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European journal of preventive cardiology最新文献

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Exercise-training and smiling: two faces of the same coin! 锻炼与微笑:一枚硬币的两面
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-18 DOI: 10.1093/eurjpc/zwae191
Francesco Giallauria, Raffaele Napoli
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引用次数: 0
Moderate obesity is not a limiting factor in cardiac rehabilitation after aortic valve replacement for severe stenosis. 中度肥胖不是严重狭窄主动脉瓣置换术后心脏康复的限制因素。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-18 DOI: 10.1093/eurjpc/zwae120
Marco Ranucci, Vittoria Mazzotta, Martina Anguissola, Luca Ranucci, Luca Brischigiaro, Francesco Bedogni, Laura Adelaide Dalla Vecchia, Marianna Volpe, Maria Teresa La Rovere
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引用次数: 0
Lipoprotein(a) and Cardiovascular Risk: New Insights. 脂蛋白(a)与心血管风险:新见解。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-15 DOI: 10.1093/eurjpc/zwae378
Fahimeh Varzideh, Urna Kansakar, Gaetano Santulli
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引用次数: 0
Colchicine in Patients with Stable Coronary Disease: should we consider basal inflammation - and how? 稳定型冠心病患者服用秋水仙碱:是否应考虑基础炎症?
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-15 DOI: 10.1093/eurjpc/zwae376
François Roubille
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引用次数: 0
Performance of LDL-C only compared to the Dutch Lipid Clinic Network Score for screening of familial hypercholesterolaemia: the Austrian experience and literature review. 在筛查家族性高胆固醇血症时,仅将低密度脂蛋白胆固醇与荷兰血脂诊所网络评分进行比较:奥地利的经验和文献综述。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-13 DOI: 10.1093/eurjpc/zwae331
Moritz Ferch, Lukas Galli, Paul Fellinger, Sabina Baumgartner-Parzer, Raute Sunder-Plassmann, Konstantin Krychtiuk, Alexandra Kautzky-Willer, Walter Speidl, Yvonne Winhofer

Aims: Familial hypercholesterolaemia (FH) is a severely underdiagnosed, inherited disease, causing dyslipidaemia and premature atherosclerotic cardiovascular disease. In order to facilitate screening in a broad clinical spectrum, we aimed to analyse the current yield of routine genetic diagnostics for FH and to evaluate the performance of the Dutch Lipid Clinic Network Score (DLCNS) compared to a single value, the off-treatment LDL-cholesterol exceeding 190 mg/dL.

Methods and results: We investigated all patients that underwent molecular genotyping routinely performed for FH over a 4-year period in two Austrian specialist lipid clinics. Variants reported in FH-causing genes including LDLR, APOB, PCSK9, LDLRAP, and APOE were collected and classified. For clinical classification, the DLCNS was calculated retrospectively and compared to the original scores documented in patient charts. Additionally, a literature review on comparisons of DLCNS to LDL-C was performed. Of 469 patients tested, 21.3% had a disease-causing variant. A median of 3 out of 8 (excluding genotyping results and LDL-C) DLCNS criteria were unavailable. DLCNS was documented in 48% of cases, with significant discrepancies compared to retrospective scoring (P < 0.001). DLCNS did not outperform off-treatment LDL-C alone (Δ = 0.006; P = 0.660), analogously to several reports identified in the literature. A single cut-off of 190 mg/dL LDL-C compared to DLCNS ≥ 6 showed excellent sensitivity (84.9% vs. 53.8%) and acceptable specificity (39.0% vs. 84.1%).

Conclusion: Missing criteria and severe discrepancies observed between retrospective and on-site scoring by treating physicians were highly prevalent, confirming limited utility of DLCNS in clinical routine and warranting a single off-treatment LDL-C cut-off of 190 mg/dL for enhanced index-case identification.

