Pub Date : 2025-05-01Epub Date: 2025-05-14DOI: 10.1016/j.artere.2025.100736
J. Ildefonzo Arocha Rodulfo , Gestne Aure Fariñez
Objectives
Cardiovascular diseases (CVD) are the greatest threat to the health of women and is the leading cause of death amongst women globally; however, cardiovascular disease in women remains understudied, under-recognized, underdiagnosed, and undertreated. The aim of this descriptive review is to summarize the existing problem and to identify the knowledge gaps in cardiovascular disease research, prevention, treatment, and access to care for women.
Material and methods
This is a descriptive review of the literature based on numerous articles published in peer-reviewed journals since the beginning of this century related to the spectrum of cardiovascular disease in women.
Results
There are several obstacles to improve cardiovascular disease outcomes in women. One of them is the lack of reliable, effective screening modalities since her participation in clinical trial is quite low. Other concern is the complexity of the female organism with several hormonal changes during her life and the hemodynamics stress during pregnancy. Moreover, in the last stage of their life several cardiometabolic risk factor may appear, most of them not recognized by the health team in primary care attention.
Discussion
Effective strategies are required to address inequalities in the diagnosis, treatment and prevention of heart disease in women; to advance innovative solutions for early detection and oriented management; to clarify the underlying biological mechanisms that contribute to sex-specific differences in outcomes; and finally, reduce the global burden of cardiovascular disease in women.
{"title":"The complexity of cardiovascular risk in women. Descriptive review","authors":"J. Ildefonzo Arocha Rodulfo , Gestne Aure Fariñez","doi":"10.1016/j.artere.2025.100736","DOIUrl":"10.1016/j.artere.2025.100736","url":null,"abstract":"<div><h3>Objectives</h3><div>Cardiovascular diseases (CVD) are the greatest threat to the health of women and is the leading cause of death amongst women globally; however, cardiovascular disease in women remains understudied, under-recognized, underdiagnosed, and undertreated. The aim of this descriptive review is to summarize the existing problem and to identify the knowledge gaps in cardiovascular disease research, prevention, treatment, and access to care for women.</div></div><div><h3>Material and methods</h3><div>This is a descriptive review of the literature based on numerous articles published in peer-reviewed journals since the beginning of this century related to the spectrum of cardiovascular disease in women.</div></div><div><h3>Results</h3><div>There are several obstacles to improve cardiovascular disease outcomes in women. One of them is the lack of reliable, effective screening modalities since her participation in clinical trial is quite low. Other concern is the complexity of the female organism with several hormonal changes during her life and the hemodynamics stress during pregnancy. Moreover, in the last stage of their life several cardiometabolic risk factor may appear, most of them not recognized by the health team in primary care attention.</div></div><div><h3>Discussion</h3><div>Effective strategies are required to address inequalities in the diagnosis, treatment and prevention of heart disease in women; to advance innovative solutions for early detection and oriented management; to clarify the underlying biological mechanisms that contribute to sex-specific differences in outcomes; and finally, reduce the global burden of cardiovascular disease in women.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 3","pages":"Article 100736"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204388","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 : 2025-03-01Epub Date: 2025-04-16DOI: 10.1016/j.artere.2025.100729
Núria Puig , Pol Camps-Renom , Eduardo Garcia , Aleyda Benítez-Amaro , Ana Aguilera-Simón , Alejandro Fernández-León , Jose Luis Sanchez Quesada , Vicenta Llorente-Cortés , Sonia Benitez
Background
Atherosclerotic plaques in the internal carotid artery are responsible for more than 15% of ischemic strokes. Carotid 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) detects plaque inflammation. Plasma ICAM-1 and LRP1 concentrations have been associated with inflammation in ipsilateral carotid plaque. The aim of the present study was to test the association between the soluble (s) form of these biomarkers and contralateral carotid plaques.
