Pub Date : 2024-07-01DOI: 10.1016/j.arteri.2024.02.003
Alejandro A. Castellanos , María del Carmen Castillo , Laura Montoya , María Elvira Ruiz , Jorge L. Zapateiro , Juan Patricio Nogueira
Sitosterolemia is an autosomal recessive and very rare disease. Its main characteristic is that there is a greater absorption and a decrease in the excretion of sterols, which leads to them being deposited in tissues. It is given by mutations in the ABCG5 or ABCG8 genes found on chromosome 2p21. In this clinical note, we describe the first two patients with familial sitosterolemia described in Colombia, brothers, one of them with xanthomas in extremities as the only symptom, and the other, completely asymptomatic. Genetic studies were performed as a diagnostic test in both patients, where a pathogenic homozygous variant could be identified in the ABCG8 gene in the first case (symptomatic), and a heterozygous variant in the ABCG8 gene in the second case (asymptomatic); the first patient has responded to treatment with ezetimibe. In conclusion, xanthomas should be studied in depth in pediatric age as they may be the only visible sign of such complex and hereditary diseases as familial sitosterolemia, which can be controlled and prevent cardiovascular complications of the disease.
{"title":"Sitosterolemia familiar: reporte de dos casos en Colombia","authors":"Alejandro A. Castellanos , María del Carmen Castillo , Laura Montoya , María Elvira Ruiz , Jorge L. Zapateiro , Juan Patricio Nogueira","doi":"10.1016/j.arteri.2024.02.003","DOIUrl":"10.1016/j.arteri.2024.02.003","url":null,"abstract":"<div><p>Sitosterolemia is an autosomal recessive and very rare disease. Its main characteristic is that there is a greater absorption and a decrease in the excretion of sterols, which leads to them being deposited in tissues. It is given by mutations in the ABCG5 or ABCG8 genes found on chromosome 2p21. In this clinical note, we describe the first two patients with familial sitosterolemia described in Colombia, brothers, one of them with xanthomas in extremities as the only symptom, and the other, completely asymptomatic. Genetic studies were performed as a diagnostic test in both patients, where a pathogenic homozygous variant could be identified in the ABCG8 gene in the first case (symptomatic), and a heterozygous variant in the ABCG8 gene in the second case (asymptomatic); the first patient has responded to treatment with ezetimibe. In conclusion, xanthomas should be studied in depth in pediatric age as they may be the only visible sign of such complex and hereditary diseases as familial sitosterolemia, which can be controlled and prevent cardiovascular complications of the disease.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040626","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 : 2024-07-01DOI: 10.1016/j.arteri.2023.12.006
Antonio López-Téllez , José Manuel Ramírez Torres , Estrella Pérez Vázquez , Miguel Ángel Babiano Fernández , Helena López-Martí , Irene Zapata Martínez , Cristóbal Trillo Fernández , Manuel Frías Vargas , María Dolores Domínguez Pinos , Juan Fernando Peiró Morant , José Antonio González-Fajardo , Pedro Valdivielso Felices
Introduction
Abdominal aortic aneurysm (AAA) constitutes a pathology with high mortality. There is currently no screening program implemented in primary care in Spain.
Objectives
To evaluate the usefulness of ultrasound in the detection of AAA in the at-risk population in primary care. Secondarily, to identify subjects whose vascular risk (VR) should be reclassified and to determine whether AAA is associated with the presence of carotid plaque and other risk factors.
Material and methods
Cross-sectional, descriptive, multicenter, national, descriptive study in primary care.
Subjects
A consecutive selection of hypertensive males aged between 65 and 75 who are either smokers or former smokers, or individuals over the age of 50 of both sexes with a family history of AAA. Measurements: Diameter of abdominal aorta and iliac arteries; detection of abdominal aortic and carotid atherosclerotic plaque. VR was calculated at the beginning and after testing (SCORE).
