAS Study","authors":"José Luis Díaz-Díaz , M. Eugenia Ameneiros , Rosa Argüeso Armesto , José María Mostaza Prieto , Xavier Pintó Sala , Avelino Rodríguez González , José Antonio Díaz-Peromingo , Alberto del Alamo Alonso , Pablo Fernández Catalina , Manuel Suárez Tembra , Carlos Alberto Názara Otero , Marta Pena Seijo , Javier Muñiz García , Teresa Rosalía Pérez-Castro , Antonio Pose Reino , Juan Pedro-Botet Montoya","doi":"10.1016/j.artere.2025.500804","DOIUrl":"10.1016/j.artere.2025.500804","url":null,"abstract":"<div><h3>Objectives</h3><div>GALIPEMIAS is a study designed to determine the prevalence of familial dyslipidemias in the adult population of Galicia, evaluate the degree of lipid control according to the criteria of current clinical guidelines and analyze its association with atherosclerotic cardiovascular disease (ASCVD).</div></div><div><h3>Methods</h3><div>Cross-sectional study carried out in the general population over 18 years of age residing in Galicia and with a health card from the Galician Health Service (N = 1,000). The sample was selected by random cluster sampling. The prevalence of familial combined hyperlipidemia (FCH), hypercholesterolemia with dominant inheritance pattern (HC-DI) and familial hypertriglyceridemia (FHTG), as well as suspected familial dysbetalipoproteinemia (FDB) and the joint prevalence of familial dyslipidemias with dominant inheritance (FDL-DI) were analyzed. For the assessment of cardiovascular risk (CVR), the criteria of the 2021 European guidelines for cardiovascular prevention were followed. The LDL-C control target required according to the CVR level was defined according to the 2019 European ESC/EAS guidelines.</div></div><div><h3>Results</h3><div>The prevalence of FCH was 15.9% (95% CI: 13.6–18.4%), that of HC-DI 5.9% (95% CI: 4.5–7.6%), that of FHTG 1.7% (95% CI: 1.0–2.8%) and that of subjects with suspected FDB 0.9% (95% CI 0.4–1.6%). The joint prevalence of FDL-DI was 23.5% (95% CI: 20.8–26.3%), also present in 1 in 3 subjects with ASCVD. Overall, 60.5% of participants with FDL-DI had high or very high CV risk and 4.6% of them were on target for LDL-C control.</div></div><div><h3>Conclusions</h3><div>The presence of familial dyslipidemia with dominant inheritance is the majority among the adult population living in Galicia with dyslipidemia, with FCH being the most prevalent of them. These subjects are underdiagnosed, are generally at high or very high cardiovascular risk, hardly receive lipid-lowering treatment (1 in 3) and the degree of LDL-C control according to guidelines is very poor.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"38 1","pages":"Article 500804"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.artere.2025.500846
Joanna Popiolek-Kalisz
Background
Although aggressive low-density lipoprotein cholesterol (LDL-C) reduction has demonstrated significant cardiovascular benefits, concerns have emerged regarding potential adverse effects of very low LDL-C on cellular functions, particularly membrane integrity as cholesterol constitutes an essential component of cellular membranes. The phase angle (PhA), derived from bioelectrical impedance analysis (BIA) reflects cellular membranes integrity and nutritional status. The MALIPID study aimed to assess if LDL-C levels are associated with PhA in high cardiovascular risk patients.
Methods
A cross-sectional study was conducted in 140 patients matched 1:1 for age, sex, and body mass index, stratified by LDL-C levels (<55 vs. ≥55 mg/dL). Laboratory parameters, anthropometry, and BIA measurements were collected with PhA at 50 kHz as the primary outcome.