Methods
Prospective study conducted in 53 patients with a recent ischemic stroke and at least one atherosclerotic plaque in both carotid arteries. All of the patients underwent an early carotid 18F-FDG PET, and a blood sample was obtained at 7 ± 1 days. Several plasma inflammatory markers were evaluated by Multiplex and sLRP1 levels were measured by commercial ELISA. Bivariate and multivariable linear regression was used to assess the association between inflammatory markers and the clinical variables, including contralateral maximum standardized uptake value (SUVmax) and mean SUVmax (mean of contralateral and ipsilateral SUVmax) of 18F-FDG uptake. Hazard ratio (HR) was estimated with Cox models adjusted for potential confounding factors to evaluate recurrence.
Results
Multivariable linear regression analysis showed an independent association between sICAM-1 and sVCAM-1 and mean SUVmax (CI = −0.064–0.325, p = 0.004; CI = 0.079–0.554, p = 0.010). In addition, in bivariate regression analysis, sICAM-1 was associated with contralateral SUVmax (CI = 0.049–0.382, p = 0.012). Cox regression showed that mean SUVmax was associated with stroke recurrence (HR = 5.604, p = 0.044).
Conclusions
sICAM-1 was independently associated with mean carotid plaque inflammation and with inflammation in contralateral plaque. sICAM-1 could be an indicator of plaque inflammation even in asymptomatic plaques.
背景：15%以上的缺血性中风是由颈内动脉粥样硬化斑块引起的。颈动脉18f -氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）检测斑块炎症。血浆ICAM-1和LRP1浓度与同侧颈动脉斑块炎症有关。本研究的目的是测试这些生物标志物的可溶性形式与对侧颈动脉斑块之间的关系。方法对53例近期缺血性卒中且双颈动脉至少有一个动脉粥样硬化斑块的患者进行前瞻性研究。所有患者都进行了早期颈动脉18F-FDG PET检查，并在7±1天采集血样。采用Multiplex评估几种血浆炎症标志物，采用商用ELISA检测sLRP1水平。采用双变量和多变量线性回归来评估炎症标志物与临床变量之间的关系，包括对侧最大标准化摄取值（SUVmax）和平均SUVmax（对侧和同侧SUVmax的平均值）对18F-FDG摄取。风险比（HR）用Cox模型估计，校正了潜在的混杂因素以评估复发率。结果多变量线性回归分析显示，sICAM-1和sVCAM-1与平均SUVmax存在独立相关性(CI = - 0.064-0.325, p = 0.004；CI = 0.079 ~ 0.554, p = 0.010)。此外，在双变量回归分析中，sICAM-1与对侧SUVmax相关（CI = 0.049 ~ 0.382, p = 0.012）。Cox回归分析显示，平均SUVmax与卒中复发相关（HR = 5.604, p = 0.044）。结论ssicam -1与颈动脉斑块平均炎症及对侧斑块炎症独立相关。即使在无症状斑块中，sICAM-1也可能是斑块炎症的一个指标。
{"title":"sICAM-1 concentrations are associated with inflammation in contralateral carotid plaque in patients with ischemic stroke","authors":"Núria Puig , Pol Camps-Renom , Eduardo Garcia , Aleyda Benítez-Amaro , Ana Aguilera-Simón , Alejandro Fernández-León , Jose Luis Sanchez Quesada , Vicenta Llorente-Cortés , Sonia Benitez","doi":"10.1016/j.artere.2025.100729","DOIUrl":"10.1016/j.artere.2025.100729","url":null,"abstract":"<div><h3>Background</h3><div>Atherosclerotic plaques in the internal carotid artery are responsible for more than 15% of ischemic strokes. Carotid <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (<sup>18</sup>F-FDG PET) detects plaque inflammation. Plasma ICAM-1 and LRP1 concentrations have been associated with inflammation in ipsilateral carotid plaque. The aim of the present study was to test the association between the soluble (s) form of these biomarkers and contralateral carotid plaques.</div></div><div><h3>Methods</h3><div>Prospective study conducted in 53 patients with a recent ischemic stroke and at least one atherosclerotic plaque in both carotid arteries. All of the patients underwent an early carotid <sup>18</sup>F-FDG PET, and a blood sample was obtained at 7<!--> <!-->±<!--> <!