目的:家族性高胆固醇血症(FH)是一种严重低诊断率的遗传性疾病,可导致血脂异常和过早发生动脉粥样硬化性心血管疾病。为了便于在广泛的临床范围内进行筛查,我们旨在分析目前FH常规基因诊断的结果,并评估荷兰血脂临床网络评分(DLCNS)与单一值(治疗后低密度脂蛋白胆固醇超过190毫克/分升)相比的性能:我们调查了奥地利两家血脂专科诊所在 4 年内对 FH 进行常规分子基因分型的所有患者。收集并分类了 FH 致病基因的变异,包括 LDLR、APOB、PCSK9、LDLRAP 和 APOE。在临床分类方面,对 DLCNS 进行了回顾性计算,并与患者病历中记录的原始分数进行了比较。此外,还对 DLCNS 与 LDL-C 的比较进行了文献回顾。在接受检测的 469 名患者中,21.3% 存在致病变异。在 8 项 DLCNS 标准(不包括基因分型结果和 LDL-C)中,有 3 项标准无法获得。有 48% 的病例记录了 DLCNS,与回顾性评分相比差异显著(P < 0.001)。DLCNS 的效果并不优于单纯的非治疗低密度脂蛋白胆固醇(Δ = 0.006; P = 0.660),这与文献中发现的一些报告类似。与 DLCNS ≥ 6 相比,190 mg/dL LDL-C 的单一临界值显示出极佳的灵敏度(84.9% 对 53.8%)和可接受的特异性(39.0% 对 84.1%):结论:治疗医生的回顾性评分和现场评分之间普遍存在标准缺失和严重差异,这证实了 DLCNS 在临床常规中的作用有限,因此有必要将治疗后 LDL-C 的单一临界值定为 190 mg/dL,以加强指数病例的识别。
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引用次数: 0
Evolocumab treatment reduces carotid intima-media thickness in paediatric patients with heterozygous familial hypercholesterolaemia. Evolocumab 治疗可降低杂合子家族性高胆固醇血症儿科患者的颈动脉内膜中层厚度。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-12 DOI: 10.1093/eurjpc/zwae369
Albert Wiegman, Andrea Ruzza, G Kees Hovingh, Raul D Santos, François Mach, Claudia Stefanutti, Ilse K Luirink, Ian Bridges, Bei Wang, Ajay K Bhatia, Frederick J Raal, John J P Kastelein, Daniel Gaudet

Aim: Children with heterozygous familial hypercholesterolaemia (HeFH) show greater carotid intima-media thickness (cIMT). Evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor monoclonal antibody, substantially reduced low-density lipoprotein cholesterol (LDL-C) and modestly reduced lipoprotein(a) in children with HeFH. We investigated evolocumab's effect on cIMT progression.

Methods: HAUSER-RCT was a randomised, placebo-controlled trial. 157 paediatric patients with FH (age: 10-17 years) and LDL-C >130mg/dL despite statin therapy received monthly evolocumab 420mg or placebo for 24 weeks. Patients who continued into an open-label extension (HAUSER-OLE; n=150) received 80 weeks of monthly evolocumab plus statins. cIMT was measured by B-mode ultrasound scanning of right and left common carotid artery at baseline; week 24 of RCT [day 1 OLE]; and weeks 24, 48, and 80 of OLE. Descriptive analysis of cIMT was a prespecified HAUSER secondary endpoint, and inferential tests reported here were post-hoc.

Results: 151 patients had evaluable cIMT summary scores at ≥1 visit. From RCT baseline to week 24, mean cIMT increased by 0.006mm (SD=0.05) with placebo (n=37) and decreased by 0.003mm (SD=0.05) with evolocumab (n=76). From RCT baseline to OLE week 80, mean cIMT summary score decreased by 0.019mm (SD=0.04) and 0.012mm (SD=0.05), respectively, in patients who initially received placebo (n=34, P=0.007) versus receiving evolocumab throughout (n=59, P=0.067). Across patients who received evolocumab in OLE, mean cIMT significantly decreased by 0.011mm (SD=0.05) from OLE day 1 to week 80 (n=94, P=0.034).

Conclusions: In children with HeFH, evolocumab plus statin treatment up to 104 weeks led to regression in carotid arterial wall thickening.