Results
One hundred and fifty patients were analyzed (age: 68.3 ± 5 years; 89.3% male). Baseline RV was high/very high in 55.3%. AAA was detected in 12 patients (8%; 95% CI: 4–12); aortic ectasia in 13 (8.7%); abdominal aortic plaque in 44% and carotid plaque in 62% of the participants. VR was reclassified in 50% of subjects. The detection of AAA or ectasia was associated with the presence of carotid plaque, current smoking and lipoprotein(a), p < 0.01.
Conclusions
The prevalence of AAA in patients with VR is high. Ultrasound in primary care allows detection of AAA and subclinical atherosclerosis and consequently reclassification of the VR, demonstrating its utility in screening for AAA in the at-risk population.
{"title":"Utilidad de la ecografía en el cribado del aneurisma de aorta abdominal en atención primaria","authors":"Antonio López-Téllez , José Manuel Ramírez Torres , Estrella Pérez Vázquez , Miguel Ángel Babiano Fernández , Helena López-Martí , Irene Zapata Martínez , Cristóbal Trillo Fernández , Manuel Frías Vargas , María Dolores Domínguez Pinos , Juan Fernando Peiró Morant , José Antonio González-Fajardo , Pedro Valdivielso Felices","doi":"10.1016/j.arteri.2023.12.006","DOIUrl":"10.1016/j.arteri.2023.12.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Abdominal aortic aneurysm (AAA) constitutes a pathology with high mortality. There is currently no screening program implemented in primary care in Spain.</p></div><div><h3>Objectives</h3><p>To evaluate the usefulness of ultrasound in the detection of AAA in the at-risk population in primary care. Secondarily, to identify subjects whose vascular risk (VR) should be reclassified and to determine whether AAA is associated with the presence of carotid plaque and other risk factors.</p></div><div><h3>Material and methods</h3><p>Cross-sectional, descriptive, multicenter, national, descriptive study in primary care.</p></div><div><h3>Subjects</h3><p>A consecutive selection of hypertensive males aged between 65 and 75 who are either smokers or former smokers, or individuals over the age of 50 of both sexes with a family history of AAA. Measurements: Diameter of abdominal aorta and iliac arteries; detection of abdominal aortic and carotid atherosclerotic plaque. VR was calculated at the beginning and after testing (SCORE).</p></div><div><h3>Results</h3><p>One hundred and fifty patients were analyzed (age: 68.3<!--> <!-->±<!--> <!-->5 years; 89.3% male). Baseline RV was high/very high in 55.3%. AAA was detected in 12 patients (8%; 95% <span>C</span>I: 4–12); aortic ectasia in 13 (8.7%); abdominal aortic plaque in 44% and carotid plaque in 62% of the participants. VR was reclassified in 50% of subjects. The detection of AAA or ectasia was associated with the presence of carotid plaque, current smoking and lipoprotein(a), <em>p</em> <!--><<!--> <!-->0.01.</p></div><div><h3>Conclusions</h3><p>The prevalence of AAA in patients with VR is high. Ultrasound in primary care allows detection of AAA and subclinical atherosclerosis and consequently reclassification of the VR, demonstrating its utility in screening for AAA in the at-risk population.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730642","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 : 2024-07-01DOI: 10.1016/j.arteri.2024.06.001
José A. Páramo
{"title":"Riesgo trombótico asociado a COVID-19 y diabetes: ¿es PAI-1 el nexo?","authors":"José A. Páramo","doi":"10.1016/j.arteri.2024.06.001","DOIUrl":"10.1016/j.arteri.2024.06.001","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471477","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 : 2024-07-01DOI: 10.1016/j.arteri.2023.12.005
Ana Palanca , Amparo Bartual-Rodrigo , Carolina Cuenca , Oscar D. Mayo-López , Francisco Javier Ampudia-Blasco , Herminia González-Navarro , Juan F. Ascaso , Ana Bárbara García-García , Felipe Javier Chaves , José T. Real , Sergio Martínez-Hervás
Background
Atherosclerosis is an inflammatory disease. Interleukin 18 (IL-18) is an inflammatory molecule that has been linked to the development of atherosclerosis and cardiovascular disease.