-->1 days. Several plasma inflammatory markers were evaluated by Multiplex and sLRP1 levels were measured by commercial ELISA. Bivariate and multivariable linear regression was used to assess the association between inflammatory markers and the clinical variables, including contralateral maximum standardized uptake value (SUVmax) and mean SUVmax (mean of contralateral and ipsilateral SUVmax) of <sup>18</sup>F-FDG uptake. Hazard ratio (HR) was estimated with Cox models adjusted for potential confounding factors to evaluate recurrence.</div></div><div><h3>Results</h3><div>Multivariable linear regression analysis showed an independent association between sICAM-1 and sVCAM-1 and mean SUVmax (CI<!--> <!-->=<!--> <!-->−0.064–0.325, <em>p</em> <!-->=<!--> <!-->0.004; CI<!--> <!-->=<!--> <!-->0.079–0.554, <em>p</em> <!-->=<!--> <!-->0.010). In addition, in bivariate regression analysis, sICAM-1 was associated with contralateral SUVmax (CI<!--> <!-->=<!--> <!-->0.049–0.382, <em>p</em> <!-->=<!--> <!-->0.012). Cox regression showed that mean SUVmax was associated with stroke recurrence (HR<!--> <!-->=<!--> <!-->5.604, <em>p</em> <!-->=<!--> <!-->0.044).</div></div><div><h3>Conclusions</h3><div>sICAM-1 was independently associated with mean carotid plaque inflammation and with inflammation in contralateral plaque. sICAM-1 could be an indicator of plaque inflammation even in asymptomatic plaques.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 2","pages":"Article 100729"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835224","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 : 2025-03-01Epub Date: 2025-04-16DOI: 10.1016/j.artere.2025.500771
Francesco Sbrana, Beatrice Dal Pino
{"title":"PCSK9 inhibitors tug of war: Compliance, adverse events and LDL-cholesterol target","authors":"Francesco Sbrana, Beatrice Dal Pino","doi":"10.1016/j.artere.2025.500771","DOIUrl":"10.1016/j.artere.2025.500771","url":null,"abstract":"","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 2","pages":"Article 500771"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834727","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 : 2025-03-01Epub Date: 2025-03-25DOI: 10.1016/j.artere.2025.100726
Elena Vilalta Doñate , Francisca García Fernández , Salvador Martínez Meléndez , Consuelo Castillo Castillo , Pablo Salas Medina , Isabel Almodóvar Fernández
Introduction
Adherence to the Mediterranean diet (Dietmed) exerts protective effects on cardiovascular disease (CVD). In the Lower Extremity Peripheral Arterial Disease (PAD) there are fewer studies that analyze these data.
Objective
To determine adherence to Dietmed and dietary habits in patients with PAD, according to a history of CVD (coronary and/or cerebral ischaemic pathology) and according to the ankle-brachial index (ABI ≥ or < 0,5).
Material and methods
Cross-sectional analytical study carried out in a tertiary hospital. The sample was collected consecutively. Sociodemographic and clinical history, ankle-brachial index (ABI) and a 14-point Dietmed adherence dietary questionnaire were included. The analysis of categorical variables was carried out using the Pearson’s Chi-Square test, the T-Student’s statistic test for independent samples was used for parametric variables and the U. Mann-Whitney test for non-parametric variables.
Results
Of the 97 patients, 87,6% had low adherence to Dietmed, with no differences according to the severity of PAD. However, when we analysed the data according to whether or not they had a history of CVD, we observed a high adherence to some items included in Dietmed, specifically, in the CVD group, the consumption of lean meat (95,5% vs 64%; p = 0.004). In addition, we observed a significant difference in the consumption in the group without a history of CVD (32% vs 9,1%; p = 0.033).
