Pub Date : 2025-02-14DOI: 10.1016/j.arteri.2025.500768
Julio A Carbayo-Herencia, Marta Simarro Rueda, Luis Miguel Artigao Ródenas, Juan A Divisón Garrote, Francisca Molina Escribano, Isabel Ponce García, Antonio Palazón Bru, Pilar Torres Moreno, David Caldevilla Bernardo, Rosalina Martínez López, Vicente Francisco Gil Guillén, José R Banegas
Introduction: Control of the main cardiovascular risk factors had succeeded in reducing cardiovascular diseases (CVD). However, the general increase in the prevalence of type 2 diabetes mellitus (DM2) and obesity has slowed this decline. Both CVRFs are strongly associated, and the term diabesity has been coined to refer to this relationship. The main objective of this study was to assess the influence of diabesity on cardiovascular mortality.
Methods: Prospective cohort study involving 1246 individuals (54.3% women) followed for 20.9 years (SD=7.31) and selected by random two-stage sampling in a province in southeastern Spain. Diabesity was defined as the combination of DM2 with overweight and obesity. Survival curves (Kaplan-Meier) were calculated and two Cox regression models were used, one unadjusted and the other adjusted by the main explanatory variables in which the diabesity variable consisted of 6 categories (normal weight, overweight, obesity, normal weight+DM2, overweight+DM2 and obesity+DM2).
Results: There were 95 deaths due to CV causes (7.6% of the total; 6.2% women and 9.3% men; p=0.01). After adjustment, the combination of DM2 and overweight increased the incidence of cardiovascular mortality by 133% (HR=2.33; 95% CI: 1.18-4.58; p=0.014) and the combination of DM2 and obesity by 49% (HR=1.49; 95% CI: 0.64-3.45; p=0.351), not reaching statistical significance in the latter case.
Conclusions: In the general population, the results of our study show that the combination of overweight and DM2 is associated with higher CV mortality. It seems a priority to intervene intensively in the control of both overweight and DM2.
{"title":"Diabesity and cardiovascular mortality in a prospective population cohort followed for more than 20 years.","authors":"Julio A Carbayo-Herencia, Marta Simarro Rueda, Luis Miguel Artigao Ródenas, Juan A Divisón Garrote, Francisca Molina Escribano, Isabel Ponce García, Antonio Palazón Bru, Pilar Torres Moreno, David Caldevilla Bernardo, Rosalina Martínez López, Vicente Francisco Gil Guillén, José R Banegas","doi":"10.1016/j.arteri.2025.500768","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500768","url":null,"abstract":"<p><strong>Introduction: </strong>Control of the main cardiovascular risk factors had succeeded in reducing cardiovascular diseases (CVD). However, the general increase in the prevalence of type 2 diabetes mellitus (DM2) and obesity has slowed this decline. Both CVRFs are strongly associated, and the term diabesity has been coined to refer to this relationship. The main objective of this study was to assess the influence of diabesity on cardiovascular mortality.</p><p><strong>Methods: </strong>Prospective cohort study involving 1246 individuals (54.3% women) followed for 20.9 years (SD=7.31) and selected by random two-stage sampling in a province in southeastern Spain. Diabesity was defined as the combination of DM2 with overweight and obesity. Survival curves (Kaplan-Meier) were calculated and two Cox regression models were used, one unadjusted and the other adjusted by the main explanatory variables in which the diabesity variable consisted of 6 categories (normal weight, overweight, obesity, normal weight+DM2, overweight+DM2 and obesity+DM2).</p><p><strong>Results: </strong>There were 95 deaths due to CV causes (7.6% of the total; 6.2% women and 9.3% men; p=0.01). After adjustment, the combination of DM2 and overweight increased the incidence of cardiovascular mortality by 133% (HR=2.33; 95% CI: 1.18-4.58; p=0.014) and the combination of DM2 and obesity by 49% (HR=1.49; 95% CI: 0.64-3.45; p=0.351), not reaching statistical significance in the latter case.</p><p><strong>Conclusions: </strong>In the general population, the results of our study show that the combination of overweight and DM2 is associated with higher CV mortality. It seems a priority to intervene intensively in the control of both overweight and DM2.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500768"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426264","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 : 2025-02-04DOI: 10.1016/j.arteri.2024.500757
Carlos Santiago Díaz, Francisco J Medrano, N Muñoz-Rivas, Luis Castilla Guerra, M Belén Alonso Ortiz
Chronic Obstructive Pulmonary Disease (COPD) usually presents joined to other pathologies we call comorbidities. The more frequent of them are those related to cardiovascular risk, either its risk factors or its clinical manifestations. Cardiovascular risk of these patients grows up with the severity of the airflow obstruction, specially during and after an exacerbation of COPD. Patients with COPD have between 2 and 5 times more risk of ischaemic heart disease than people without COPD, even after adjusting for cofounding factors. Cardiovascular diseases are up to the second cause of mortality in these patients, close to those due to the lung disease. Although COPD is associated to several cardiovascular risk factors such as tobacco, arterial hypertension or Diabetes Mellitus, they don't explain all the excess in cardiovascular risk these patients have. Despite that excess of cardiovascular risk in COPD patients, most widely used cardiovascular risk scores don't include COPD as a risk factor itself, so global risk is understimated in these patients. In this review, we make a bibliography revision of the avaliable evidence about COPD and cardiovascular risk factors as well as the excess of cardiovascular risk COPD itself involves.