Results
Median PhA values were comparable between LDL-C groups (4.88 vs. 4.93; p = 0.67). LDL-C was not significantly associated with PhA multivariable regression models adjusted for age, sex, fat-free mass, and biochemical parameters. PhA significantly inversely correlated with age (R = −0.60, p < 0.0001) and positively with eGFR (R = 0.38, p < 0.0001), but not with LDL-C. Subgroup analyses in patients aged >75 years also presented lack of relationship between LDL-C and PhA.
Conclusions
No association was found between LDL-C levels and cellular membrane integrity assessed by PhA. These findings potentially support the physiological safety of intensive LDL-C reduction and highlight the dominant role of age and body composition in determining PhA. Larger, prospective studies are needed to confirm these results.
背景：虽然积极降低低密度脂蛋白胆固醇（LDL-C）已被证明对心血管有显著的益处，但人们担心极低的LDL-C对细胞功能的潜在不良影响，特别是对细胞膜完整性的潜在不良影响，因为胆固醇是细胞膜的重要组成部分。由生物电阻抗分析（BIA）得出的相位角（PhA）反映了细胞膜的完整性和营养状况。MALIPID研究旨在评估高危心血管患者LDL-C水平是否与PhA相关。方法对140例年龄、性别和体重指数1:1匹配的患者进行横断面研究，按LDL-C水平（55 vs.≥55 mg/dL）分层。实验室参数、人体测量和BIA测量以50 kHz的PhA作为主要结果收集。结果中位PhA值在LDL-C组之间具有可比性（4.88 vs 4.93; p = 0.67）。LDL-C与PhA多变量回归模型无显著相关性，校正了年龄、性别、无脂量和生化参数。PhA与年龄呈显著负相关（R = - 0.60, p < 0.0001），与eGFR呈正相关（R = 0.38, p < 0.0001），但与LDL-C无关。75岁患者的亚组分析也显示LDL-C与PhA之间缺乏相关性。结论LDL-C水平与PhA测定的细胞膜完整性无相关性。这些发现潜在地支持了强化LDL-C降低的生理安全性，并强调了年龄和身体成分在决定PhA中的主导作用。需要更大规模的前瞻性研究来证实这些结果。
{"title":"No association between LDL cholesterol levels and cellular membrane integrity assessed with phase angle: Insights from the MALIPID study","authors":"Joanna Popiolek-Kalisz","doi":"10.1016/j.artere.2025.500846","DOIUrl":"10.1016/j.artere.2025.500846","url":null,"abstract":"<div><h3>Background</h3><div>Although aggressive low-density lipoprotein cholesterol (LDL-C) reduction has demonstrated significant cardiovascular benefits, concerns have emerged regarding potential adverse effects of very low LDL-C on cellular functions, particularly membrane integrity as cholesterol constitutes an essential component of cellular membranes. The phase angle (PhA), derived from bioelectrical impedance analysis (BIA) reflects cellular membranes integrity and nutritional status. The MALIPID study aimed to assess if LDL-C levels are associated with PhA in high cardiovascular risk patients.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in 140 patients matched 1:1 for age, sex, and body mass index, stratified by LDL-C levels (<55 vs. ≥55<!--> <!-->mg/dL). Laboratory parameters, anthropometry, and BIA measurements were collected with PhA at 50<!--> <!-->kHz as the primary outcome.</div></div><div><h3>Results</h3><div>Median PhA values were comparable between LDL-C groups (4.88 vs. 4.93; <em>p</em> <!-->=<!--> <!-->0.67). LDL-C was not significantly associated with PhA multivariable regression models adjusted for age, sex, fat-free mass, and biochemical parameters. PhA significantly inversely correlated with age (<em>R</em> <!-->=<!--> <!-->−0.60, <em>p</em> <!--><<!--> <!-->0.0001) and positively with eGFR (<em>R</em> <!-->=<!--> <!-->0.38, <em>p</em> <!--><<!--> <!-->0.0001), but not with LDL-C. Subgroup analyses in patients aged >75 years also presented lack of relationship between LDL-C and PhA.</div></div><div><h3>Conclusions</h3><div>No association was found between LDL-C levels and cellular membrane integrity assessed by PhA. These findings potentially support the physiological safety of intensive LDL-C reduction and highlight the dominant role of age and body composition in determining PhA. Larger, prospective studies are needed to confirm these results.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 6","pages":"Article 500846"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.artere.2025.500773
Juan Cosín Sales , Carlos Escobar Cervantes , José Javier Gómez-Barrado , José Manuel Andreu Cayuelas , Abel García del Egido , Jorge Joaquín Castro Martín , Ana Isabel Huelmos Rodrigo , Miguel Corbi-Pascual , Ariana Varela Cancelo , Rafael Vidal-Pérez , Leticia Fernandez-Friera , Enrique Santas Olmeda , Almudena Aguilera-Saborido , Antonio Fernández Romero , Antonio Sánchez Hidalgo , Francisco Pérez-Sádaba , Román Freixa-Pamias