Conclusion
In our population, patients with PAD, regardless of the stage of the disease and whether they had associated coronary or cerebral ischaemic pathology, had low adherence to Dietmed. Therefore, it is important to implement nutritional education programmes in patients with PAD in all stages, as well as in those patients who have already suffered a vascular event, so that they maintain adherence to healthy dietary habits in the long term.
坚持地中海饮食（Dietmed）对心血管疾病（CVD）有保护作用。在下肢外周动脉疾病（PAD）中，分析这些数据的研究较少。目的根据心血管疾病（冠状动脉和/或脑缺血病理）病史和踝肱指数(ABI≥或<；0, 5)。材料与方法在某三级医院进行横断面分析研究。连续采集样品。包括社会人口学和临床病史，踝肱指数（ABI）和14分饮食依从性饮食问卷。分类变量的分析采用皮尔逊卡方检验，参数变量的独立样本采用T-Student统计检验，非参数变量采用U. Mann-Whitney检验。结果97例患者中，86.7%的患者对Dietmed的依从性较低，根据PAD的严重程度没有差异。然而，当我们根据他们是否有心血管疾病史来分析数据时，我们观察到他们对饮食中的一些项目有很高的依从性，特别是在心血管疾病组中，瘦肉的消耗(95.5% vs 64%；P = 0.004)。此外，我们观察到无心血管疾病史组的消费量有显著差异(32% vs 9.1%；P = 0.033)。结论：在我们的人群中，PAD患者，无论疾病的分期，是否有相关的冠状动脉或脑缺血病理，对Dietmed的依从性较低。因此，重要的是在所有阶段的PAD患者以及已经发生血管事件的患者中实施营养教育计划，以便他们长期坚持健康的饮食习惯。
{"title":"Nutritional habits in patients with peripheral arterial disease: Adherence to the Mediterranean diet","authors":"Elena Vilalta Doñate , Francisca García Fernández , Salvador Martínez Meléndez , Consuelo Castillo Castillo , Pablo Salas Medina , Isabel Almodóvar Fernández","doi":"10.1016/j.artere.2025.100726","DOIUrl":"10.1016/j.artere.2025.100726","url":null,"abstract":"<div><h3>Introduction</h3><div>Adherence to the Mediterranean diet (Dietmed) exerts protective effects on cardiovascular disease (CVD). In the Lower Extremity Peripheral Arterial Disease (PAD) there are fewer studies that analyze these data.</div></div><div><h3>Objective</h3><div>To determine adherence to Dietmed and dietary habits in patients with PAD, according to a history of CVD (coronary and/or cerebral ischaemic pathology) and according to the ankle-brachial index (ABI ≥ or < 0,5).</div></div><div><h3>Material and methods</h3><div>Cross-sectional analytical study carried out in a tertiary hospital. The sample was collected consecutively. Sociodemographic and clinical history, ankle-brachial index (ABI) and a 14-point Dietmed adherence dietary questionnaire were included. The analysis of categorical variables was carried out using the Pearson’s Chi-Square test, the T-Student’s statistic test for independent samples was used for parametric variables and the U. Mann-Whitney test for non-parametric variables.</div></div><div><h3>Results</h3><div>Of the 97 patients, 87,6% had low adherence to Dietmed, with no differences according to the severity of PAD. However, when we analysed the data according to whether or not they had a history of CVD, we observed a high adherence to some items included in Dietmed, specifically, in the CVD group, the consumption of lean meat (95,5% vs 64%; p = 0.004). In addition, we observed a significant difference in the consumption in the group without a history of CVD (32% vs 9,1%; p = 0.033).</div></div><div><h3>Conclusion</h3><div>In our population, patients with PAD, regardless of the stage of the disease and whether they had associated coronary or cerebral ischaemic pathology, had low adherence to Dietmed. Therefore, it is important to implement nutritional education programmes in patients with PAD in all stages, as well as in those patients who have already suffered a vascular event, so that they maintain adherence to healthy dietary habits in the long term.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 2","pages":"Article 100726"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834703","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 : 2025-03-01Epub Date: 2025-03-25DOI: 10.1016/j.artere.2025.100751
Emilio Ortega , Amanda Jiménez , Sheila López-Ruiz , Eva Castro-Boqué , José Manuel Valdivielso , Marcelino Bermúdez-López , Gemma Chiva-Blanch
Introduction and objectives
More than 50% of first cardiovascular events (CVE) occur in populations identified as at low or intermediate risk by the risk equations, so the inclusion of additional variables, such as polygenic risk scores (PRS), has been proposed to improve the predictive capacity of these equations. The aim of this study was to assess whether a PRS, independently or with clinical risk equations, is associated with the presence, severity and extent of subclinical atherosclerosis.