Objective
To evaluate the possible relationship between plasma levels of IL-18 and the presence of atherosclerosis evaluated at the carotid level, as well as to analyze the possible modulation by different polymorphisms in a Mediterranean population.
Material and methods
Seven hundred and forty-six individuals from the metropolitan area of Valencia were included, recruited over a period of 2 years. Hydrocarbon and lipid metabolism parameters were determined using standard methodology and IL-18 using ELISA. In addition, carotid ultrasound was performed and the genotype of four SNPs related to the IL-18 signaling pathway was analyzed.
Results
Patients with higher plasma levels of IL-18 had other associated cardiovascular risk factors. Elevated IL-18 levels were significantly associated with higher carotid IMT and the presence of atheromatous plaques. The genotype with the A allele of the SNP rs2287037 was associated with a higher prevalence of carotid atheromatous plaque. On the contrary, the genotype with the C allele of the SNP rs2293224 was associated with a lower prevalence of atheromatous plaque.
Conclusions
High levels of IL-18 were significantly associated with a higher carotid IMT and the presence of atheromatous plaques, which appear to be influenced by genetic factors, as evidenced by associations between SNPs in the IL-18 receptor gene and the presence of atheroma plaque.
背景:动脉粥样硬化是一种炎症性疾病:动脉粥样硬化是一种炎症性疾病。白细胞介素 18(IL-18)是一种炎症分子,与动脉粥样硬化和心血管疾病的发生有关:评估血浆中 IL-18 水平与颈动脉粥样硬化之间可能存在的关系,并分析不同多态性对地中海人群可能产生的调节作用:研究对象包括来自巴伦西亚大都会地区的 746 人,招募时间为两年。采用标准方法测定碳氢化合物和脂质代谢参数,采用 ELISA 方法测定 IL-18。此外,还进行了颈动脉超声检查,并分析了与 IL-18 信号通路相关的四个 SNPs 基因型:结果:血浆中IL-18水平较高的患者有其他相关的心血管风险因素。IL-18水平升高与颈动脉内中膜厚度升高和动脉粥样斑块的存在明显相关。带有 SNP rs2287037 的 A 等位基因的基因型与较高的颈动脉粥样斑块发病率相关。相反,SNP rs2293224的C等位基因的基因型与较低的动脉粥样斑块发病率相关:结论:高水平的IL-18与较高的颈动脉内中膜厚度和动脉粥样斑块的存在明显相关,这似乎受到遗传因素的影响,IL-18受体基因中的SNP与动脉粥样斑块的存在之间的关联就证明了这一点。
{"title":"Asociación de la placa de ateroma carotídea con los niveles plasmáticos de IL-18 y con polimorfismos en el gen del receptor de la IL-18 en la población mediterránea","authors":"Ana Palanca , Amparo Bartual-Rodrigo , Carolina Cuenca , Oscar D. Mayo-López , Francisco Javier Ampudia-Blasco , Herminia González-Navarro , Juan F. Ascaso , Ana Bárbara García-García , Felipe Javier Chaves , José T. Real , Sergio Martínez-Hervás","doi":"10.1016/j.arteri.2023.12.005","DOIUrl":"10.1016/j.arteri.2023.12.005","url":null,"abstract":"<div><h3>Background</h3><p>Atherosclerosis is an inflammatory disease. Interleukin 18 (IL-18) is an inflammatory molecule that has been linked to the development of atherosclerosis and cardiovascular disease.</p></div><div><h3>Objective</h3><p>To evaluate the possible relationship between plasma levels of IL-18 and the presence of atherosclerosis evaluated at the carotid level, as well as to analyze the possible modulation by different polymorphisms in a Mediterranean population.</p></div><div><h3>Material and methods</h3><p>Seven hundred and forty-six individuals from the metropolitan area of Valencia were included, recruited over a period of 2 years. Hydrocarbon and lipid metabolism parameters were determined using standard methodology and IL-18 using ELISA. In addition, carotid ultrasound was performed and the genotype of four SNPs related to the IL-18 signaling pathway was analyzed.