Pub Date : 2026-01-01DOI: 10.1016/j.arteri.2025.500770
Patricio Lopez-Jaramillo , Gladys Lizarazo , Raúl Torres , Fausto Posso , Jose P. Lopez-Lopez , Maya Caicedo , Fernando Vargas-Mendoza
Cardiovascular diseases (CVD) are the main cause of death globally, especially in low- and middle-income countries (LMICs), where the largest number of inhabitants on the planet are concentrated. Air pollution inside and outside the home by microparticles 2 5 (PM2·5) has become an important risk factor for the presence of CVD and other chronic non-communicable diseases, particularly in LMICs. The use of solid fuels as an energy source for cooking food and heating inside the home has negative effects not only on human health but also on the health of the planet, as it contributes to deforestation and the consequent effect on climate change. In this narrative review we update how air pollution inside the home from cooking food with firewood and charcoal impacts the risk of CVD, the factors that determine the use of these polluting fuels, and the actions necessary for the massive transition toward the use of non-polluting energy, highlighting the development of university research to offer a stove that uses green hydrogen as a non-polluting energy source.
{"title":"Efectos de la contaminación del aire dentro de la casa en la incidencia de enfermedades cardiovasculares","authors":"Patricio Lopez-Jaramillo , Gladys Lizarazo , Raúl Torres , Fausto Posso , Jose P. Lopez-Lopez , Maya Caicedo , Fernando Vargas-Mendoza","doi":"10.1016/j.arteri.2025.500770","DOIUrl":"10.1016/j.arteri.2025.500770","url":null,"abstract":"<div><div>Cardiovascular diseases (CVD) are the main cause of death globally, especially in low- and middle-income countries (LMICs), where the largest number of inhabitants on the planet are concentrated. Air pollution inside and outside the home by microparticles 2 5 (PM2·5) has become an important risk factor for the presence of CVD and other chronic non-communicable diseases, particularly in LMICs. The use of solid fuels as an energy source for cooking food and heating inside the home has negative effects not only on human health but also on the health of the planet, as it contributes to deforestation and the consequent effect on climate change. In this narrative review we update how air pollution inside the home from cooking food with firewood and charcoal impacts the risk of CVD, the factors that determine the use of these polluting fuels, and the actions necessary for the massive transition toward the use of non-polluting energy, highlighting the development of university research to offer a stove that uses green hydrogen as a non-polluting energy source.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"38 1","pages":"Article 500770"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.arteri.2025.500804
José Luis Díaz-Díaz , M. Eugenia Ameneiros , Rosa Argüeso Armesto , José María Mostaza Prieto , Xavier Pintó Sala , Avelino Rodríguez González , José Antonio Díaz-Peromingo , Alberto del Alamo Alonso , Pablo Fernández Catalina , Manuel Suárez Tembra , Carlos Alberto Názara Otero , Marta Pena Seijo , Javier Muñiz García , Teresa Rosalía Pérez-Castro , Antonio Pose Reino , Juan Pedro-Botet Montoya
Objectives
GALIPEMIAS is a study designed to determine the prevalence of familial dyslipidemias in the adult population of Galicia, evaluate the degree of lipid control according to the criteria of current clinical guidelines and analyze its association with atherosclerotic cardiovascular disease (ASCVD).
Methods
Cross-sectional study carried out in the general population over 18 years of age residing in Galicia and with a health card from the Galician Health Service (n = 1,000). The sample was selected by random cluster sampling. The prevalence of familial combined hyperlipidemia (FCH), hypercholesterolemia with dominant inheritance pattern (HC-DI) and familial hypertriglyceridemia (FHTG), as well as suspected familial dysbetalipoproteinemia (FDB) and the joint prevalence of familial dyslipidemias with dominant inheritance (FDL-DI) were analyzed. For the assessment of cardiovascular risk (CVR), the criteria of the 2021 European guidelines for cardiovascular prevention were followed. The LDL-C control target required according to the CVR level was defined according to the 2019 European ESC/EAS guidelines.