Methods
109 subjects with atherosclerosis were selected from the ILERVAS cohort (primary prevention) and matched with 109 participants without atherosclerosis of the same age, sex and SCORE2 risk level. Atherosclerosis was assessed and quantified by arterial wall vascular ultrasound in 12 territories, and PRS was estimated using the Cardio inCode Score®. The predictive capacity of the presence of subclinical atherosclerosis was estimated, as well as the association between the extent and severity of atherosclerosis with PRS and clinical risk (SCORE2).
Results
PRS was similar between participants with or without atherosclerosis (P = .525). We did not find an association between PRS and SCORE2 (r = −.29, P = .709), and the addition of PRS to SCORE2 did not improve the prediction of atherosclerosis [AUC (95% CI) = .566 (.477, .654, P = .148). The extent of atherosclerosis was related to SCORE2 (P = .009), but not to PRS (P = .709).
Conclusions
The Selected PRS is not associated with the presence of atherosclerosis or clinical risk, suggesting that its additional contribution to CVE risk would be mediated by mechanisms independent of the development of atherosclerosis. Additional biomarkers are needed to improve the prediction of subclinical atherosclerosis without using imaging tests as a first step in personalised assessment.
{"title":"Polygenic risk and subclinical atherosclerosis in asymptomatic middle-aged individuals. The ILERVAS study","authors":"Emilio Ortega , Amanda Jiménez , Sheila López-Ruiz , Eva Castro-Boqué , José Manuel Valdivielso , Marcelino Bermúdez-López , Gemma Chiva-Blanch","doi":"10.1016/j.artere.2025.100751","DOIUrl":"10.1016/j.artere.2025.100751","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>More than 50% of first cardiovascular events (CVE) occur in populations identified as at low or intermediate risk by the risk equations, so the inclusion of additional variables, such as polygenic risk scores (PRS), has been proposed to improve the predictive capacity of these equations. The aim of this study was to assess whether a PRS, independently or with clinical risk equations, is associated with the presence, severity and extent of subclinical atherosclerosis.</div></div><div><h3>Methods</h3><div>109 subjects with atherosclerosis were selected from the ILERVAS cohort (primary prevention) and matched with 109 participants without atherosclerosis of the same age, sex and SCORE2 risk level. Atherosclerosis was assessed and quantified by arterial wall vascular ultrasound in 12 territories, and PRS was estimated using the Cardio inCode Score®. The predictive capacity of the presence of subclinical atherosclerosis was estimated, as well as the association between the extent and severity of atherosclerosis with PRS and clinical risk (SCORE2).</div></div><div><h3>Results</h3><div>PRS was similar between participants with or without atherosclerosis (<em>P</em> = .525). We did not find an association between PRS and SCORE2 (r = −.29, <em>P</em> = .709), and the addition of PRS to SCORE2 did not improve the prediction of atherosclerosis [AUC (95% CI) = .566 (.477, .654, <em>P</em> = .148). The extent of atherosclerosis was related to SCORE2 (<em>P</em> = .009), but not to PRS (<em>P</em> = .709).</div></div><div><h3>Conclusions</h3><div>The Selected PRS is not associated with the presence of atherosclerosis or clinical risk, suggesting that its additional contribution to CVE risk would be mediated by mechanisms independent of the development of atherosclerosis. Additional biomarkers are needed to improve the prediction of subclinical atherosclerosis without using imaging tests as a first step in personalised assessment.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 2","pages":"Article 100751"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835235","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 : 2025-03-01Epub Date: 2025-04-16DOI: 10.1016/j.artere.2025.100718