{"title":"COPD and cardiovascular risk.","authors":"Carlos Santiago Díaz, Francisco J Medrano, N Muñoz-Rivas, Luis Castilla Guerra, M Belén Alonso Ortiz","doi":"10.1016/j.arteri.2024.500757","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.500757","url":null,"abstract":"<p><p>Chronic Obstructive Pulmonary Disease (COPD) usually presents joined to other pathologies we call comorbidities. The more frequent of them are those related to cardiovascular risk, either its risk factors or its clinical manifestations. Cardiovascular risk of these patients grows up with the severity of the airflow obstruction, specially during and after an exacerbation of COPD. Patients with COPD have between 2 and 5 times more risk of ischaemic heart disease than people without COPD, even after adjusting for cofounding factors. Cardiovascular diseases are up to the second cause of mortality in these patients, close to those due to the lung disease. Although COPD is associated to several cardiovascular risk factors such as tobacco, arterial hypertension or Diabetes Mellitus, they don't explain all the excess in cardiovascular risk these patients have. Despite that excess of cardiovascular risk in COPD patients, most widely used cardiovascular risk scores don't include COPD as a risk factor itself, so global risk is understimated in these patients. In this review, we make a bibliography revision of the avaliable evidence about COPD and cardiovascular risk factors as well as the excess of cardiovascular risk COPD itself involves.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500757"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257004","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}
Introduction: Rheumatoid arthritis (RA) is an autoimmune and inflammatory disorder that leads to cartilage and bone deterioration. This inflammatory activity causes extra-articular manifestations, including the acceleration of the atherosclerotic process. However, the exact causes of this accelerated process are under investigation. In this study, we compared the advanced lipid profile between patients with RA, patients with metabolic disorders, and controls. We also explored how microRNAs previously associated with subclinical atherosclerosis in RA are linked to these lipid subfractions in RA.
Methods: The study included 219 patients with RA, 82 with metabolic disorders and 64 controls. Clinical evaluations were performed, and blood samples were collected. Quantification of microRNAs (Let7a, 24, 96, 103, 125a, 125b, 132, 146, 191, 223, 425, 451) and measurement of the advanced lipid profile using nuclear magnetic resonance (NMR) were carried out. Kruskal-Wallis tests and multivariate linear models were applied.
Results: Patients with RA exhibited elevated total, large, medium, and small VLDL particles compared to controls. Their LDL subfractions were decreased compared to patients with metabolic disorders, with differences with controls. Patients with RA had fewer and smaller HDL particles than both groups. MicroRNA-125a was associated with VLDL subfractions and small LDL particles. Other microRNAs (96, 132, 191, 451) showed associations with certain LDL subfractions.
Conclusions: In patients with RA, elevated levels of VLDL particles have been observed, while LDL levels remain similar to controls. The notable association of microRNA-125a with the metabolism of both VLDL and LDL in RA patients suggests its involvement in lipid regulation. This could point to microRNA-125a as a promising therapeutic target to address the increased cardiovascular risks of RA.
{"title":"Plasma expression of a microRNA panel is differentially associated with 1H-NMR lipoprotein profile in rheumatoid arthritis patients.","authors":"Dídac Llop, Silvia Paredes, Roser Rosales, Josep Ribalta, Joan-Carles Vallvé","doi":"10.1016/j.arteri.2025.500759","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500759","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis (RA) is an autoimmune and inflammatory disorder that leads to cartilage and bone deterioration. This inflammatory activity causes extra-articular manifestations, including the acceleration of the atherosclerotic process. However, the exact causes of this accelerated process are under investigation. In this study, we compared the advanced lipid profile between patients with RA, patients with metabolic disorders, and controls. We also explored how microRNAs previously associated with subclinical atherosclerosis in RA are linked to these lipid subfractions in RA.</p><p><strong>Methods: </strong>The study included 219 patients with RA, 82 with metabolic disorders and 64 controls. Clinical evaluations were performed, and blood samples were collected. Quantification of microRNAs (Let7a, 24, 96, 103, 125a, 125b, 132, 146, 191, 223, 425, 451) and measurement of the advanced lipid profile using nuclear magnetic resonance (NMR) were carried out. Kruskal-Wallis tests and multivariate linear models were applied.</p><p><strong>Results: </strong>Patients with RA exhibited elevated total, large, medium, and small VLDL particles compared to controls. Their LDL subfractions were decreased compared to patients with metabolic disorders, with differences with controls. Patients with RA had fewer and smaller HDL particles than both groups. MicroRNA-125a was associated with VLDL subfractions and small LDL particles. Other microRNAs (96, 132, 191, 451) showed associations with certain LDL subfractions.</p><p><strong>Conclusions: </strong>In patients with RA, elevated levels of VLDL particles have been observed, while LDL levels remain similar to controls. The notable association of microRNA-125a with the metabolism of both VLDL and LDL in RA patients suggests its involvement in lipid regulation. This could point to microRNA-125a as a promising therapeutic target to address the increased cardiovascular risks of RA.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500759"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068590","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 : 2025-01-27DOI: 10.1016/j.arteri.2024.500756
Pedro Luis Rodríguez García, Juan José Pérez Soto, Eliseo García Cantó, Pedro Javier Tarraga Marcos, Pedro Juan Tárraga López
Background: Physical-sports habits in adulthood constitute one of the predictors of physical, psychological and social health within healthy lifestyles.