Results
The prevalence of FCH was 15.9% (95% CI: 13.6-18.4%), that of HC-DI 5.9% (95% CI: 4.5-7.6%), that of FHTG 1.7% (95% CI: 1.0-2.8%) and that of subjects with suspected FDB 0.9% (95% CI 0.4-1.6%). The joint prevalence of FDL-DI was 23.5% (95% CI: 20.8-26.3%), also present in 1 in 3 subjects with ASCVD. Overall, 60.5% of participants with FDL-DI had high or very high CV risk and 4.6% of them were on target for LDL-C control.
Conclusions
The presence of familial dyslipidemia with dominant inheritance is the majority among the adult population living in Galicia with dyslipidemia, with FCH being the most prevalent of them. These subjects are underdiagnosed, are generally at high or very high cardiovascular risk, hardly receive lipid-lowering treatment (1 in 3) and the degree of LDL-C control according to guidelines is very poor.
{"title":"Prevalencia de dislipemias familiares, grado de control lipídico y relación con la enfermedad cardiovascular aterosclerótica en población general de Galicia. Estudio GALIPEMIAS","authors":"José Luis Díaz-Díaz , M. Eugenia Ameneiros , Rosa Argüeso Armesto , José María Mostaza Prieto , Xavier Pintó Sala , Avelino Rodríguez González , José Antonio Díaz-Peromingo , Alberto del Alamo Alonso , Pablo Fernández Catalina , Manuel Suárez Tembra , Carlos Alberto Názara Otero , Marta Pena Seijo , Javier Muñiz García , Teresa Rosalía Pérez-Castro , Antonio Pose Reino , Juan Pedro-Botet Montoya","doi":"10.1016/j.arteri.2025.500804","DOIUrl":"10.1016/j.arteri.2025.500804","url":null,"abstract":"<div><h3>Objectives</h3><div>GALIPEMIAS is a study designed to determine the prevalence of familial dyslipidemias in the adult population of Galicia, evaluate the degree of lipid control according to the criteria of current clinical guidelines and analyze its association with atherosclerotic cardiovascular disease (ASCVD).</div></div><div><h3>Methods</h3><div>Cross-sectional study carried out in the general population over 18<!--> <!-->years of age residing in Galicia and with a health card from the Galician Health Service (n<!--> <!-->=<!--> <!-->1,000). The sample was selected by random cluster sampling. The prevalence of familial combined hyperlipidemia (FCH), hypercholesterolemia with dominant inheritance pattern (HC-DI) and familial hypertriglyceridemia (FHTG), as well as suspected familial dysbetalipoproteinemia (FDB) and the joint prevalence of familial dyslipidemias with dominant inheritance (FDL-DI) were analyzed. For the assessment of cardiovascular risk (CVR), the criteria of the 2021 European guidelines for cardiovascular prevention were followed. The LDL-C control target required according to the CVR level was defined according to the 2019 European ESC/EAS guidelines.</div></div><div><h3>Results</h3><div>The prevalence of FCH was 15.9% (95%<!--> <!-->CI: 13.6-18.4%), that of HC-DI 5.9% (95%<!--> <!-->CI: 4.5-7.6%), that of FHTG 1.7% (95%<!--> <!-->CI: 1.0-2.8%) and that of subjects with suspected FDB 0.9% (95%<!--> <!-->CI 0.4-1.6%). The joint prevalence of FDL-DI was 23.5% (95%<!--> <!-->CI: 20.8-26.3%), also present in 1 in 3 subjects with ASCVD. Overall, 60.5% of participants with FDL-DI had high or very high CV risk and 4.6% of them were on target for LDL-C control.</div></div><div><h3>Conclusions</h3><div>The presence of familial dyslipidemia with dominant inheritance is the majority among the adult population living in Galicia with dyslipidemia, with FCH being the most prevalent of them. These subjects are underdiagnosed, are generally at high or very high cardiovascular risk, hardly receive lipid-lowering treatment (1 in 3) and the degree of LDL-C control according to guidelines is very poor.</div><div>.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"38 1","pages":"Article 500804"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.arteri.2025.500890
Johanna Vicuña
{"title":"Importancia del riesgo cardiovascular y aterogénico en profesionales sanitarios","authors":"Johanna Vicuña","doi":"10.1016/j.arteri.2025.500890","DOIUrl":"10.1016/j.arteri.2025.500890","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"38 1","pages":"Article 500890"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876926","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 : 2025-12-19DOI: 10.1016/j.arteri.2025.500888
Ana Ojeda-Rodriguez, Maria Jose Parraga-Viudez, Juan L Romero-Cabrera, Alejandro López-Moreno, Javier Arenas-Montes, Ana Isabel Pérez Caballero, Raul M Luque, Javier Delgado-Lista, Oriol Rangel-Zuñiga, Jose Lopez-Miranda
Background: The presence of type 2 diabetes mellitus (T2DM) in cardiovascular disease (CVD) is associated with poorer clinical outcomes. To identify biomarkers is essential to predict T2DM onset and progression in the context of secondary prevention. Telomere length (TL), a marker of cellular aging, has been linked to oxidative stress, inflammation, and metabolic dysfunction, including diabetes-related complications. This study aims to evaluate TL as a potential biomarker for T2DM in patients with coronary heart disease (CHD).