José A. Páramo , Ana Cenarro , Fernando Civeira , Carmen Roncal
Atherosclerosis is the main pathogenic substrate for cardiovascular diseases (CVDs). Initially categorized as a passive cholesterol storage disease, nowadays, it is considered an active process, identifying inflammation among the key players for its initiation and progression. Despite these advances, patients with CVDs are still at high risk of thrombotic events and death, urging to deepen into the molecular mechanisms underlying atherogenesis, and to identify novel diagnosis and prognosis biomarkers for their stratification. In this context, extracellular vesicles (EVs) have been postulated as an alternative in search of novel biomarkers in atherosclerotic diseases, as well as to investigate the crosstalk between the cells participating in the processes leading to arterial remodelling. EVs are nanosized lipidic particles released by most cell types in physiological and pathological conditions, that enclose lipids, proteins, and nucleic acids from parental cells reflecting their activation status. First considered cellular waste disposal systems, at present, EVs have been recognized as active effectors in a myriad of cellular processes, and as potential diagnosis and prognosis biomarkers also in CVDs. This review summarizes the role of EVs as potential biomarkers of CVDs, and their involvement into the processes leading to atherosclerosis.
{"title":"Extracellular vesicles in atherosclerosis: Current and forthcoming impact.","authors":"José A. Páramo , Ana Cenarro , Fernando Civeira , Carmen Roncal","doi":"10.1016/j.artere.2025.100718","DOIUrl":"10.1016/j.artere.2025.100718","url":null,"abstract":"<div><div>Atherosclerosis is the main pathogenic substrate for cardiovascular diseases (CVDs). Initially categorized as a passive cholesterol storage disease, nowadays, it is considered an active process, identifying inflammation among the key players for its initiation and progression. Despite these advances, patients with CVDs are still at high risk of thrombotic events and death, urging to deepen into the molecular mechanisms underlying atherogenesis, and to identify novel diagnosis and prognosis biomarkers for their stratification. In this context, extracellular vesicles (EVs) have been postulated as an alternative in search of novel biomarkers in atherosclerotic diseases, as well as to investigate the crosstalk between the cells participating in the processes leading to arterial remodelling. EVs are nanosized lipidic particles released by most cell types in physiological and pathological conditions, that enclose lipids, proteins, and nucleic acids from parental cells reflecting their activation status. First considered cellular waste disposal systems, at present, EVs have been recognized as active effectors in a myriad of cellular processes, and as potential diagnosis and prognosis biomarkers also in CVDs. This review summarizes the role of EVs as potential biomarkers of CVDs, and their involvement into the processes leading to atherosclerosis.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 2","pages":"Article 100718"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834726","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 : 2025-03-01Epub Date: 2025-03-29DOI: 10.1016/j.artere.2025.100735
Sebastián Mas-Fontao , Nieves Tarín , Carmen Cristóbal , Manuel Soto-Catalán , Ana Pello , Alvaro Aceña , Jairo Lumpuy-Castillo , Carmen Garces , Carmen Gomez-Guerrero , Carlos Gutiérrez-Landaluce , Luis M. Blanco-Colio , José Luis Martín-Ventura , Ana Huelmos , Joaquín Alonso , Lorenzo López Bescós , Juan A. Moreno , Ignacio Mahíllo-Fernández , Óscar Lorenzo , María Luisa González-Casaus , Jesús Egido , José Tuñón
Objectives
To examine the relationship between inflammatory biomarkers and the occurrence of cardiovascular events in patients with type 2 diabetes mellitus (DM2) and stable coronary artery disease.