Methods: The Acquired Healthy Lifestyle Assessment Scale was applied to a sample of 788 subjects between the ages of 22 and 72 and the dimension that makes up physical-sports practice habits was analyzed.
Results: 74.4% of adults have habits of physical-sports practice that are not healthy or unhealthy, 18.8% tend towards health and only 6.9% are healthy. Pearson's 2 tests show a significant association between men and healthy habits, without observing changes associated with the age variable. The t-Student and one-factor ANOVA tests confirm the relationship between the level of health and physical-sports practice habits depending on sex and age.
Conclusions: It is necessary to promote preventive programs to increase participation in the practice of physical and sports exercise in the adult population that has unhealthy or unhealthy levels of lifestyle.
{"title":"Habit of physical-sports practice and the healthy lifestyle among Spanish adults from 22 to 72 years of age.","authors":"Pedro Luis Rodríguez García, Juan José Pérez Soto, Eliseo García Cantó, Pedro Javier Tarraga Marcos, Pedro Juan Tárraga López","doi":"10.1016/j.arteri.2024.500756","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.500756","url":null,"abstract":"<p><strong>Background: </strong>Physical-sports habits in adulthood constitute one of the predictors of physical, psychological and social health within healthy lifestyles.</p><p><strong>Methods: </strong>The Acquired Healthy Lifestyle Assessment Scale was applied to a sample of 788 subjects between the ages of 22 and 72 and the dimension that makes up physical-sports practice habits was analyzed.</p><p><strong>Results: </strong>74.4% of adults have habits of physical-sports practice that are not healthy or unhealthy, 18.8% tend towards health and only 6.9% are healthy. Pearson's 2 tests show a significant association between men and healthy habits, without observing changes associated with the age variable. The t-Student and one-factor ANOVA tests confirm the relationship between the level of health and physical-sports practice habits depending on sex and age.</p><p><strong>Conclusions: </strong>It is necessary to promote preventive programs to increase participation in the practice of physical and sports exercise in the adult population that has unhealthy or unhealthy levels of lifestyle.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500756"},"PeriodicalIF":1.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060625","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 : 2025-01-25DOI: 10.1016/j.arteri.2024.500755
Antón González-Guerrero, Eugenia Navarrete-Rouco, David Benaiges, Eva Giralt-Steinhauer, Lidia Marcos, Anna Oliveras, Lluis Recasens, Juan Pedro-Botet
Objective: To confirm the effectiveness and safety of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in daily clinical practice.
Methods: Retrospective observational study of patients from hospital registry of PCSK9 inhibitor treatment with a follow-up ≥ 6 months. The lipid-lowering effect and safety were evaluated.
Results: Of the 193 patients included in the study, 168 (87%) had cardiovascular disease, and 54 (28%) had familial hypercholesterolemia; 85 (44%) were intolerant to statins/ezetimibe. No differences between alirocumab and evolocumab groups regarding the rate of LDL-C reduction ≥ 50% (82.8% vs. 83.1%), achievement of the therapeutic target (60.9% vs. 65.5%), or complete remission (60.2% vs. 58.5%) were found. An erythema at the injection site in one patient treated with alirocumab and urticaria in one patient treated with evolocumab were recorded. According to the logistic regression analysis, complete remission of LDL-C in subjects treated with PCSK9 inhibitors was positively associated with increased age (OR: 1.045; 95%CI: 1.0-1.092; P=.049) and active smoking (OR: 4.562; 95%CI: 1.434-14.515; P=.010), and negatively associated with female gender (OR: 0.403; 95%CI: 0.171-0.949; P=.038), baseline LDL-C levels (OR: 0.969; 95%CI: 0.957-0.981; P<.001)and statin/ezetimibe intolerance (OR: 0.403; 95%CI: 0.176-0.925; P=.041).