Methods: We included 956 patients from the CORDIOPREV study with available TL data. Participants were classified according to their diabetes status at the end of the dietary intervention: 407 were free of T2DM and 549 were classified as having T2DM. TL was measured by quantitative PCR. Patients with TL values below the 20th percentile of the study population were categorized as having short telomeres.
Results: TL was significantly shorter in T2DM patients compared to non-T2DM (1.26±0.74 vs. 1.38±0.84; p=0.026). Each 1-SD increase in TL was associated with a 17% lower risk of T2DM (OR 0.83, 95% CI 0.69-0.98). Patients at risk of short TL (<20th percentile) showed a higher prevalence of T2DM (20% vs. 17%; p=0.035) and a 42% increased risk of its presence (OR 1.42, 95% CI 0.99-2.02). In stepwise regression models, TL, age, BMI, insulin, triglycerides, and HbA1c emerged as independent predictors of T2DM. After adjusting for fasting glucose, TL lost significance as a continuous variable, but short TL risk remained independently associated with T2DM (OR 1.57, p=0.049).
Conclusions: Shorter TL is associated with the presence of T2DM in patients with CHD, supporting its potential role as an independent biomarker for T2DM risk in secondary prevention.
背景：2型糖尿病（T2DM）合并心血管疾病（CVD）与较差的临床预后相关。在二级预防的背景下，确定生物标志物对于预测T2DM的发生和进展至关重要。端粒长度（TL）是细胞衰老的标志，与氧化应激、炎症和代谢功能障碍（包括糖尿病相关并发症）有关。本研究旨在评估TL作为T2DM合并冠心病（CHD）患者的潜在生物标志物。方法：我们从CORDIOPREV研究中纳入956例具有可用TL数据的患者。根据饮食干预结束时的糖尿病状况对参与者进行分类：407人没有2型糖尿病，549人被归类为患有2型糖尿病。用定量PCR法测定TL。TL值低于研究人群第20百分位数的患者被归类为端粒短。结果：T2DM患者的TL明显短于非T2DM患者（1.26±0.74∶1.38±0.84;p=0.026）。TL每增加1个标准差，患T2DM的风险降低17% （OR 0.83, 95% CI 0.69-0.98）。结论：较短的TL与冠心病患者存在T2DM相关，支持其在二级预防中作为T2DM风险的独立生物标志物的潜在作用。
{"title":"Risk of short telomere as biomarker of diabetes mellitus type 2 status in the CORDIOPREV study.","authors":"Ana Ojeda-Rodriguez, Maria Jose Parraga-Viudez, Juan L Romero-Cabrera, Alejandro López-Moreno, Javier Arenas-Montes, Ana Isabel Pérez Caballero, Raul M Luque, Javier Delgado-Lista, Oriol Rangel-Zuñiga, Jose Lopez-Miranda","doi":"10.1016/j.arteri.2025.500888","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500888","url":null,"abstract":"<p><strong>Background: </strong>The presence of type 2 diabetes mellitus (T2DM) in cardiovascular disease (CVD) is associated with poorer clinical outcomes. To identify biomarkers is essential to predict T2DM onset and progression in the context of secondary prevention. Telomere length (TL), a marker of cellular aging, has been linked to oxidative stress, inflammation, and metabolic dysfunction, including diabetes-related complications. This study aims to evaluate TL as a potential biomarker for T2DM in patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>We included 956 patients from the CORDIOPREV study with available TL data. Participants were classified according to their diabetes status at the end of the dietary intervention: 407 were free of T2DM and 549 were classified as having T2DM. TL was measured by quantitative PCR. Patients with TL values below the 20th percentile of the study population were categorized as having short telomeres.</p><p><strong>Results: </strong>TL was significantly shorter in T2DM patients compared to non-T2DM (1.26±0.74 vs. 1.38±0.84; p=0.026). Each 1-SD increase in TL was associated with a 17% lower risk of T2DM (OR 0.83, 95% CI 0.69-0.98). Patients at risk of short TL (<20th percentile) showed a higher prevalence of T2DM (20% vs. 17%; p=0.035) and a 42% increased risk of its presence (OR 1.42, 95% CI 0.99-2.02). In stepwise regression models, TL, age, BMI, insulin, triglycerides, and HbA1c emerged as independent predictors of T2DM. After adjusting for fasting glucose, TL lost significance as a continuous variable, but short TL risk remained independently associated with T2DM (OR 1.57, p=0.049).