Methods
A total of 964 patients with stable coronary artery disease were included. Plasma levels of inflammatory markers, including tumour necrosis factor receptors 1 and 2 (TNF-R1 and TNF-R2), growth differentiation factor-15 (GDF-15), soluble suppression of tumorigenicity 2 (sST2), and high-sensitivity C-reactive protein (hsCRP) were measured. The primary endpoint was the development of acute ischaemic events (any type of acute coronary syndrome, stroke, or transient ischaemic attack).
Results
There were 232 diabetic patients and 732 non-diabetic patients. Patients with coronary artery disease and DM2 (232, 24%) had higher levels of TNF-R1, TNF-R2, GDF-15, sST2 (p < .001), and hsCRP compared to patients without DM2, indicating a higher inflammatory state. After a median follow-up of 5.39 (2.81–6.92) years, patients with DM2 more frequently developed the primary endpoint (15.9% vs 10.8%; p = .035). Plasma levels of TNF-R1 were independent predictors of the primary endpoint in patients with DM2, along with male gender, triglyceride levels, and the absence of treatment with angiotensin-converting enzyme inhibitors. None of these inflammatory markers predicted the development of this event in non-diabetic patients.
Conclusions
Patients with stable coronary artery disease and DM2 exhibit elevated levels of the proinflammatory markers TNF-R1, TNF-R2, GDF-15, and sST2. Moreover, TNF-R1 is an independent predictor of acute ischaemic events only in diabetic patients.
{"title":"Elevated plasma levels of TNF-R1 predict the development of acute ischemic events in coronary patients with diabetes","authors":"Sebastián Mas-Fontao , Nieves Tarín , Carmen Cristóbal , Manuel Soto-Catalán , Ana Pello , Alvaro Aceña , Jairo Lumpuy-Castillo , Carmen Garces , Carmen Gomez-Guerrero , Carlos Gutiérrez-Landaluce , Luis M. Blanco-Colio , José Luis Martín-Ventura , Ana Huelmos , Joaquín Alonso , Lorenzo López Bescós , Juan A. Moreno , Ignacio Mahíllo-Fernández , Óscar Lorenzo , María Luisa González-Casaus , Jesús Egido , José Tuñón","doi":"10.1016/j.artere.2025.100735","DOIUrl":"10.1016/j.artere.2025.100735","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the relationship between inflammatory biomarkers and the occurrence of cardiovascular events in patients with type 2 diabetes mellitus (DM2) and stable coronary artery disease.</div></div><div><h3>Methods</h3><div>A total of 964 patients with stable coronary artery disease were included. Plasma levels of inflammatory markers, including tumour necrosis factor receptors 1 and 2 (TNF-R1 and TNF-R2), growth differentiation factor-15 (GDF-15), soluble suppression of tumorigenicity 2 (sST2), and high-sensitivity C-reactive protein (hsCRP) were measured. The primary endpoint was the development of acute ischaemic events (any type of acute coronary syndrome, stroke, or transient ischaemic attack).</div></div><div><h3>Results</h3><div>There were 232 diabetic patients and 732 non-diabetic patients. Patients with coronary artery disease and DM2 (232, 24%) had higher levels of TNF-R1, TNF-R2, GDF-15, sST2 (p < .001), and hsCRP compared to patients without DM2, indicating a higher inflammatory state. After a median follow-up of 5.39 (2.81–6.92) years, patients with DM2 more frequently developed the primary endpoint (15.9% vs 10.8%; p = .035). Plasma levels of TNF-R1 were independent predictors of the primary endpoint in patients with DM2, along with male gender, triglyceride levels, and the absence of treatment with angiotensin-converting enzyme inhibitors. None of these inflammatory markers predicted the development of this event in non-diabetic patients.</div></div><div><h3>Conclusions</h3><div>Patients with stable coronary artery disease and DM2 exhibit elevated levels of the proinflammatory markers TNF-R1, TNF-R2, GDF-15, and sST2. Moreover, TNF-R1 is an independent predictor of acute ischaemic events only in diabetic patients.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 2","pages":"Article 100735"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835225","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 : 2025-01-01Epub Date: 2025-02-13DOI: 10.1016/j.artere.2025.100723
Kung-Hung Lin , Nuria Amigo , Pablo Ortiz , Cristina Alonso , Alexander V. Smolensky , Deven Parmar , Naga P. Chalasani , Samer Gawrieh
Background and aims
Comprehensive assessment of pharmacotherapy effects on atherogenic parameters (AP) that influence the risk of cardiovascular disease (CVD) is challenging due to interactions among a large number of parameters that modulate CVD risk.
