Pub Date : 2024-05-01DOI: 10.1016/j.arteri.2023.11.004
Lídia Puertas-Umbert , Judith Alonso , Elena Roselló-Díez , Alicia Santamaría-Orleans , José Martínez-González , Cristina Rodríguez
Introduction
Cyclic nucleotide phosphodiesterases (PDEs) of the PDE4 subfamily are responsible for the hydrolysis and subcellular compartmentalization of cAMP, a second messenger that modulates vascular functionality. We had shown that PDE4B is induced in abdominal aortic aneurysms (AAA) and that PDE4 inhibition by rolipram limits experimental aneurysms. In this study we have delved into the mechanisms underlying the beneficial effect of rolipram on AAA.
Methods
AAA were induced in ApoE-/− mice by angiotensin II (Ang II) infusion. Aneurysm formation was evaluated by ultrasonography. The expression of enzymes involved in rédox homeostasis was analyzed by real-time RT-PCR and the activation of signaling pathways by Western blot.
Results
Induction of PDE4B in human AAA has been confirmed in a second cohort of patients. In Ang II-infused ApoE-/− mice, rolipram increased the percentage of animals free of aneurysms without affecting the percentage of aortic ruptures. Quantitative analyses determined that this drug significantly attenuated aortic collagen deposition. Additionally, rolipram reduced the increased Nox2 expression triggered by Ang II, exacerbated Sod1 induction, and normalized Sod3 expression. Likewise, PDE4 inhibition decreased the activation of both ERK1/2 and the canonical Wnt pathway, while AKT activity was not altered.
Conclusions
The inhibition of PDE4 activity modulates the expression of enzymes involved in rédox homeostasis and affects cell signaling pathways involved in the development of AAA.
导言:PDE4 亚家族的环核苷酸磷酸二酯酶 (PDE) 负责 cAMP 的水解和亚细胞区划,cAMP 是调节血管功能的第二信使。我们已经证明,腹主动脉瘤(AAA)会诱发 PDE4B,而罗立普仑对 PDE4 的抑制可限制实验性动脉瘤的发生。在本研究中,我们深入探讨了罗利普兰对 AAA 有利影响的机制:方法:输注血管紧张素 II(Ang II)诱导载脂蛋白E-/-小鼠发生 AAA。通过超声波检查评估动脉瘤的形成。通过实时 RT-PCR 分析了参与 rédox 平衡的酶的表达,并通过 Western 印迹分析了信号通路的激活情况:结果:在第二批患者中证实了 PDE4B 在人类 AAA 中的诱导作用。在注入血管紧张素 II 的载脂蛋白E-/-小鼠中,罗利普仑增加了无动脉瘤动物的比例,但不影响主动脉破裂的比例。定量分析确定,这种药物能显著减少主动脉胶原沉积。此外,罗利普仑还能减少 Ang II 引发的 Nox2 表达增加,加剧 Sod1 诱导,并使 Sod3 表达正常化。同样,PDE4抑制也减少了ERK1/2和典型Wnt通路的激活,而AKT活性没有改变:结论:抑制PDE4的活性可调节参与rédox平衡的酶的表达,并影响参与AAA发生的细胞信号通路。
{"title":"Impacto del tratamiento con rolipram sobre la homeostasis rédox y la señalización celular en un modelo experimental de aneurisma de aorta abdominal","authors":"Lídia Puertas-Umbert , Judith Alonso , Elena Roselló-Díez , Alicia Santamaría-Orleans , José Martínez-González , Cristina Rodríguez","doi":"10.1016/j.arteri.2023.11.004","DOIUrl":"10.1016/j.arteri.2023.11.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Cyclic nucleotide phosphodiesterases (PDEs) of the PDE4 subfamily are responsible for the hydrolysis and subcellular compartmentalization of cAMP, a second messenger that modulates vascular functionality. We had shown that PDE4B is induced in abdominal aortic aneurysms (AAA) and that PDE4 inhibition by rolipram limits experimental aneurysms. In this study we have delved into the mechanisms underlying the beneficial effect of rolipram on AAA.</p></div><div><h3>Methods</h3><p>AAA were induced in ApoE<sup>-/−</sup> mice by angiotensin II (Ang II) infusion. Aneurysm formation was evaluated by ultrasonography. The expression of enzymes involved in rédox homeostasis was analyzed by real-time RT-PCR and the activation of signaling pathways by Western blot.</p></div><div><h3>Results</h3><p>Induction of PDE4B in human AAA has been confirmed in a second cohort of patients. In Ang II-infused ApoE<sup>-/−</sup> mice, rolipram increased the percentage of animals free of aneurysms without affecting the percentage of aortic ruptures. Quantitative analyses determined that this drug significantly attenuated aortic collagen deposition. Additionally, rolipram reduced the increased <em>Nox2</em> expression triggered by Ang II, exacerbated Sod1 induction, and normalized Sod3 expression. Likewise, PDE4 inhibition decreased the activation of both ERK1/2 and the canonical Wnt pathway, while AKT activity was not altered.</p></div><div><h3>Conclusions</h3><p>The inhibition of PDE4 activity modulates the expression of enzymes involved in rédox homeostasis and affects cell signaling pathways involved in the development of AAA.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 108-117"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811748","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 : 2024-05-01DOI: 10.1016/j.arteri.2023.12.003
Carlos Fernández-Labandera Ramos , Irene Moral , Carlos Brotons , Luis Quevedo Aguado , Inmaculada Coca Prieto , Pedro Valdivielso , Miguel Ángel Sánchez Chaparro
Background
This study aimed to validate the IberScore cardiovascular risk model in a population attended in the primary care setting.