Aims
A high number of patients do not achieve the therapeutic goals set by clinical practice guidelines, despite the therapeutic alternatives that currently exist in lipid-lowering treatment (LLT). This study aimed to estimate the proportion of patients who have recently suffered an acute coronary syndrome (ACS) who do not meet the therapeutic goal with LLT and the proportion of routine follow-up visits where therapeutic inertia (TI) occurs.
Methods
A retrospective study chart review was conducted in 13 Spanish centres. Patients aged ≥18 years who suffered an ACS event in the last two years and had received LLT were included. Sociodemographic, clinical, treatment and participating centre/physician-related variables were collected. TI was considered when a visit did not result in a change in the patient's therapy despite the non-achievement of therapeutic goals. Descriptive analysis was performed, and factors associated with TI were evaluated using logistic regression.
Results
159 patients were included (mean age 63.08 years old, 80.5% male) and 338 follow-up visits were analysed. Over 50% of the patients did not meet the therapeutic target and TI was estimated in 39.13% of visits. Some factors were associated with a lower risk of TI: professional experience, number of vessels affected, and diabetes. And others with higher risk: being female, previous CV pathology and a complete revascularisation.
Conclusion
The management of patients after ACS is still suboptimal. The importance of clinical inertia in ACS remains a real awareness and active strategies will help mitigate this phenomenon due to the risk of recurrent ACS.
{"title":"Impact of therapeutic inertia in lipid-lowering therapy in patients at very high cardiovascular risk","authors":"Juan Cosín Sales , Carlos Escobar Cervantes , José Javier Gómez-Barrado , José Manuel Andreu Cayuelas , Abel García del Egido , Jorge Joaquín Castro Martín , Ana Isabel Huelmos Rodrigo , Miguel Corbi-Pascual , Ariana Varela Cancelo , Rafael Vidal-Pérez , Leticia Fernandez-Friera , Enrique Santas Olmeda , Almudena Aguilera-Saborido , Antonio Fernández Romero , Antonio Sánchez Hidalgo , Francisco Pérez-Sádaba , Román Freixa-Pamias","doi":"10.1016/j.artere.2025.500773","DOIUrl":"10.1016/j.artere.2025.500773","url":null,"abstract":"<div><h3>Aims</h3><div>A high number of patients do not achieve the therapeutic goals set by clinical practice guidelines, despite the therapeutic alternatives that currently exist in lipid-lowering treatment (LLT). This study aimed to estimate the proportion of patients who have recently suffered an acute coronary syndrome (ACS) who do not meet the therapeutic goal with LLT and the proportion of routine follow-up visits where therapeutic inertia (TI) occurs.</div></div><div><h3>Methods</h3><div>A retrospective study chart review was conducted in 13 Spanish centres. Patients aged ≥18 years who suffered an ACS event in the last two years and had received LLT were included. Sociodemographic, clinical, treatment and participating centre/physician-related variables were collected. TI was considered when a visit did not result in a change in the patient's therapy despite the non-achievement of therapeutic goals. Descriptive analysis was performed, and factors associated with TI were evaluated using logistic regression.</div></div><div><h3>Results</h3><div>159 patients were included (mean age 63.08 years old, 80.5% male) and 338 follow-up visits were analysed. Over 50% of the patients did not meet the therapeutic target and TI was estimated in 39.13% of visits. Some factors were associated with a lower risk of TI: professional experience, number of vessels affected, and diabetes. And others with higher risk: being female, previous CV pathology and a complete revascularisation.</div></div><div><h3>Conclusion</h3><div>The management of patients after ACS is still suboptimal. The importance of clinical inertia in ACS remains a real awareness and active strategies will help mitigate this phenomenon due to the risk of recurrent ACS.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 6","pages":"Article 500773"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.artere.2025.500874