目的:杂合子家族性高胆固醇血症(HeFH)患儿的颈动脉内膜中层厚度(cIMT)较大。Evolocumab 是一种丙蛋白转化酶枯草酶/kexin 9 型抑制剂单克隆抗体,可显著降低 HeFH 儿童的低密度脂蛋白胆固醇(LDL-C),并适度降低脂蛋白(a)。方法:HAUSER-RCT 是一项随机、安慰剂对照试验。157名FH儿童患者(年龄:10-17岁)尽管接受了他汀类药物治疗,但低密度脂蛋白胆固醇(LDL-C)仍大于130毫克/分升,他们每月接受依维莫司420毫克或安慰剂治疗,为期24周。在基线、RCT 第 24 周[OLE 第 1 天]、OLE 第 24、48 和 80 周时,通过 B 型超声波扫描左右颈总动脉测量 cIMT。cIMT 的描述性分析是预先设定的 HAUSER 次要终点,此处报告的推论性测试为事后测试:结果:151 名患者在≥1 次就诊时有可评估的 cIMT 总分。从 RCT 基线到第 24 周,安慰剂(37 人)的平均 cIMT 增加了 0.006 毫米(SD=0.05),evolocumab(76 人)的平均 cIMT 减少了 0.003 毫米(SD=0.05)。从 RCT 基线到 OLE 第 80 周,最初接受安慰剂治疗的患者(34 人,P=0.007)与全程接受 evolocumab 治疗的患者(59 人,P=0.067)的平均 cIMT 总分分别下降了 0.019 毫米(SD=0.04)和 0.012 毫米(SD=0.05)。在OLE中接受evolocumab治疗的患者中,从OLE第1天到第80周,平均cIMT显著下降了0.011毫米(SD=0.05)(n=94,P=0.034):结论:对于患有 HeFH 的儿童,evolocumab 加上他汀类药物治疗长达 104 周,可使颈动脉壁增厚消退。
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引用次数: 0
Eight Essential Ounces of Cardiovascular Disease Prevention. 预防心血管疾病的八大基本盎司。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-12 DOI: 10.1093/eurjpc/zwae370
Gerald S Bloomfield
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引用次数: 0
Variants in LPA are associated with Familial Hypercholesterolaemia: whole genome sequencing analysis in the 100,000 Genomes Project. LPA 变异与家族性高胆固醇血症有关:10 万基因组计划的全基因组测序分析。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-12 DOI: 10.1093/eurjpc/zwae371
Martin Bird, Antoine Rimbert, Alan M Pittman, Steve E Humphries, Marta Futema

Background: Familial Hypercholesterolaemia (FH) is an inherited disease of high LDL-cholesterol (LDL-C) caused by defects in LDLR, APOB, APOE and PCSK9 genes. A pathogenic variant cannot be found in ∼60% of clinical FH patients. Using whole genome sequencing (WGS) we examined genetic determinants of FH.

Methods: WGS data generated by the 100,000 Genomes Project (100KGP) included 536 FH patients diagnosed using the FH Simon Broome criteria. Rare variants in known FH genes were analysed. Genome-wide association study (GWAS) between 443 FH variant-negative unrelated FH cases and 77,275 control participants of the 100KGP was run using high coverage WGS data. Polygenic risk scores for LDL-C (LDL PRS) and lipoprotein(a) (Lp(a) PRS) were computed.

Results: An FH-causing variant was found in 17.4% of FH cases. GWAS identified the LPA gene locus being significantly associated (p<1x10-8). FH variant-negative participants had higher LDL and Lp(a) PRSs in comparison to the controls (p<1.0×10-16 and p<4.09×10-6, respectively). Similar associations were found in the monogenic FH with both LDL and Lp(a) PRSs being higher than in controls (p<4.03×10-4 and p<3.01x10-3, respectively). High LDL PRS was observed in 36.4% of FH variant-negative cases, whereas high Lp(a) PRS in 18.5%, with 7.0% having both high LDL and Lp(a) PRSs.