</p><p><strong>Conclusions: </strong>Shorter TL is associated with the presence of T2DM in patients with CHD, supporting its potential role as an independent biomarker for T2DM risk in secondary prevention.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500888"},"PeriodicalIF":1.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800767","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 : 2025-12-08DOI: 10.1016/j.arteri.2025.500887
Salomón Martín Pérez, Remo Suppi, Teresa Arrobas Velilla, Francisco de Borja Téllez Hernández, Antonio León-Justel
Introduction: Low-density lipoprotein cholesterol (LDL-C) is a significant cardiovascular risk factor, as direct measurement is expensive and often unavailable in most clinical laboratories. The Friedewald formula (FD), despite its widespread use since 1972, has notable limitations, especially at high triglyceride levels and low LDL-C concentrations. Machine learning (ML) techniques offer promising alternatives for accurate LDL-C estimation, potentially overcoming traditional formula limitations by leveraging complex pattern recognition in lipid profile data.
Material and methods: This retrospective study analyzed 34,678 lipid profiles from patients over 18 years attending Hospital Virgen Macarena, Seville (January 2021-December 2022). The study was approved by the Ethics Committee (CEI HVM-VR_03/2024). All lipid parameters (total cholesterol, triglycerides, HDL-C, LDL-C) were measured using Cobas 6000 analyzer. Twenty-two machine learning models were developed using Python's PyCaret library with 80/20 train-test split. Models included Linear Regression, Random Forest, XGBoost, LightGBM, and Gradient Boosting among others. Performance was evaluated using coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE). Four triglyceride subgroups were analyzed: <150, 150-250, 250-400, and >400mg/dL.
Results: The dataset comprised 34,678 individuals with mean values: total cholesterol 204.6±73.36mg/dL, triglycerides 203.95±143.94mg/dL, HDL-C 51.83±18.45mg/dL, and LDL-C 120.38±62.29mg/dL. LightGBM achieved the highest performance (R2=0.965, RMSE=11.35, MAE=7.99), followed by Gradient Boosting (R2=0.962, RMSE=11.89, MAE=7.87) and XGBoost (R2=0.958, RMSE=12.49, MAE=8.3). Traditional formulas showed inferior performance: Martin-Hopkins (R2=0.951, RMSE=13.82, MAE=9.3) and Friedewald (R2=0.926, RMSE=16.92, MAE=11.97). Performance differences were more pronounced at triglyceride levels≥250mg/dL, with ML models maintaining R2>0.92 while classical formulas deteriorated significantly, particularly Friedewald (R2=0.34) at triglycerides>400mg/dL.
Conclusions: Machine learning models, particularly boosting algorithms (LightGBM, Gradient Boosting, XGBoost), significantly outperformed traditional LDL-C calculation formulas across all triglyceride ranges. These AI-based approaches yielded superior accuracy and robustness, especially in challenging clinical scenarios with elevated triglycerides where conventional formulas fail. Implementation of ML models in clinical laboratories could provide more reliable LDL-C estimations, contributing to improved cardiovascular risk stratification and patient management. This technological advancement represents a promising transformation in laboratory medicine methodology.