Francisco Martín Luján , Rosa Solà Alberich
{"title":"Usefulness of visceral fat assessment for the early stratification of atherogenic risk: From conventional anthropometry to more accurate measurements","authors":"Francisco Martín Luján , Rosa Solà Alberich","doi":"10.1016/j.artere.2025.500874","DOIUrl":"10.1016/j.artere.2025.500874","url":null,"abstract":"","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 6","pages":"Article 500874"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.artere.2025.500767
Santiago Redondo
In the last decade, the coming of next-generation sequencing and its application to large human populations is breaking the barrier between inflammation and cancer. Indeed, acquired mutations in key genes that regulate hematopoiesis and thus confer a selective advantage in the proliferation of hematopoietic progenitors have established the concept of clonal hematopoiesis of indeterminate potential or CHIP. A growing body of clinical and experimental evidence is highlighting the link between CHIP and adverse outcomes, in particular atherosclerotic cardiovascular disease and cancer. The apparent surprise about how these two different entities share common mechanisms can be explained by myeloproliferation and inflammation. These mechanisms are involved not only in the development of myeloid tumors but also in atherogenesis. Myeloproliferative neoplasms or MPN are a type of myeloid tumors where thrombotic risk is increased not only by higher blood counts but also by means of an accelerated atherosclerosis. Therefore, myeloproliferative neoplasms are a model of the link between clonal hematopoiesis and atherosclerotic cardiovascular disease. The concept of CHIP has important clinical applications. A deeper understanding of these mechanisms may pave the way for the future early diagnosis and potential pre-emptive treatments of these two major causes of death.
{"title":"Myeloproliferative neoplasms: A model of the journey from clonal hematopoiesis to cardiovascular disease and cancer","authors":"Santiago Redondo","doi":"10.1016/j.artere.2025.500767","DOIUrl":"10.1016/j.artere.2025.500767","url":null,"abstract":"<div><div>In the last decade, the coming of next-generation sequencing and its application to large human populations is breaking the barrier between inflammation and cancer. Indeed, acquired mutations in key genes that regulate hematopoiesis and thus confer a selective advantage in the proliferation of hematopoietic progenitors have established the concept of clonal hematopoiesis of indeterminate potential or CHIP. A growing body of clinical and experimental evidence is highlighting the link between CHIP and adverse outcomes, in particular atherosclerotic cardiovascular disease and cancer. The apparent surprise about how these two different entities share common mechanisms can be explained by myeloproliferation and inflammation. These mechanisms are involved not only in the development of myeloid tumors but also in atherogenesis. Myeloproliferative neoplasms or MPN are a type of myeloid tumors where thrombotic risk is increased not only by higher blood counts but also by means of an accelerated atherosclerosis. Therefore, myeloproliferative neoplasms are a model of the link between clonal hematopoiesis and atherosclerotic cardiovascular disease. The concept of CHIP has important clinical applications. A deeper understanding of these mechanisms may pave the way for the future early diagnosis and potential pre-emptive treatments of these two major causes of death.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 6","pages":"Article 500767"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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