</p></div><div><h3>Results</h3><p>Patients with higher plasma levels of IL-18 had other associated cardiovascular risk factors. Elevated IL-18 levels were significantly associated with higher carotid IMT and the presence of atheromatous plaques. The genotype with the A allele of the SNP rs2287037 was associated with a higher prevalence of carotid atheromatous plaque. On the contrary, the genotype with the C allele of the SNP rs2293224 was associated with a lower prevalence of atheromatous plaque.</p></div><div><h3>Conclusions</h3><p>High levels of IL-18 were significantly associated with a higher carotid IMT and the presence of atheromatous plaques, which appear to be influenced by genetic factors, as evidenced by associations between SNPs in the IL-18 receptor gene and the presence of atheroma plaque.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433087","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 : 2024-07-01DOI: 10.1016/j.arteri.2024.06.003
Juan F Ascaso
{"title":"Prof. Rafael Carmena Rodríguez","authors":"Juan F Ascaso","doi":"10.1016/j.arteri.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.06.003","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916824000470/pdfft?md5=6630edd5e6f1ce1259d5d554e497d908&pid=1-s2.0-S0214916824000470-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.arteri.2023.12.004
Lourdes Basurto , Leticia Manuel-Apolinar , Ariadna Robledo , Sean O’Leary , Carlos Martínez-Murillo , Lina Ivette Medina-Ortíz , Mario German Montes Osorio , Julio Zarazua , Lourdes Balcázar-Hernández , Juan Carlos Anda-Garay
Objective
To assess thrombotic risk with PAI-1 levels in patients with COVID-19, to evaluate PAI-1 differences between hyperglycemic and/or Type 2 Diabetes Mellitus (T2DM) versus non-hyperglycemic patients, and to analyze the association of plasminogen activator inhibitor-1 (PAI-1) with hyperglycemia and T2DM.
Methods
A cross-sectional study carried out in 181 patients hospitalized for COVID-19. Two groups were formed: the patients with hyperglycemia at admission and/or previously diagnosed T2DM group and the non-hyperglycemic group. Fibrinolysis was assessed by measuring PAI-1 levels by ELISA.
Results
The mean age was 59.4 ± 16.1 years; 55.8% were male 54.1% of patients presented obesity, 38.1% had pre-existing T2DM and 50.8% had admission hyperglycemia and/or pre-existing T2DM. The patients with admission hyperglycemia and/or preexisting T2DM had higher PAI-1 compared with non-hyperglycemic patients [197.5 (128.8–315.9) vs 158.1 (113.4–201.4) ng/mL; p = 0.031]. The glucose levels showed a positive correlation with PAI-1 levels (r = 0.284, p = 0.041). A multivariate logistic regression analysis showed association of PAI-1 level and hyperglycemia and pre-existing T2DM with severity of COVID-19.
Conclusion
Patients hospitalized for COVID-19 infection with preexisting T2DM or hyperglycemia detected during their hospitalization presented a greater increase in PAI-1 levels, which suggests that hyperglycemia contributes directly to the hypercoagulable state and probably a worse outcome from the patients.