Conclusions: This genome-wide analysis of monogenic and polygenic FH causes confirms a complex and heterogenous architecture of hypercholesterolaemia, with the LPA gene playing a significant role. Both Lp(a) and LDL-C should be measured for precision FH diagnosis. Specific therapies to lower Lp(a) should be targeted to those who will benefit most.

背景:家族性高胆固醇血症(FH)是一种由 LDLR、APOB、APOE 和 PCSK9 基因缺陷引起的高低密度脂蛋白胆固醇(LDL-C)遗传性疾病。在 60% 的临床 FH 患者中找不到致病变体。我们利用全基因组测序(WGS)研究了 FH 的遗传决定因素:100,000基因组计划(100KGP)生成的WGS数据包括536名根据FH西蒙-布鲁姆标准诊断出的FH患者。对已知 FH 基因中的罕见变异进行了分析。利用高覆盖率的 WGS 数据,在 443 例 FH 变异阴性的无关 FH 病例和 100KGP 的 77275 例对照参与者之间进行了全基因组关联研究(GWAS)。计算了低密度脂蛋白胆固醇(LDL-C)(LDL PRS)和脂蛋白(a)(Lp(a)PRS)的多基因风险评分:结果:在17.4%的FH病例中发现了FH致病变体。GWAS 发现 LPA 基因位点与 FH 有显著相关性(pConclusions):对单基因和多基因 FH 病因的全基因组分析证实,高胆固醇血症的结构复杂而多变,其中 LPA 基因起着重要作用。要精确诊断 FH,应同时测量脂蛋白(a)和低密度脂蛋白胆固醇(LDL-C)。降低脂蛋白(a)的特定疗法应针对受益最大的人群。
{"title":"Variants in LPA are associated with Familial Hypercholesterolaemia: whole genome sequencing analysis in the 100,000 Genomes Project.","authors":"Martin Bird, Antoine Rimbert, Alan M Pittman, Steve E Humphries, Marta Futema","doi":"10.1093/eurjpc/zwae371","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae371","url":null,"abstract":"<p><strong>Background: </strong>Familial Hypercholesterolaemia (FH) is an inherited disease of high LDL-cholesterol (LDL-C) caused by defects in LDLR, APOB, APOE and PCSK9 genes. A pathogenic variant cannot be found in ∼60% of clinical FH patients. Using whole genome sequencing (WGS) we examined genetic determinants of FH.</p><p><strong>Methods: </strong>WGS data generated by the 100,000 Genomes Project (100KGP) included 536 FH patients diagnosed using the FH Simon Broome criteria. Rare variants in known FH genes were analysed. Genome-wide association study (GWAS) between 443 FH variant-negative unrelated FH cases and 77,275 control participants of the 100KGP was run using high coverage WGS data. Polygenic risk scores for LDL-C (LDL PRS) and lipoprotein(a) (Lp(a) PRS) were computed.</p><p><strong>Results: </strong>An FH-causing variant was found in 17.4% of FH cases. GWAS identified the LPA gene locus being significantly associated (p<1x10-8). FH variant-negative participants had higher LDL and Lp(a) PRSs in comparison to the controls (p<1.0×10-16 and p<4.09×10-6, respectively). Similar associations were found in the monogenic FH with both LDL and Lp(a) PRSs being higher than in controls (p<4.03×10-4 and p<3.01x10-3, respectively). High LDL PRS was observed in 36.4% of FH variant-negative cases, whereas high Lp(a) PRS in 18.5%, with 7.0% having both high LDL and Lp(a) PRSs.</p><p><strong>Conclusions: </strong>This genome-wide analysis of monogenic and polygenic FH causes confirms a complex and heterogenous architecture of hypercholesterolaemia, with the LPA gene playing a significant role. Both Lp(a) and LDL-C should be measured for precision FH diagnosis. Specific therapies to lower Lp(a) should be targeted to those who will benefit most.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PCSK9 inhibitor with cause-specific mortality amongst cancer survivors: a chance to kill two birds with one stone. PCSK9抑制剂与癌症幸存者的特异性死亡率:一石二鸟的机会。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-12 DOI: 10.1093/eurjpc/zwae368
Nan Zhang, Tianshu Gu, Sutao Hu, Tong Liu, Kang-Yin Chen
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引用次数: 0
Trends in atherosclerotic cardiovascular disease and lipid management: a population-level observational cohort study in Wales. 动脉粥样硬化性心血管疾病和血脂管理趋势。威尔士人群观察性队列研究。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-11-11 DOI: 10.1093/eurjpc/zwae233
Daniel E Harris, Daniel King, Ashley Akbari, Mike Gravenor, Mathew Lawrence, Clive Weston, Chris Hopkins, Leighton Phillips, Julian Halcox