Conclusion: This real-world practice study has confirmed that PCSK9 inhibitors are effective, safe and well tolerated, with lipid-lowering effects comparable to those described in randomized controlled trials, regardless of the monoclonal antibody used.
{"title":"Efficacy and safety of PCSK9 inhibitors in real life.","authors":"Antón González-Guerrero, Eugenia Navarrete-Rouco, David Benaiges, Eva Giralt-Steinhauer, Lidia Marcos, Anna Oliveras, Lluis Recasens, Juan Pedro-Botet","doi":"10.1016/j.arteri.2024.500755","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.500755","url":null,"abstract":"<p><strong>Objective: </strong>To confirm the effectiveness and safety of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in daily clinical practice.</p><p><strong>Methods: </strong>Retrospective observational study of patients from hospital registry of PCSK9 inhibitor treatment with a follow-up ≥ 6 months. The lipid-lowering effect and safety were evaluated.</p><p><strong>Results: </strong>Of the 193 patients included in the study, 168 (87%) had cardiovascular disease, and 54 (28%) had familial hypercholesterolemia; 85 (44%) were intolerant to statins/ezetimibe. No differences between alirocumab and evolocumab groups regarding the rate of LDL-C reduction ≥ 50% (82.8% vs. 83.1%), achievement of the therapeutic target (60.9% vs. 65.5%), or complete remission (60.2% vs. 58.5%) were found. An erythema at the injection site in one patient treated with alirocumab and urticaria in one patient treated with evolocumab were recorded. According to the logistic regression analysis, complete remission of LDL-C in subjects treated with PCSK9 inhibitors was positively associated with increased age (OR: 1.045; 95%CI: 1.0-1.092; P=.049) and active smoking (OR: 4.562; 95%CI: 1.434-14.515; P=.010), and negatively associated with female gender (OR: 0.403; 95%CI: 0.171-0.949; P=.038), baseline LDL-C levels (OR: 0.969; 95%CI: 0.957-0.981; P<.001)and statin/ezetimibe intolerance (OR: 0.403; 95%CI: 0.176-0.925; P=.041).</p><p><strong>Conclusion: </strong>This real-world practice study has confirmed that PCSK9 inhibitors are effective, safe and well tolerated, with lipid-lowering effects comparable to those described in randomized controlled trials, regardless of the monoclonal antibody used.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500755"},"PeriodicalIF":1.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048217","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 : 2025-01-16DOI: 10.1016/j.arteri.2024.500754
Ángel Arturo López-González, Emilio Martínez-Almoyna Rifá, Hernán Paublini Oliveira, Cristina Martorell Sánchez, Pedro Juan Tárraga López, José Ignacio Ramírez-Manent
Introduction: Diabesity is a pathological condition that combines obesity and type 2 diabetes in the same individual. Due to the current rise in both conditions, the prevalence of diabesity is increasing worldwide. Its etiology is known to be multifactorial; therefore, the aim of this study is to understand how diabesity is associated with various sociodemographic variables, healthy habits, and stress.
Materials and methods: A descriptive, cross-sectional study was conducted on 24,224 Spanish workers to evaluate the association between diabesity and various factors such as age, gender, socioeconomic status, smoking, alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress. The criteria used to define diabesity included body mass index (BMI), body fat (BF), and visceral fat (VF).
Results: All the aforementioned variables were found to be associated with diabesity. The highest odds ratios (OR) were observed for age, with values ranging from 5.57 (95% CI: 4.48-6.67) when BF was used as the diabesity criterion to 6.89 (95% CI: 5.60-8.19) when VF was the criterion. Similarly, elevated ORs were observed for male gender, with ORs of 6.77 (95% CI: 5.31-8.24) for VF and 3.34 (95% CI: 2.77-3.94) for BF.
Conclusions: In our study, the profile of a person at highest risk of diabesity is a man over 50 years old from a lower socioeconomic status, who is a smoker, regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high stress levels.
{"title":"Association between sociodemographic variables, healthy habits and stress with diabesity.","authors":"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.arteri.2024.500754","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.500754","url":null,"abstract":"<p><strong>Introduction: </strong>Diabesity is a pathological condition that combines obesity and type 2 diabetes in the same individual. Due to the current rise in both conditions, the prevalence of diabesity is increasing worldwide. Its etiology is known to be multifactorial; therefore, the aim of this study is to understand how diabesity is associated with various sociodemographic variables, healthy habits, and stress.</p><p><strong>Materials and methods: </strong>A descriptive, cross-sectional study was conducted on 24,224 Spanish workers to evaluate the association between diabesity and various factors such as age, gender, socioeconomic status, smoking, alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress. The criteria used to define diabesity included body mass index (BMI), body fat (BF), and visceral fat (VF).</p><p><strong>Results: </strong>All the aforementioned variables were found to be associated with diabesity. The highest odds ratios (OR) were observed for age, with values ranging from 5.57 (95% CI: 4.48-6.67) when BF was used as the diabesity criterion to 6.89 (95% CI: 5.60-8.19) when VF was the criterion. Similarly, elevated ORs were observed for male gender, with ORs of 6.77 (95% CI: 5.31-8.24) for VF and 3.34 (95% CI: 2.77-3.94) for BF.</p><p><strong>Conclusions: </strong>In our study, the profile of a person at highest risk of diabesity is a man over 50 years old from a lower socioeconomic status, who is a smoker, regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high stress levels.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500754"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013852","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 : 2025-01-02DOI: 10.1016/j.arteri.2024.500753
Carlos Guijarro, Angel Diaz, Eva Moreno, Paula Gamonal, Maria Soler, Neus Vidal-Vilar, Maria Rosa Fernandez
Objective: To estimate the clinical and economic benefits derived from increasing the use of fixed-dose combinations of high-intensity statins and ezetimibe in patients at high/very high cardiovascular risk, from the perspective of the Spanish National Health System (SNS).