{"title":"Comparative performance of machine learning vs classical formulas for LDL-cholesterol calculation.","authors":"Salomón Martín Pérez, Remo Suppi, Teresa Arrobas Velilla, Francisco de Borja Téllez Hernández, Antonio León-Justel","doi":"10.1016/j.arteri.2025.500887","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500887","url":null,"abstract":"<p><strong>Introduction: </strong>Low-density lipoprotein cholesterol (LDL-C) is a significant cardiovascular risk factor, as direct measurement is expensive and often unavailable in most clinical laboratories. The Friedewald formula (FD), despite its widespread use since 1972, has notable limitations, especially at high triglyceride levels and low LDL-C concentrations. Machine learning (ML) techniques offer promising alternatives for accurate LDL-C estimation, potentially overcoming traditional formula limitations by leveraging complex pattern recognition in lipid profile data.</p><p><strong>Material and methods: </strong>This retrospective study analyzed 34,678 lipid profiles from patients over 18 years attending Hospital Virgen Macarena, Seville (January 2021-December 2022). The study was approved by the Ethics Committee (CEI HVM-VR_03/2024). All lipid parameters (total cholesterol, triglycerides, HDL-C, LDL-C) were measured using Cobas 6000 analyzer. Twenty-two machine learning models were developed using Python's PyCaret library with 80/20 train-test split. Models included Linear Regression, Random Forest, XGBoost, LightGBM, and Gradient Boosting among others. Performance was evaluated using coefficient of determination (R<sup>2</sup>), mean absolute error (MAE), and root mean square error (RMSE). Four triglyceride subgroups were analyzed: <150, 150-250, 250-400, and >400mg/dL.</p><p><strong>Results: </strong>The dataset comprised 34,678 individuals with mean values: total cholesterol 204.6±73.36mg/dL, triglycerides 203.95±143.94mg/dL, HDL-C 51.83±18.45mg/dL, and LDL-C 120.38±62.29mg/dL. LightGBM achieved the highest performance (R<sup>2</sup>=0.965, RMSE=11.35, MAE=7.99), followed by Gradient Boosting (R<sup>2</sup>=0.962, RMSE=11.89, MAE=7.87) and XGBoost (R<sup>2</sup>=0.958, RMSE=12.49, MAE=8.3). Traditional formulas showed inferior performance: Martin-Hopkins (R<sup>2</sup>=0.951, RMSE=13.82, MAE=9.3) and Friedewald (R<sup>2</sup>=0.926, RMSE=16.92, MAE=11.97). Performance differences were more pronounced at triglyceride levels≥250mg/dL, with ML models maintaining R<sup>2</sup>>0.92 while classical formulas deteriorated significantly, particularly Friedewald (R<sup>2</sup>=0.34) at triglycerides>400mg/dL.</p><p><strong>Conclusions: </strong>Machine learning models, particularly boosting algorithms (LightGBM, Gradient Boosting, XGBoost), significantly outperformed traditional LDL-C calculation formulas across all triglyceride ranges. These AI-based approaches yielded superior accuracy and robustness, especially in challenging clinical scenarios with elevated triglycerides where conventional formulas fail. Implementation of ML models in clinical laboratories could provide more reliable LDL-C estimations, contributing to improved cardiovascular risk stratification and patient management. This technological advancement represents a promising transformation in laboratory medicine methodology.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500887"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716118","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 : 2025-12-02DOI: 10.1016/j.arteri.2025.500878
Ana Ojeda-Rodriguez, Maria Jose Parraga-Viudez, Alejandro López-Moreno, Alejandro Serrán-Jiménez, Alberto Díaz-Cáceres, Javier Arenas-Montes, José D Torres-Peña, Justo P Castaño, Javier Delgado-Lista, José López-Miranda
Background: Telomere length (TL) has emerged as a recognized biomarker of biological aging and cardiovascular risk. Several studies have associated short TL with increased incidence of cardiovascular disease and adverse outcomes. However, its value as a predictor of arterial injury remains unclear, especially in secondary prevention. This study examined the baseline association between TL and common carotid intima-media thickness (IMT-CC) in patients with coronary heart disease (CHD).