Methods
A cohort of patients with no history of cardiovascular disease visited in a primary care center during the years 2008 and/or 2009 and followed up until 2018 was selected.
Cardiovascular risk was calculated with the IberScore formula for all the subjects of the cohort and the model was calibrated, graphically represented by risk deciles the proportion of expected events and proportion of observed events at 10-year follow-up, stratified by sex. The area under the ROC curve was calculated to assess the discrimination of the model.
Results
A total of 10,085 patients visited during the years 2008 and/or 2009 were included in the study. Men showed a mean 10-year risk of suffering a fatal or non-fatal cardiovascular events according to IberScore of 17.07% (SD 20.13), with a mean estimated vascular age of more than 4 years higher than the biological age; while women had a mean 10-year risk of 7.91% (SD 9.03), with an estimated vascular age of more than 2 years above the biological age.
The area under the ROC curve showed a discrimination index of the model of 0.86 (95% CI 0.84–0.88) in men and 0.82 (95% CI 0.79–0.85) in women.
Conclusion
IberScore model discriminates well in the population attended in primary care but the model overestimates the risk.
{"title":"Validation of the IberScore model in a primary care population","authors":"Carlos Fernández-Labandera Ramos , Irene Moral , Carlos Brotons , Luis Quevedo Aguado , Inmaculada Coca Prieto , Pedro Valdivielso , Miguel Ángel Sánchez Chaparro","doi":"10.1016/j.arteri.2023.12.003","DOIUrl":"10.1016/j.arteri.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to validate the IberScore cardiovascular risk model in a population attended in the primary care setting.</p></div><div><h3>Methods</h3><p>A cohort of patients with no history of cardiovascular disease visited in a primary care center during the years 2008 and/or 2009 and followed up until 2018 was selected.</p><p>Cardiovascular risk was calculated with the IberScore formula for all the subjects of the cohort and the model was calibrated, graphically represented by risk deciles the proportion of expected events and proportion of observed events at 10-year follow-up, stratified by sex. The area under the ROC curve was calculated to assess the discrimination of the model.</p></div><div><h3>Results</h3><p>A total of 10,085 patients visited during the years 2008 and/or 2009 were included in the study. Men showed a mean 10-year risk of suffering a fatal or non-fatal cardiovascular events according to IberScore of 17.07% (SD 20.13), with a mean estimated vascular age of more than 4 years higher than the biological age; while women had a mean 10-year risk of 7.91% (SD 9.03), with an estimated vascular age of more than 2 years above the biological age.</p><p>The area under the ROC curve showed a discrimination index of the model of 0.86 (95% CI 0.84–0.88) in men and 0.82 (95% CI 0.79–0.85) in women.</p></div><div><h3>Conclusion</h3><p>IberScore model discriminates well in the population attended in primary care but the model overestimates the risk.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 101-107"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467316","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 : 2024-05-01DOI: 10.1016/j.arteri.2024.03.003
Manuel Frías Vargas , Estíbaliz Jarauta
Cardiovascular disease secondary to atherosclerosis is the main cause of morbidity and mortality in the world. Cardiovascular risk stratification has proven to be an insufficient approach to detect those subjects who are going to suffer a cardiovascular event, which is why for years other markers have been sought to help stratify each individual with greater precision. Two-dimensional vascular ultrasound is a excellent method for vascular risk assessment.