Methods: A baseline scenario (current market shares) was compared with scenarios that increased the use of fixed-dose combinations (alternative: 30% increase; optimized: 69% increase). The potential annual increase in the number of controlled patients, cardiovascular events avoided and the associated savings in direct medical costs were estimated, including the cost of pharmacological treatment, follow-up, and managing cardiovascular events over a three-year time horizon.
Results: Over the three years of the study, the baseline scenario estimated a total of 1,552,686 controlled patients and 39,449 cardiovascular events, with a total cost to the SNS of €1,841,057,122. In the alternative scenario, controlled patients would increase by 36.1%, and 139 cardiovascular events would be avoided, resulting in savings for the SNS of €36,116,631. In the optimized scenario, there would be a 64% increase in controlled patients and 250cardiovascular events would be avoided, leading to savings of €56,415,300 for the SNS.
Conclusion: Increased use of high-intensity statin and ezetimibe fixed-dose combinations in patients with high/very high cardiovascular risk may increase the number of controlled patients, reduce cardiovascular events and produce economic savings from an SNS perspective.
{"title":"Efficiency of fixed-dose combinations of statin and ezetimibe in the treatment of hypercholesterolemia.","authors":"Carlos Guijarro, Angel Diaz, Eva Moreno, Paula Gamonal, Maria Soler, Neus Vidal-Vilar, Maria Rosa Fernandez","doi":"10.1016/j.arteri.2024.500753","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.500753","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the clinical and economic benefits derived from increasing the use of fixed-dose combinations of high-intensity statins and ezetimibe in patients at high/very high cardiovascular risk, from the perspective of the Spanish National Health System (SNS).</p><p><strong>Methods: </strong>A baseline scenario (current market shares) was compared with scenarios that increased the use of fixed-dose combinations (alternative: 30% increase; optimized: 69% increase). The potential annual increase in the number of controlled patients, cardiovascular events avoided and the associated savings in direct medical costs were estimated, including the cost of pharmacological treatment, follow-up, and managing cardiovascular events over a three-year time horizon.</p><p><strong>Results: </strong>Over the three years of the study, the baseline scenario estimated a total of 1,552,686 controlled patients and 39,449 cardiovascular events, with a total cost to the SNS of €1,841,057,122. In the alternative scenario, controlled patients would increase by 36.1%, and 139 cardiovascular events would be avoided, resulting in savings for the SNS of €36,116,631. In the optimized scenario, there would be a 64% increase in controlled patients and 250cardiovascular events would be avoided, leading to savings of €56,415,300 for the SNS.</p><p><strong>Conclusion: </strong>Increased use of high-intensity statin and ezetimibe fixed-dose combinations in patients with high/very high cardiovascular risk may increase the number of controlled patients, reduce cardiovascular events and produce economic savings from an SNS perspective.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500753"},"PeriodicalIF":1.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928225","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 : 2025-01-01DOI: 10.1016/j.arteri.2024.10.002
Javier Rodríguez Lega, Ángel González Pinto
{"title":"Evaluación del efecto sobre la trombogenicidad de modificaciones de la superficie en stents de nitinol en un modelo in vitro","authors":"Javier Rodríguez Lega, Ángel González Pinto","doi":"10.1016/j.arteri.2024.10.002","DOIUrl":"10.1016/j.arteri.2024.10.002","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 1","pages":"Article 100742"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640066","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 : 2025-01-01DOI: 10.1016/j.arteri.2024.04.002
Oscar Zaragoza-García , Olivia Briceño , José Rafael Villafan-Bernal , Ilse Adriana Gutiérrez-Pérez , Héctor Ugo Rojas-Delgado , Gustavo Adolfo Alonso-Silverio , Antonio Alarcón-Paredes , José Eduardo Navarro-Zarza , Cristina Morales-Martínez , Rubén Rodríguez-García , Iris Paola Guzmán-Guzmán
Aim
The soluble scavenger receptor differentiation antigen 163 (sCD163), a monocyte/macrophage activation marker, is related to cardiovascular mortality in the general population. This study aimed to evaluate their relationship between serum levels of sCD163 with cardiovascular risk indicators in rheumatoid arthritis (RA).
