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}
Pub Date : 2024-05-08DOI: 10.1016/j.arteri.2024.03.007
Irene San Sebastián-Jaraba, María José Fernández-Gómez, Rafael Blázquez-Serra, Sandra Sanz-Andrea, Luis Miguel Blanco-Colio, Nerea Méndez-Barbero
Pathological vascular remodeling of the vessel wall refers to the structural and functional changes of the vessel wall that occur in response to injury that eventually leads to cardiovascular disease. The vessel wall is composed of two main types of cells, endothelial cells and vascular smooth muscle cells, whose communication is crucial in both the development of the vasculature and the homeostasis of mature vessels. Changes in the dialogue between endothelial cells and vascular smooth muscle cells are associated with various pathological states that triggers remodeling of the vascular wall. For many years, considerable efforts have been made to develop effective diagnoses and treatments for these pathologies by studying their mechanisms in both in vitro and in vivo models. Compared to animal models, in vitro models can provide great opportunities to obtain data in a more homogeneous, economical and massive way, providing an overview of the signaling pathways responsible for these pathologies. The implementation of three-dimensional in vitro co-culture models for the study of other pathologies has been postulated as a potentially applicable methodology, which determines the importance of its application in studies of cardiovascular diseases. In this article we present a method for culturing human endothelial cells and vascular smooth muscle cells, grown under non-adherent conditions, that generate three-dimensional spheroidal structures with greater physiological equivalence to in vivo conditions. This in vitro modeling could be used as a study tool to identify cellular and molecular mechanisms involved in the pathological processes underlying vascular remodeling.
{"title":"In vitro 3D co-culture model of human endothelial and smooth muscle cells to study pathological vascular remodeling.","authors":"Irene San Sebastián-Jaraba, María José Fernández-Gómez, Rafael Blázquez-Serra, Sandra Sanz-Andrea, Luis Miguel Blanco-Colio, Nerea Méndez-Barbero","doi":"10.1016/j.arteri.2024.03.007","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.03.007","url":null,"abstract":"<p><p>Pathological vascular remodeling of the vessel wall refers to the structural and functional changes of the vessel wall that occur in response to injury that eventually leads to cardiovascular disease. The vessel wall is composed of two main types of cells, endothelial cells and vascular smooth muscle cells, whose communication is crucial in both the development of the vasculature and the homeostasis of mature vessels. Changes in the dialogue between endothelial cells and vascular smooth muscle cells are associated with various pathological states that triggers remodeling of the vascular wall. For many years, considerable efforts have been made to develop effective diagnoses and treatments for these pathologies by studying their mechanisms in both in vitro and in vivo models. Compared to animal models, in vitro models can provide great opportunities to obtain data in a more homogeneous, economical and massive way, providing an overview of the signaling pathways responsible for these pathologies. The implementation of three-dimensional in vitro co-culture models for the study of other pathologies has been postulated as a potentially applicable methodology, which determines the importance of its application in studies of cardiovascular diseases. In this article we present a method for culturing human endothelial cells and vascular smooth muscle cells, grown under non-adherent conditions, that generate three-dimensional spheroidal structures with greater physiological equivalence to in vivo conditions. This in vitro modeling could be used as a study tool to identify cellular and molecular mechanisms involved in the pathological processes underlying vascular remodeling.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898853","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 : 2024-05-06DOI: 10.1016/j.arteri.2024.03.006
José A Páramo, Ana Cenarro, Fernando Civeira, Carmen Roncal
Atherosclerosis is the main pathogenic substrate for cardiovascular diseases (CVDs). Initially categorized as a passive cholesterol storage disease, nowadays, it is considered an active process, identifying inflammation among the key players for its initiation and progression. Despite these advances, patients with CVDs are still at high risk of thrombotic events and death, urging to deepen into the molecular mechanisms underlying atherogenesis, and to identify novel diagnosis and prognosis biomarkers for their stratification. In this context, extracellular vesicles (EVs) have been postulated as an alternative in search of novel biomarkers in atherosclerotic diseases, as well as to investigate the crosstalk between the cells participating in the processes leading to arterial remodelling. EVs are nanosized lipidic particles released by most cell types in physiological and pathological conditions, that enclose lipids, proteins, and nucleic acids from parental cells reflecting their activation status. First considered cellular waste disposal systems, at present, EVs have been recognized as active effectors in a myriad of cellular processes, and as potential diagnosis and prognosis biomarkers also in CVDs. This review summarizes the role of EVs as potential biomarkers of CVDs, and their involvement into the processes leading to atherosclerosis.