{"title":"Thrombotic risk assessed by PAI-1 in patients with COVID-19: The influence of hyperglycemia and diabetes mellitus","authors":"Lourdes Basurto , Leticia Manuel-Apolinar , Ariadna Robledo , Sean O’Leary , Carlos Martínez-Murillo , Lina Ivette Medina-Ortíz , Mario German Montes Osorio , Julio Zarazua , Lourdes Balcázar-Hernández , Juan Carlos Anda-Garay","doi":"10.1016/j.arteri.2023.12.004","DOIUrl":"10.1016/j.arteri.2023.12.004","url":null,"abstract":"<div><h3>Objective</h3><p>To assess thrombotic risk with PAI-1 levels in patients with COVID-19, to evaluate PAI-1 differences between hyperglycemic and/or Type 2 Diabetes Mellitus (T2DM) versus non-hyperglycemic patients, and to analyze the association of plasminogen activator inhibitor-1 (PAI-1) with hyperglycemia and T2DM.</p></div><div><h3>Methods</h3><p>A cross-sectional study carried out in 181 patients hospitalized for COVID-19. Two groups were formed: the patients with hyperglycemia at admission and/or previously diagnosed T2DM group and the non-hyperglycemic group. Fibrinolysis was assessed by measuring PAI-1 levels by ELISA.</p></div><div><h3>Results</h3><p>The mean age was 59.4<!--> <!-->±<!--> <!-->16.1 years; 55.8% were male 54.1% of patients presented obesity, 38.1% had pre-existing T2DM and 50.8% had admission hyperglycemia and/or pre-existing T2DM. The patients with admission hyperglycemia and/or preexisting T2DM had higher PAI-1 compared with non-hyperglycemic patients [197.5 (128.8–315.9) vs 158.1 (113.4–201.4) ng/mL; <em>p</em> <!-->=<!--> <!-->0.031]. The glucose levels showed a positive correlation with PAI-1 levels (<em>r</em> <!-->=<!--> <!-->0.284, <em>p</em> <!-->=<!--> <!-->0.041). A multivariate logistic regression analysis showed association of PAI-1 level and hyperglycemia and pre-existing T2DM with severity of COVID-19.</p></div><div><h3>Conclusion</h3><p>Patients hospitalized for COVID-19 infection with preexisting T2DM or hyperglycemia detected during their hospitalization presented a greater increase in PAI-1 levels, which suggests that hyperglycemia contributes directly to the hypercoagulable state and probably a worse outcome from the patients.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916823001195/pdfft?md5=86b08e9724c54f8fed9aa1ddc260273c&pid=1-s2.0-S0214916823001195-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.arteri.2024.03.002
Javier Delgado-Lista , Jose M. Mostaza , Teresa Arrobas-Velilla , Francisco Blanco-Vaca , Luis Masana , Juan Pedro-Botet , Pablo Perez-Martinez , Fernando Civeira , Jose I. Cuende-Melero , Jose J. Gomez-Barrado , Carlos Lahoz , Xavier Pintó , Manuel Suarez-Tembra , Jose Lopez-Miranda , Carlos Guijarro
The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only iPCSK9 (limited for use because of its cost) significantly reduces Lp(a).
However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).
{"title":"Consenso sobre lipoproteína (a) de la Sociedad Española de Arteriosclerosis. Revisión bibliográfica y recomendaciones para la práctica clínica","authors":"Javier Delgado-Lista , Jose M. Mostaza , Teresa Arrobas-Velilla , Francisco Blanco-Vaca , Luis Masana , Juan Pedro-Botet , Pablo Perez-Martinez , Fernando Civeira , Jose I. Cuende-Melero , Jose J. Gomez-Barrado , Carlos Lahoz , Xavier Pintó , Manuel Suarez-Tembra , Jose Lopez-Miranda , Carlos Guijarro","doi":"10.1016/j.arteri.2024.03.002","DOIUrl":"10.1016/j.arteri.2024.03.002","url":null,"abstract":"<div><p>The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only iPCSK9 (limited for use because of its cost) significantly reduces Lp(a).</p><p>However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916824000238/pdfft?md5=76435180d7cbcd8d281b2b14c374f51e&pid=1-s2.0-S0214916824000238-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-29DOI: 10.1016/j.arteri.2024.04.004
Kung-Hung Lin, Nuria Amigo, Pablo Ortiz, Cristina Alonso, Alexander V Smolensky, Deven Parmar, Naga P Chalasani, Samer Gawrieh
Background and aims: Comprehensive assessment of pharmacotherapy effects on atherogenic parameters (AP) that influence the risk of cardiovascular disease (CVD) is challenging due to interactions among a large number of parameters that modulate CVD risk.