Methods: Of the 1002 CHD patients enrolled in the CORDIOPREV study, 903 completed baseline assessments of IMT-CC and TL. IMT-CC was measured bilaterally using high-resolution B-mode Doppler ultrasonography and categorized, according to the European Society of Cardiology guidelines, into three groups reflecting arterial injury: <0.7mm, 0.7-0.9mm, and ≥0.9mm. TL was determined using the quantitative PCR method. Patients were classified as at risk of short TL if their value was below the 20th percentile, and as non-risk if above this threshold.
Results: Patients with the highest IMT-CC values (≥0.9mm) had significantly shorter TL compared to those in the lowest group (<0.7mm, p=0.005), with a progressive decrease across IMT-CC categories (p for trend=0.02). The proportion of participants at risk of short telomeres increased significantly from 15% to 30% across these categories (p<0.001). In addition, the highest IMT-CC group showed a twofold greater risk of short telomeres compared to the reference group (<0.7mm; OR 2.373, 95%CI 1.4962-3.764), while no significant association was observed for the intermediate IMT-CC group (0.7-0.9mm; OR 1.352, 95%CI 0.896-2.039).
Conclusions: In CHD patients, shorter TL is associated to advanced subclinical arterial damage, supporting its potential role as a complementary biomarker for vascular aging and improved risk stratification in secondary prevention.
{"title":"Telomere length is associated with arterial damage in the CORDIOPREV study.","authors":"Ana Ojeda-Rodriguez, Maria Jose Parraga-Viudez, Alejandro López-Moreno, Alejandro Serrán-Jiménez, Alberto Díaz-Cáceres, Javier Arenas-Montes, José D Torres-Peña, Justo P Castaño, Javier Delgado-Lista, José López-Miranda","doi":"10.1016/j.arteri.2025.500878","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500878","url":null,"abstract":"<p><strong>Background: </strong>Telomere length (TL) has emerged as a recognized biomarker of biological aging and cardiovascular risk. Several studies have associated short TL with increased incidence of cardiovascular disease and adverse outcomes. However, its value as a predictor of arterial injury remains unclear, especially in secondary prevention. This study examined the baseline association between TL and common carotid intima-media thickness (IMT-CC) in patients with coronary heart disease (CHD).</p><p><strong>Methods: </strong>Of the 1002 CHD patients enrolled in the CORDIOPREV study, 903 completed baseline assessments of IMT-CC and TL. IMT-CC was measured bilaterally using high-resolution B-mode Doppler ultrasonography and categorized, according to the European Society of Cardiology guidelines, into three groups reflecting arterial injury: <0.7mm, 0.7-0.9mm, and ≥0.9mm. TL was determined using the quantitative PCR method. Patients were classified as at risk of short TL if their value was below the 20th percentile, and as non-risk if above this threshold.</p><p><strong>Results: </strong>Patients with the highest IMT-CC values (≥0.9mm) had significantly shorter TL compared to those in the lowest group (<0.7mm, p=0.005), with a progressive decrease across IMT-CC categories (p for trend=0.02). The proportion of participants at risk of short telomeres increased significantly from 15% to 30% across these categories (p<0.001). In addition, the highest IMT-CC group showed a twofold greater risk of short telomeres compared to the reference group (<0.7mm; OR 2.373, 95%CI 1.4962-3.764), while no significant association was observed for the intermediate IMT-CC group (0.7-0.9mm; OR 1.352, 95%CI 0.896-2.039).</p><p><strong>Conclusions: </strong>In CHD patients, shorter TL is associated to advanced subclinical arterial damage, supporting its potential role as a complementary biomarker for vascular aging and improved risk stratification in secondary prevention.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500878"},"PeriodicalIF":1.9,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arteri.2025.500772
María Gordito Soler , José Ignacio Ramírez-Manent , Pedro Juan Tárraga López , Emilio Martínez-Almoyna Rifá , Hernán Paublini , Ángel Arturo López González
Introduction
Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms.