{"title":"Extracellular vesicles in atherosclerosis: Current and forthcoming impact?","authors":"José A Páramo, Ana Cenarro, Fernando Civeira, Carmen Roncal","doi":"10.1016/j.arteri.2024.03.006","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.03.006","url":null,"abstract":"<p><p>Atherosclerosis is the main pathogenic substrate for cardiovascular diseases (CVDs). Initially categorized as a passive cholesterol storage disease, nowadays, it is considered an active process, identifying inflammation among the key players for its initiation and progression. Despite these advances, patients with CVDs are still at high risk of thrombotic events and death, urging to deepen into the molecular mechanisms underlying atherogenesis, and to identify novel diagnosis and prognosis biomarkers for their stratification. In this context, extracellular vesicles (EVs) have been postulated as an alternative in search of novel biomarkers in atherosclerotic diseases, as well as to investigate the crosstalk between the cells participating in the processes leading to arterial remodelling. EVs are nanosized lipidic particles released by most cell types in physiological and pathological conditions, that enclose lipids, proteins, and nucleic acids from parental cells reflecting their activation status. First considered cellular waste disposal systems, at present, EVs have been recognized as active effectors in a myriad of cellular processes, and as potential diagnosis and prognosis biomarkers also in CVDs. This review summarizes the role of EVs as potential biomarkers of CVDs, and their involvement into the processes leading to atherosclerosis.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877622","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 : 2024-05-02DOI: 10.1016/j.arteri.2024.03.005
Javier Espíldora-Hernández, Tania Díaz-Antonio, Jesús Olmedo-Llanes, Jesús Zarzuela León, José Rioja, Pedro Valdivielso, Miguel Ángel Sánchez-Chaparro, María José Ariza
Introduction and objectives: The association between HDL cholesterol (HDL-C) levels and death from cardiovascular disease follows a U-shaped pattern, increasing at the extremes. The objective of the study was to characterize a sample of subjects with extreme hyperalphalipoproteinemia (HAE).
Material and methods: 53 cases with HAE were recruited, 24 women (HDL-C>135mg/ dL) and 29 men (HDL-C>116mg/ dL). A detailed medical history was taken and questionnaires on adherence to the Mediterranean diet and physical activity were collected. Carotid ultrasounds were performed to detect the presence of suclinical atherosclerosis.
Results: The most prevalent cardiovascular risk factor (CVRF) was dyslipidemia (64%) with no significant differences between men and women, unlike hypertension (21% in women, versus 55% in men, p=0.01) and others CVRF, for example, diabetes. 7% of the series had previous cardiovascular disease, women had higher LDL cholesterol (p=0.002) and HDL-C than men (without significant differences). Plaque was detected in 53% of cases, being more prevalent in men. Patients with plaque were older, drank more alcohol and smoked more (p<0.05).
Conclusions: Men had a higher prevalence of CVRF than women, except for dyslipidemia. Subclinical atherosclerosis occurred in more than half of the series. Age, alcohol consumption and smoking were independently associated with the presence of plaque, however, our data do not show a significant influence of HDL-C levels.
{"title":"Clinical characterization and detection of subclinical atherosclerosis in subjects with extreme hyperalphalipoproteinemia.","authors":"Javier Espíldora-Hernández, Tania Díaz-Antonio, Jesús Olmedo-Llanes, Jesús Zarzuela León, José Rioja, Pedro Valdivielso, Miguel Ángel Sánchez-Chaparro, María José Ariza","doi":"10.1016/j.arteri.2024.03.005","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.03.005","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The association between HDL cholesterol (HDL-C) levels and death from cardiovascular disease follows a U-shaped pattern, increasing at the extremes. The objective of the study was to characterize a sample of subjects with extreme hyperalphalipoproteinemia (HAE).</p><p><strong>Material and methods: </strong>53 cases with HAE were recruited, 24 women (HDL-C>135mg/ dL) and 29 men (HDL-C>116mg/ dL). A detailed medical history was taken and questionnaires on adherence to the Mediterranean diet and physical activity were collected. Carotid ultrasounds were performed to detect the presence of suclinical atherosclerosis.</p><p><strong>Results: </strong>The most prevalent cardiovascular risk factor (CVRF) was dyslipidemia (64%) with no significant differences between men and women, unlike hypertension (21% in women, versus 55% in men, p=0.01) and others CVRF, for example, diabetes. 7% of the series had previous cardiovascular disease, women had higher LDL cholesterol (p=0.002) and HDL-C than men (without significant differences). Plaque was detected in 53% of cases, being more prevalent in men. Patients with plaque were older, drank more alcohol and smoked more (p<0.05).</p><p><strong>Conclusions: </strong>Men had a higher prevalence of CVRF than women, except for dyslipidemia. Subclinical atherosclerosis occurred in more than half of the series. Age, alcohol consumption and smoking were independently associated with the presence of plaque, however, our data do not show a significant influence of HDL-C levels.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868402","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}