Methods
A cross-sectional study was performed on 80 women diagnosed with RA. The cardiovascular risks were determined using the lipid profile, metabolic syndrome, and QRISK3 calculator. For the assessment of RA activity, we evaluated the DAS28 with erythrocyte sedimentation rate (DAS28-ESR). The serum levels of sCD163 were determined by the ELISA method. Logistic regression models and receiver operating characteristics (ROC) curve were used to assess the association and predictive value of sCD163 with cardiovascular risk in RA patients.
Results
Levels of sCD163 were significantly higher in RA patients with high sensitivity protein C-reactive to HDL-c ratio (CHR) ≥ 0.121 (p = 0.003), total cholesterol/HDL-c ratio > 7% (p = 0.004), LDL-c/HDL-c ratio > 3% (p = 0.035), atherogenic index of plasma > 0.21 (p = 0.004), cardiometabolic index (CMI) ≥ 1.70 (p = 0.005), and high DAS28-ESR (p = 0.004). In multivariate analysis, levels of sCD163 ≥ 1107.3 ng/mL were associated with CHR ≥ 0.121 (OR = 3.43, p = 0.020), CMI ≥ 1.70 (OR = 4.25, p = 0.005), total cholesterol/HDL-c ratio > 7% (OR = 6.63, p = 0.044), as well as with DAS28-ESR > 3.2 (OR = 8.10, p = 0.008). Moreover, levels of sCD163 predicted CHR ≥ 0.121 (AUC = 0.701), cholesterol total/HDL ratio > 7% (AUC = 0.764), and DAS28-ESR > 3.2 (AUC = 0.720).
Conclusion
Serum levels of sCD163 could be considered a surrogate of cardiovascular risk and clinical activity in RA.
目的:可溶性清道夫受体分化抗原163(sCD163)是一种单核细胞/巨噬细胞活化标志物,与普通人群的心血管死亡率有关。本研究旨在评估类风湿关节炎(RA)患者血清中 sCD163 水平与心血管风险指标之间的关系:方法:对 80 名确诊为 RA 的女性进行了横断面研究。方法:我们对 80 名确诊为 RA 的女性进行了横断面研究,并使用血脂概况、代谢综合征和 QRISK3 计算器确定了心血管风险。为了评估 RA 的活动性,我们评估了 DAS28 和红细胞沉降率(DAS28-ESR)。血清中 sCD163 的水平采用 ELISA 方法测定。我们使用逻辑回归模型和接收器操作特征曲线(ROC)评估了sCD163与RA患者心血管风险的相关性和预测价值:结果:高敏感蛋白 C 反应与高密度脂蛋白胆固醇比值(CHR)≥0.121(P=0.003)、总胆固醇/高密度脂蛋白胆固醇比值>7%(P=0.004)、LDL-c/HDL-c 比值>3%(p=0.035)、血浆致动脉粥样硬化指数>0.21(p=0.004)、心脏代谢指数(CMI)≥1.70(p=0.005)、DAS28-ESR 偏高(p=0.004)。在多变量分析中,sCD163水平≥1107.3ng/mL与CHR≥0.121(OR=3.43,p=0.020)、CMI≥1.70(OR=4.25,p=0.005)、总胆固醇/HDL-c比值>7%(OR=6.63,p=0.044)以及DAS28-ESR>3.2(OR=8.10,p=0.008)相关。此外,sCD163水平可预测CHR≥0.121(AUC=0.701)、胆固醇总/高密度脂蛋白比率>7%(AUC=0.764)和DAS28-ESR>3.2(AUC=0.720):结论:血清sCD163水平可被视为RA心血管风险和临床活动的替代指标。
{"title":"Levels of sCD163 in women rheumatoid arthritis: Relationship with cardiovascular risk markers","authors":"Oscar Zaragoza-García , Olivia Briceño , José Rafael Villafan-Bernal , Ilse Adriana Gutiérrez-Pérez , Héctor Ugo Rojas-Delgado , Gustavo Adolfo Alonso-Silverio , Antonio Alarcón-Paredes , José Eduardo Navarro-Zarza , Cristina Morales-Martínez , Rubén Rodríguez-García , Iris Paola Guzmán-Guzmán","doi":"10.1016/j.arteri.2024.04.002","DOIUrl":"10.1016/j.arteri.2024.04.002","url":null,"abstract":"<div><h3>Aim</h3><div>The soluble scavenger receptor differentiation antigen 163 (sCD163), a monocyte/macrophage activation marker, is related to cardiovascular mortality in the general population. This study aimed to evaluate their relationship between serum levels of sCD163 with cardiovascular risk indicators in rheumatoid arthritis (RA).</div></div><div><h3>Methods</h3><div>A cross-sectional study was performed on 80 women diagnosed with RA. The cardiovascular risks were determined using the lipid profile, metabolic syndrome, and QRISK3 calculator. For the assessment of RA activity, we evaluated the DAS28 with erythrocyte sedimentation rate (DAS28-ESR). The serum levels of sCD163<span> were determined by the ELISA<span> method. Logistic regression models and receiver operating characteristics (ROC) curve were used to assess the association and predictive value of sCD163 with cardiovascular risk in RA patients.