Methods: We developed an illustrative tool, athero-contour (AC), which incorporates weighted key lipid, lipo- and glycoprotein parameters, to readily illustrate their overall changes following pharmacotherapy. We demonstrate the applicability of AC to assess changes in AP in response to saroglitazar treatment in patients with metabolic associated fatty liver disease (MAFLD) in the EVIDENCES IV study.
Results: The baseline AC of saroglitazar and placebo groups was worse than the mean of the general population. After 16-week treatment, AC improved significantly in the saroglitazar group due to alterations in very low-density lipoprotein, triglyceride, and glycoproteins.
Conclusion: Using AC, we could readily and globally evaluate and visualize changes in AP. AC improved in patients with MAFLD following saroglitazar therapy.
背景和目的:全面评估药物治疗对影响心血管疾病(CVD)风险的致动脉粥样硬化参数(AP)的影响具有挑战性,因为调节心血管疾病风险的大量参数之间存在相互作用:方法:我们开发了一种说明性工具--动脉粥样硬化轮廓(AC),它结合了加权的主要血脂、脂质和糖蛋白参数,可方便地说明药物治疗后这些参数的整体变化。我们在 EVIDENCES IV 研究中展示了 AC 的适用性,以评估代谢相关性脂肪肝(MAFLD)患者在接受沙格列扎治疗后 AP 的变化:结果:沙格列扎和安慰剂组的基线血浆浓度比一般人群的平均值低。经过16周的治疗后,由于极低密度脂蛋白、甘油三酯和糖蛋白的改变,沙格列扎尔组的AC明显改善:通过 AC,我们可以轻松、全面地评估和观察 AP 的变化。接受沙格列扎治疗后,MAFLD 患者的 AC 有所改善。
{"title":"The athero-contour: A novel tool for global and rapid assessment of atherogenic parameters. A use case in saroglitazar treatment of MAFLD patients.","authors":"Kung-Hung Lin, Nuria Amigo, Pablo Ortiz, Cristina Alonso, Alexander V Smolensky, Deven Parmar, Naga P Chalasani, Samer Gawrieh","doi":"10.1016/j.arteri.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.04.004","url":null,"abstract":"<p><strong>Background and aims: </strong>Comprehensive assessment of pharmacotherapy effects on atherogenic parameters (AP) that influence the risk of cardiovascular disease (CVD) is challenging due to interactions among a large number of parameters that modulate CVD risk.</p><p><strong>Methods: </strong>We developed an illustrative tool, athero-contour (AC), which incorporates weighted key lipid, lipo- and glycoprotein parameters, to readily illustrate their overall changes following pharmacotherapy. We demonstrate the applicability of AC to assess changes in AP in response to saroglitazar treatment in patients with metabolic associated fatty liver disease (MAFLD) in the EVIDENCES IV study.</p><p><strong>Results: </strong>The baseline AC of saroglitazar and placebo groups was worse than the mean of the general population. After 16-week treatment, AC improved significantly in the saroglitazar group due to alterations in very low-density lipoprotein, triglyceride, and glycoproteins.</p><p><strong>Conclusion: </strong>Using AC, we could readily and globally evaluate and visualize changes in AP. AC improved in patients with MAFLD following saroglitazar therapy.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471476","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 : 2024-06-22DOI: 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
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) (2.8mmHg), higher body weight (BW) (3.7kg), 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","doi":"10.1016/j.arteri.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.05.001","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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) (2.8mmHg), higher body weight (BW) (3.7kg), 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%).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-22","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}
Pub Date : 2024-05-09DOI: 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≥1107.3ng/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":"https://doi.org/10.1016/j.arteri.2024.04.002","url":null,"abstract":"<p><strong>Aim: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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≥1107.3ng/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).</p><p><strong>Conclusion: </strong>Serum levels of sCD163 could be considered a surrogate of cardiovascular risk and clinical activity in RA.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-09","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}