Objectives
Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5 years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed.
Results
All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women.
Conclusions
The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.
{"title":"Utilidad de la grasa corporal y visceral determinada por bioimpedanciometría frente al índice de masa corporal y el perímetro de cintura en la identificación de valores elevados de diferentes escalas de riesgo de aterogénesis","authors":"María Gordito Soler , José Ignacio Ramírez-Manent , Pedro Juan Tárraga López , Emilio Martínez-Almoyna Rifá , Hernán Paublini , Ángel Arturo López González","doi":"10.1016/j.arteri.2025.500772","DOIUrl":"10.1016/j.arteri.2025.500772","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms.</div></div><div><h3>Objectives</h3><div>Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5<!--> <!-->years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed.</div></div><div><h3>Results</h3><div>All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women.</div></div><div><h3>Conclusions</h3><div>The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 6","pages":"Article 500772"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arteri.2025.500767
Santiago Redondo
In the last decade, the coming of next-generation sequencing and its application to large human populations is breaking the barrier between inflammation and cancer. Indeed, acquired mutations in key genes that regulate hematopoiesis and thus confer a selective advantage in the proliferation of hematopoietic progenitors have established the concept of clonal hematopoiesis of indeterminate potential or CHIP. A growing body of clinical and experimental evidence is highlighting the link between CHIP and adverse outcomes, in particular atherosclerotic cardiovascular disease and cancer. The apparent surprise about how these two different entities share common mechanisms can be explained by myeloproliferation and inflammation. These mechanisms are involved not only in the development of myeloid tumors but also in atherogenesis. Myeloproliferative neoplasms or MPN are a type of myeloid tumors where thrombotic risk is increased not only by higher blood counts but also by means of an accelerated atherosclerosis. Therefore, myeloproliferative neoplasms are a model of the link between clonal hematopoiesis and atherosclerotic cardiovascular disease. The concept of CHIP has important clinical applications. A deeper understanding of these mechanisms may pave the way for the future early diagnosis and potential pre-emptive treatments of these two major causes of death.
{"title":"Myeloproliferative neoplasms: A model of the journey from clonal hematopoiesis to cardiovascular disease and cancer","authors":"Santiago Redondo","doi":"10.1016/j.arteri.2025.500767","DOIUrl":"10.1016/j.arteri.2025.500767","url":null,"abstract":"<div><div>In the last decade, the coming of next-generation sequencing and its application to large human populations is breaking the barrier between inflammation and cancer. Indeed, acquired mutations in key genes that regulate hematopoiesis and thus confer a selective advantage in the proliferation of hematopoietic progenitors have established the concept of clonal hematopoiesis of indeterminate potential or CHIP. A growing body of clinical and experimental evidence is highlighting the link between CHIP and adverse outcomes, in particular atherosclerotic cardiovascular disease and cancer. The apparent surprise about how these two different entities share common mechanisms can be explained by myeloproliferation and inflammation. These mechanisms are involved not only in the development of myeloid tumors but also in atherogenesis. Myeloproliferative neoplasms or MPN are a type of myeloid tumors where thrombotic risk is increased not only by higher blood counts but also by means of an accelerated atherosclerosis. Therefore, myeloproliferative neoplasms are a model of the link between clonal hematopoiesis and atherosclerotic cardiovascular disease. The concept of CHIP has important clinical applications. A deeper understanding of these mechanisms may pave the way for the future early diagnosis and potential pre-emptive treatments of these two major causes of death.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 6","pages":"Article 500767"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arteri.2025.500773
Juan Cosín Sales , Carlos Escobar Cervantes , José Javier Gómez-Barrado , José Manuel Andreu Cayuelas , Abel García del Egido , Jorge Joaquín Castro Martín , Ana Isabel Huelmos Rodrigo , Miguel Corbi-Pascual , Ariana Varela Cancelo , Rafael Vidal-Pérez , Leticia Fernandez-Friera , Enrique Santas Olmeda , Almudena Aguilera-Saborido , Antonio Fernández Romero , Antonio Sánchez Hidalgo , Francisco Pérez-Sádaba , Román Freixa-Pamias
Aims
A high number of patients do not achieve the therapeutic goals set by clinical practice guidelines, despite the therapeutic alternatives that currently exist in lipid-lowering treatment (LLT). This study aimed to estimate the proportion of patients who have recently suffered an acute coronary syndrome (ACS) who do not meet the therapeutic goal with LLT and the proportion of routine follow-up visits where therapeutic inertia (TI) occurs.