{"title":"Detección de aterosclerosis subclínica mediante ecografía vascular como método de evaluación de riesgo vascular. Protocolo simplificado","authors":"Manuel Frías Vargas , Estíbaliz Jarauta","doi":"10.1016/j.arteri.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.03.003","url":null,"abstract":"<div><p>Cardiovascular disease secondary to atherosclerosis is the main cause of morbidity and mortality in the world. Cardiovascular risk stratification has proven to be an insufficient approach to detect those subjects who are going to suffer a cardiovascular event, which is why for years other markers have been sought to help stratify each individual with greater precision. Two-dimensional vascular ultrasound is a excellent method for vascular risk assessment.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 3","pages":"Pages 195-199"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021491682400024X/pdfft?md5=917950dabec97cbd32281a780d5c2767&pid=1-s2.0-S021491682400024X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824104","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 : 2024-03-01DOI: 10.1016/j.arteri.2023.10.003
Sergio Martínez-Hervás , José T. Real , Rafael Carmena , Juan F. Ascaso
Diabetes, especially type 2, is considered a risk situation for atherosclerotic cardiovascular disease (ASCVD). Subjects with diabetes type 2 have a mortality rate due to ASCVD 3 times higher than that found in the general population, attributed to hyperglycemia and the frequent association of other cardiovascular risk factors, such as atherogenic dyslipidemia.
Numerous scientific societies have established a risk classification for ASCVD in diabetes based on 3 degrees (moderate, high and very high). The objectives of dyslipidemia control are clearly defined and accepted, and vary depending on the previously established cardiovascular risk.
In moderate or intermediate risk, the guidelines propose a less intensive intervention, maintaining LDL-C levels < 100 mg/dL and NO-HDL-C levels < 130 mg/dL, and waiting 10 years until reaching the high-risk category to initiate more intensive treatment. However, during the decade of follow-up recommended in the guidelines, cholesterol deposition in the arterial wall increases, facilitating the development of an unstable and inflammatory atheromatous plaque, and the development of ASCVD. Alternatively, diabetes could be considered from the outset to be a high-risk situation and the goal should be LDL-C < 70 mg/dL. Furthermore, maintaining LDL-C levels < 70 mg/dL contributes to reducing and stabilizing atheromatous plaque, avoiding or reducing mortality episodes due to ASCVD during those years of diabetes evolution.
Should we maintain the proposed objectives in subjects with diabetes and moderate risk for a decade until reaching the high cardiovascular risk phase or, on the contrary, should we adopt a more intensive stance from the beginning seeking to reduce cardiovascular risk in the majority of patients with diabetes? Is it better to wait or prevent with effective therapeutic measures from the first moment?
{"title":"Prevención cardiovascular en la diabetes mellitus. ¿Es adecuado hablar de riesgo moderado o intermedio?","authors":"Sergio Martínez-Hervás , José T. Real , Rafael Carmena , Juan F. Ascaso","doi":"10.1016/j.arteri.2023.10.003","DOIUrl":"10.1016/j.arteri.2023.10.003","url":null,"abstract":"<div><p>Diabetes, especially type 2, is considered a risk situation for atherosclerotic cardiovascular disease (ASCVD). Subjects with diabetes type 2 have a mortality rate due to ASCVD 3 times higher than that found in the general population, attributed to hyperglycemia and the frequent association of other cardiovascular risk factors, such as atherogenic dyslipidemia.</p><p>Numerous scientific societies have established a risk classification for ASCVD in diabetes based on 3 degrees (moderate, high and very high). The objectives of dyslipidemia control are clearly defined and accepted, and vary depending on the previously established cardiovascular risk.</p><p>In moderate or intermediate risk, the guidelines propose a less intensive intervention, maintaining LDL-C levels<!--> <!--><<!--> <!-->100<!--> <!-->mg/dL and NO-HDL-C levels<!--> <!--><<!--> <!-->130<!--> <!-->mg/dL, and waiting 10 years until reaching the high-risk category to initiate more intensive treatment. However, during the decade of follow-up recommended in the guidelines, cholesterol deposition in the arterial wall increases, facilitating the development of an unstable and inflammatory atheromatous plaque, and the development of ASCVD. Alternatively, diabetes could be considered from the outset to be a high-risk situation and the goal should be LDL-C<!--> <!--><<!--> <!-->70<!--> <!-->mg/dL. Furthermore, maintaining LDL-C levels<!--> <!--><<!--> <!-->70<!--> <!-->mg/dL contributes to reducing and stabilizing atheromatous plaque, avoiding or reducing mortality episodes due to ASCVD during those years of diabetes evolution.</p><p>Should we maintain the proposed objectives in subjects with diabetes and moderate risk for a decade until reaching the high cardiovascular risk phase or, on the contrary, should we adopt a more intensive stance from the beginning seeking to reduce cardiovascular risk in the majority of patients with diabetes? Is it better to wait or prevent with effective therapeutic measures from the first moment?</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 80-85"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916823000979/pdfft?md5=6e42c0294316edb14f35e06619bd47a5&pid=1-s2.0-S0214916823000979-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048164","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}
Multiple systematic reviews (SR) have been performed on the effects of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), often providing conflicting findings. This overview and network meta-analysis (NMA) aimed to summarize SR findings on the efficacy and safety of PCSK9i and provide an updated NMA.