</span></span></div></div><div><h3>Results</h3><div>Levels of sCD163 were significantly higher in RA patients with high sensitivity protein C-reactive to HDL-c ratio (CHR)<!--> <!-->≥<!--> <!-->0.121 (<em>p</em> <!-->=<!--> <!-->0.003), total cholesterol/HDL-c ratio<!--> <!-->><!--> <!-->7% (<em>p</em> <!-->=<!--> <!-->0.004), LDL-c/HDL-c ratio<!--> <!-->><!--> <!-->3% (<em>p</em> <!-->=<!--> <!-->0.035), atherogenic index of plasma<!--> <!-->><!--> <!-->0.21 (<em>p</em> <!-->=<!--> <!-->0.004), cardiometabolic index (CMI)<!--> <!-->≥<!--> <!-->1.70 (<em>p</em> <!-->=<!--> <!-->0.005), and high DAS28-ESR (<em>p</em> <!-->=<!--> <!-->0.004). In multivariate analysis, levels of sCD163<!--> <!-->≥<!--> <!-->1107.3<!--> <!-->ng/mL were associated with CHR<!--> <!-->≥<!--> <!-->0.121 (OR<!--> <!-->=<!--> <!-->3.43, <em>p</em> <!-->=<!--> <!-->0.020), CMI<!--> <!-->≥<!--> <!-->1.70 (OR<!--> <!-->=<!--> <!-->4.25, <em>p</em> <!-->=<!--> <!-->0.005), total cholesterol/HDL-c ratio<!--> <!-->><!--> <!-->7% (OR<!--> <!-->=<!--> <!-->6.63, <em>p</em> <!-->=<!--> <!-->0.044), as well as with DAS28-ESR<!--> <!-->><!--> <!-->3.2 (OR<!--> <!-->=<!--> <!-->8.10, <em>p</em> <!-->=<!--> <!-->0.008). Moreover, levels of sCD163 predicted CHR<!--> <!-->≥<!--> <!-->0.121 (AUC<!--> <!-->=<!--> <!-->0.701), cholesterol total/HDL ratio<!--> <!-->><!--> <!-->7% (AUC<!--> <!-->=<!--> <!-->0.764), and DAS28-ESR<!--> <!-->><!--> <!-->3.2 (AUC<!--> <!-->=<!--> <!-->0.720).</div></div><div><h3>Conclusion</h3><div>Serum levels of sCD163 could be considered a surrogate of cardiovascular risk and clinical activity in RA.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 1","pages":"Article 100721"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904932","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 : 2025-01-01DOI: 10.1016/j.arteri.2024.05.001
Vicente Pallarés-Carratalá , Antonio Ruiz-García , Adalberto Serrano-Cumplido , Antonio Segura Fragoso , Verónica Fernández-Pascual , Beatriz Sánchez-Sánchez , María Inmaculada Cervera-Pérez , Francisco Javier Alonso-Moreno , Ezequiel Arranz-Martínez , Alfonso Barquilla-García , Daniel Rey-Aldana , José Polo García , Sergio Cinza-Sanjurjo , on behalf of the Investigators of the AGORA study, of the Spanish Society of Primary Care Physicians SEMERGEN Foundation
Introduction
Type 2 diabetes mellitus (T2D) has acquired epidemic proportions worldwide. In recent years, new oral glucose-lowering drugs (OGLD) have emerged that improve the cardiovascular–kidney–metabolic control in T2D people.
Objectives
To compare the baseline clinical–biological characteristics among T2D people to whom had added-on dapagliflozin (DAPA group) or another OGLD (SOC group) second-line hypoglycaemic therapies among the AGORA study population.
Methods
This is a multicentre cross-sectional observational study of the baseline characteristics of T2D people recruited through competitive sampling among 46 primary care health centres in Spain for the AGORA study. The inclusion and exclusion criteria of participants, and justification of the sample size are reported. After verifying the data necessary to be evaluated and informed consent, 317 subjects were included to the DAPA group and 288 to the SOC group. Both categorical and continuous variables were analysed and compared with the usual statistics. Cohen's d was used to assess the standardised difference in means.