Aims: European clinical guidelines recommend that patients with atherosclerotic cardiovascular disease (ASCVD), including ischaemic heart disease (IHD), stroke, and peripheral arterial disease (PAD), are prescribed lipid lowering treatment (LLT) and treated to target low-density lipoprotein cholesterol (LDL-C) levels. This study aimed to document trends in ASCVD, including treatment, monitoring, and achievement of target LDL-C.

Methods and results: A retrospective observational population study was performed using linked healthcare data (2010-22). Over the study period, the number of patients with ASCVD increased from 181 153 to 207 747 (8882 to 9398 per 100 000). The proportion of patients prescribed LLT decreased from 75.3% in 2010 to 67.1% in 2022; high-intensity statin therapy increased from 9.4 to 25.2%, while non-high-intensity statin therapy decreased from 59.6 to 38.2%. The prescription of high-intensity statin therapy was consistently higher amongst patients with IHD (10.9% in 2010 increasing to 28.0% in 2022) than in patients with stroke (4.7-21.6%) or PAD (3.9-10.6%).The proportion of cases with documented LDL-C decreased from 58.0% in 2010 to 49.3% in 2022. Of those with documented LDL-C in 2022, 44.0% achieved LDL-C < 1.8 mmol/L, including 45.2% of those with IHD, 42.0% of those with stroke, and only 32.8% of those with PAD.

Conclusion: Prescription of LLT, including high-intensity statin therapy, documentation of LDL-C, and achievement of target LDL-C levels was relatively low, especially in PAD patients. Although target achievement in 'tested patients' increased over time, the proportion of patients undergoing lipid testing declined. More rigorous lipid management requires prioritisation, especially for PAD and stroke patients.

目的:欧洲临床指南建议动脉粥样硬化性心血管疾病(ASCVD)(包括缺血性心脏病(IHD)、中风和外周动脉疾病(PAD))患者接受降脂治疗(LLT),并达到目标低密度脂蛋白胆固醇(LDL-C)水平。本研究旨在记录 ASCVD 的发展趋势,包括治疗、监测和目标 LDL-C 的实现情况:方法:使用关联的医疗保健数据(2010-22 年)进行回顾性人群观察研究:在研究期间,ASCVD 患者人数从 181153 人增至 207747 人(每 10 万人中有 8882 人增至 9398 人)。接受低密度他汀治疗的患者比例从2010年的75.3%降至2022年的67.1%;接受高强度他汀治疗的患者比例从9.4%增至25.2%,接受非高强度他汀治疗的患者比例从59.6%降至38.2%。高强度他汀类药物治疗处方在 IHD 患者中的比例(2010 年为 10.9%,2022 年增至 28.0%)一直高于中风患者(4.7% 至 21.6%)或 PAD 患者(3.9% 至 10.6%)。在2022年有低密度脂蛋白胆固醇记录的病例中,44.0%达到了低密度脂蛋白胆固醇结论:低密度脂蛋白胆固醇治疗处方(包括HI-他汀治疗)、低密度脂蛋白胆固醇记录和目标低密度脂蛋白胆固醇水平的实现率相对较低,尤其是在PAD患者中。虽然随着时间的推移,"接受检测的患者 "中达到目标水平的人数有所增加,但接受血脂检测的患者比例却有所下降。更严格的血脂管理需要优先考虑,尤其是对于 PAD 和中风患者。
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引用次数: 0
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European journal of preventive cardiology
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