Methods
A retrospective study chart review was conducted in 13 Spanish centres. Patients aged ≥18 years who suffered an ACS event in the last two years and had received LLT were included. Sociodemographic, clinical, treatment and participating centre/physician-related variables were collected. TI was considered when a visit did not result in a change in the patient's therapy despite the non-achievement of therapeutic goals. Descriptive analysis was performed, and factors associated with TI were evaluated using logistic regression.
Results
159 patients were included (mean age 63.08 years old, 80.5% male) and 338 follow-up visits were analysed. Over 50% of the patients did not meet the therapeutic target and TI was estimated in 39.13% of visits. Some factors were associated with a lower risk of TI: professional experience, number of vessels affected, and diabetes. And others with higher risk: being female, previous CV pathology and a complete revascularisation.
Conclusion
The management of patients after ACS is still suboptimal. The importance of clinical inertia in ACS remains a real awareness and active strategies will help mitigate this phenomenon due to the risk of recurrent ACS.
{"title":"Impact of therapeutic inertia in lipid-lowering therapy in patients at very high cardiovascular risk","authors":"Juan Cosín Sales , Carlos Escobar Cervantes , José Javier Gómez-Barrado , José Manuel Andreu Cayuelas , Abel García del Egido , Jorge Joaquín Castro Martín , Ana Isabel Huelmos Rodrigo , Miguel Corbi-Pascual , Ariana Varela Cancelo , Rafael Vidal-Pérez , Leticia Fernandez-Friera , Enrique Santas Olmeda , Almudena Aguilera-Saborido , Antonio Fernández Romero , Antonio Sánchez Hidalgo , Francisco Pérez-Sádaba , Román Freixa-Pamias","doi":"10.1016/j.arteri.2025.500773","DOIUrl":"10.1016/j.arteri.2025.500773","url":null,"abstract":"<div><h3>Aims</h3><div>A high number of patients do not achieve the therapeutic goals set by clinical practice guidelines, despite the therapeutic alternatives that currently exist in lipid-lowering treatment (LLT). This study aimed to estimate the proportion of patients who have recently suffered an acute coronary syndrome (ACS) who do not meet the therapeutic goal with LLT and the proportion of routine follow-up visits where therapeutic inertia (TI) occurs.</div></div><div><h3>Methods</h3><div>A retrospective study chart review was conducted in 13 Spanish centres. Patients aged ≥18 years who suffered an ACS event in the last two years and had received LLT were included. Sociodemographic, clinical, treatment and participating centre/physician-related variables were collected. TI was considered when a visit did not result in a change in the patient's therapy despite the non-achievement of therapeutic goals. Descriptive analysis was performed, and factors associated with TI were evaluated using logistic regression.</div></div><div><h3>Results</h3><div>159 patients were included (mean age 63.08 years old, 80.5% male) and 338 follow-up visits were analysed. Over 50% of the patients did not meet the therapeutic target and TI was estimated in 39.13% of visits. Some factors were associated with a lower risk of TI: professional experience, number of vessels affected, and diabetes. And others with higher risk: being female, previous CV pathology and a complete revascularisation.</div></div><div><h3>Conclusion</h3><div>The management of patients after ACS is still suboptimal. The importance of clinical inertia in ACS remains a real awareness and active strategies will help mitigate this phenomenon due to the risk of recurrent ACS.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 6","pages":"Article 500773"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arteri.2025.500874
Francisco Martín Luján , Rosa Solà Alberich
{"title":"Utilidad del estudio de la grasa visceral para una estratificación precoz del riesgo aterogénico: de la antropometría convencional a las medidas más precisas","authors":"Francisco Martín Luján , Rosa Solà Alberich","doi":"10.1016/j.arteri.2025.500874","DOIUrl":"10.1016/j.arteri.2025.500874","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 6","pages":"Article 500874"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570852","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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