Results
Six hundred and five patients with T2D were assessed (mean age 63.5 [SD ± 8.1] years, 61.8% men), whom 17.4% were smokers, 47.6% had obesity, 74.8% hypertension, 87.3% dyslipidaemia, and 41.7% reported physical inactivity, with no significant differences between both comparison groups. The mean (SD) evolution time of T2D was 10.1 (5.6) years. Most baseline clinical–biological characteristics at recruitment were similar in both groups. However, DAPA group was younger (2.9 years), and had lower systolic blood pressure (SBP) (2.8 mmHg), higher body weight (BW) (3.7 kg), and higher glycated haemoglobin A1c (HbA1c) (0.3%) than SOC group. Only 11.5% of participants had poor glycaemic control (HbA1c > 8%) at recruitment, 54.9% had good glycaemic control (HbA1c < 7%), being significantly lower in the DAPA group (47.3%) than in the SOC group (63.4%). The percentage of T2D patients with high vascular risk (VR) was 46.3%, and 53.7% with very high VR, being significantly higher in the DAPA group (57.4%) than in the SOC group (49.6%).
Conclusions
Most baseline cardiovascular–kidney–metabolic characteristics were similar in T2D patients whom had added dapagliflozin on second-line hypoglycaemic therapy as those whom had added-on another OGLD. However, patients whom had added-on dapagliflozin had higher VR, lower SBP, higher BW, and slightly worse HbA1c control. Future research is necessary to explain the causes of these differences in cardiometabolic control.
{"title":"Comparison of baseline clinical characteristics among people with type 2 diabetes on second-line therapy previously added with dapagliflozin or another oral glucose-lowering drug: AGORA study","authors":"Vicente Pallarés-Carratalá , Antonio Ruiz-García , Adalberto Serrano-Cumplido , Antonio Segura Fragoso , Verónica Fernández-Pascual , Beatriz Sánchez-Sánchez , María Inmaculada Cervera-Pérez , Francisco Javier Alonso-Moreno , Ezequiel Arranz-Martínez , Alfonso Barquilla-García , Daniel Rey-Aldana , José Polo García , Sergio Cinza-Sanjurjo , on behalf of the Investigators of the AGORA study, of the Spanish Society of Primary Care Physicians SEMERGEN Foundation","doi":"10.1016/j.arteri.2024.05.001","DOIUrl":"10.1016/j.arteri.2024.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Type 2 diabetes mellitus (T2D) has acquired epidemic proportions worldwide. In recent years, new oral glucose-lowering drugs (OGLD) have emerged that improve the cardiovascular–kidney–metabolic control in T2D people.</div></div><div><h3>Objectives</h3><div>To compare the baseline clinical–biological characteristics among T2D people to whom had added-on dapagliflozin (DAPA group) or another OGLD (SOC group) second-line hypoglycaemic therapies among the AGORA study population.</div></div><div><h3>Methods</h3><div>This is a multicentre cross-sectional observational study of the baseline characteristics of T2D people recruited through competitive sampling among 46 primary care health centres in Spain for the AGORA study. The inclusion and exclusion criteria of participants, and justification of the sample size are reported. After verifying the data necessary to be evaluated and informed consent, 317 subjects were included to the DAPA group and 288 to the SOC group. Both categorical and continuous variables were analysed and compared with the usual statistics. Cohen's <em>d</em> was used to assess the standardised difference in means.</div></div><div><h3>Results</h3><div>Six hundred and five patients with T2D were assessed (mean age 63.5 [SD<!--> <!-->±<!--> <!-->8.1] years, 61.8% men), whom 17.4% were smokers, 47.6% had obesity, 74.8% hypertension, 87.3% dyslipidaemia, and 41.7% reported physical inactivity, with no significant differences between both comparison groups. The mean (SD) evolution time of T2D was 10.1 (5.6) years. Most baseline clinical–biological characteristics at recruitment were similar in both groups. However, DAPA group was younger (2.9 years), and had lower systolic blood pressure (SBP) (2.8<!--> <!-->mmHg), higher body weight (BW) (3.7<!--> <!-->kg), and higher glycated haemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) (0.3%) than SOC group. Only 11.5% of participants had poor glycaemic control (HbA<sub>1c</sub> <!-->><!--> <!-->8%) at recruitment, 54.9% had good glycaemic control (HbA<sub>1c</sub> <!--><<!--> <!-->7%), being significantly lower in the DAPA group (47.3%) than in the SOC group (63.4%). The percentage of T2D patients with high vascular risk (VR) was 46.3%, and 53.7% with very high VR, being significantly higher in the DAPA group (57.4%) than in the SOC group (49.6%).</div></div><div><h3>Conclusions</h3><div>Most baseline cardiovascular–kidney–metabolic characteristics were similar in T2D patients whom had added dapagliflozin on second-line hypoglycaemic therapy as those whom had added-on another OGLD. However, patients whom had added-on dapagliflozin had higher VR, lower SBP, higher BW, and slightly worse HbA<sub>1c</sub> control. Future research is necessary to explain the causes of these differences in cardiometabolic control.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 1","pages":"Article 100724"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443496","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}