Methods
We developed an illustrative tool, athero-contour (AC), which incorporates weighted key lipid, lipo- and glycoprotein parameters, to readily illustrate their overall changes following pharmacotherapy. We demonstrate the applicability of AC to assess changes in AP in response to saroglitazar treatment in patients with metabolic associated fatty liver disease (MAFLD) in the EVIDENCES IV study.
Results
The baseline AC of saroglitazar and placebo groups was worse than the mean of the general population. After 16-week treatment, AC improved significantly in the saroglitazar group due to alterations in very low-density lipoprotein, triglyceride, and glycoproteins.
Conclusion
Using AC, we could readily and globally evaluate and visualize changes in AP. AC improved in patients with MAFLD following saroglitazar therapy.
{"title":"The athero-contour: A novel tool for global and rapid assessment of atherogenic parameters. A use case in saroglitazar treatment of MAFLD patients","authors":"Kung-Hung Lin , Nuria Amigo , Pablo Ortiz , Cristina Alonso , Alexander V. Smolensky , Deven Parmar , Naga P. Chalasani , Samer Gawrieh","doi":"10.1016/j.artere.2025.100723","DOIUrl":"10.1016/j.artere.2025.100723","url":null,"abstract":"<div><h3>Background and aims</h3><div>Comprehensive assessment of pharmacotherapy effects on atherogenic parameters (AP) that influence the risk of cardiovascular disease (CVD) is challenging due to interactions among a large number of parameters that modulate CVD risk.</div></div><div><h3>Methods</h3><div>We developed an illustrative tool, athero-contour (AC), which incorporates weighted key lipid, lipo- and glycoprotein parameters, to readily illustrate their overall changes following pharmacotherapy. We demonstrate the applicability of AC to assess changes in AP in response to saroglitazar treatment in patients with metabolic associated fatty liver disease (MAFLD) in the EVIDENCES IV study.</div></div><div><h3>Results</h3><div>The baseline AC of saroglitazar and placebo groups was worse than the mean of the general population. After 16-week treatment, AC improved significantly in the saroglitazar group due to alterations in very low-density lipoprotein, triglyceride, and glycoproteins.</div></div><div><h3>Conclusion</h3><div>Using AC, we could readily and globally evaluate and visualize changes in AP. AC improved in patients with MAFLD following saroglitazar therapy.</div></div>","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 1","pages":"Article 100723"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395421","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 : 2025-01-01Epub Date: 2025-02-13DOI: 10.1016/j.artere.2025.500764
Francisco Pérez-Jiménez
{"title":"Nutritional recommendations: an easy and difficult task for the doctor","authors":"Francisco Pérez-Jiménez","doi":"10.1016/j.artere.2025.500764","DOIUrl":"10.1016/j.artere.2025.500764","url":null,"abstract":"","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 1","pages":"Article 500764"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395425","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 : 2025-01-01Epub Date: 2025-02-13DOI: 10.1016/j.artere.2025.100732
Francesco Sbrana, Beatrice Dal Pino
{"title":"When “old” lipid lowering therapies not should be discontinued","authors":"Francesco Sbrana, Beatrice Dal Pino","doi":"10.1016/j.artere.2025.100732","DOIUrl":"10.1016/j.artere.2025.100732","url":null,"abstract":"","PeriodicalId":100263,"journal":{"name":"Clínica e Investigación en Arteriosclerosis (English Edition)","volume":"37 1","pages":"Article 100732"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395507","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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