Materials and methods
MEDLINE (Pubmed), Scopus, Cochrane, Epistemonikos and Google Scholar were searched from inception to September 21, 2023 for SRs of randomized controlled trials (RCTs) and from January 1, 2020 to September 21, 2023 for additional RCTs. Double-independent study selection, data extraction and quality assessment were performed. Qualitative analysis was performed for SRs and a frequentist random-effects model NMA was performed for RCTs.
Results
Totally, 86 SRs and 76 RCTs were included. Alirocumab (77/86 [90%]) and evolocumab (73/86 [85%]) were mostly analyzed. Associations from SRs (35/42 [83%]) and the updated NMA indicated PCSK9i benefit on major adverse cardiovascular events (MACEs). Reductions were also noted for cerebrovascular events (47/66 [71%]), coronary revascularization (29/33 [88%]) and myocardial infarction (41/63 [65%]). Alirocumab was associated with reductions on all-cause mortality (RR = 0.82, 95%CI [0.72,0.94]). Data on any CV event reduction were conflicting (7/16 [44%]). Inclisiran appeared effective only on MACEs (RR = 0.76, 95%CI [0.61,0.94]). No reductions in heart failure were observed (0/16). No increases were identified between PCSK9i and any (0/35) or serious adverse events (0/52). However, PCSK9i were associated with injection-site reactions (20/28 [71%]).
Conclusion
PCSK9i appeared to be effective in CV outcomes and their clinical application was generally safe.
{"title":"Effectiveness and safety of injectable PCSK9 inhibitors in dyslipidaemias’ treatment and cardiovascular disease prevention: An overview of 86 systematic reviews and a network metaanalysis","authors":"Konstantinos Pamporis , Paschalis Karakasis , Spyridon Simantiris , Marios Sagris , Konstantinos I. Bougioukas , Nikolaos Fragakis , Dimitrios Tousoulis","doi":"10.1016/j.arteri.2023.11.003","DOIUrl":"10.1016/j.arteri.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><p>Multiple systematic reviews (SR) have been performed on the effects of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), often providing conflicting findings. This overview and network meta-analysis (NMA) aimed to summarize SR<span> findings on the efficacy and safety of PCSK9i and provide an updated NMA.</span></p></div><div><h3>Materials and methods</h3><p>MEDLINE (Pubmed), Scopus, Cochrane, Epistemonikos and Google Scholar were searched from inception to September 21, 2023 for SRs of randomized controlled trials (RCTs) and from January 1, 2020 to September 21, 2023 for additional RCTs. Double-independent study selection, data extraction and quality assessment were performed. Qualitative analysis was performed for SRs and a frequentist random-effects model NMA was performed for RCTs.</p></div><div><h3>Results</h3><p><span><span>Totally, 86 SRs and 76 RCTs were included. Alirocumab (77/86 [90%]) and </span>evolocumab<span> (73/86 [85%]) were mostly analyzed. Associations from SRs (35/42 [83%]) and the updated NMA indicated PCSK9i benefit on major adverse cardiovascular events (MACEs). Reductions were also noted for cerebrovascular events (47/66 [71%]), coronary revascularization (29/33 [88%]) and myocardial infarction (41/63 [65%]). Alirocumab was associated with reductions on all-cause mortality (RR</span></span> <!-->=<!--> <span>0.82, 95%CI [0.72,0.94]). Data on any CV event reduction were conflicting (7/16 [44%]). Inclisiran appeared effective only on MACEs (RR</span> <!-->=<!--> <span>0.76, 95%CI [0.61,0.94]). No reductions in heart failure were observed (0/16). No increases were identified between PCSK9i<span> and any (0/35) or serious adverse events (0/52). However, PCSK9i were associated with injection-site reactions (20/28 [71%]).</span></span></p></div><div><h3>Conclusion</h3><p>PCSK9i appeared to be effective in CV outcomes and their clinical application was generally safe.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 86-100"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470964","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 : 2024-03-01DOI: 10.1016/j.arteri.2023.09.002
Osman Başpinar , Ayça Elibol , Derya Koçer , Turgut Tursem Tokmak , Serkan Doğan , Oğuzhan Sıtkı Dizdar
Background
The aim of this study was to investigate presence of subclinical atherosclerosis by measuring carotid intima-media thickness (CIMT) in patients with Helicobacter pylori (HP) and to assess effects of HP on atherosclerosis by evaluating markers of atherosclerosis and blood growth differentiation factor (GDF-15) levels.
Materials and methods
This cross-sectional study included 59 patients without comorbid disease who had HP and 30 healthy controls without HP in upper endoscopic biopsy. In order to assess atherosclerosis, the CIMT measurement was performed by sonography. Serum GDF-15 level was measured by ELISA method. In all patients, atherosclerosis markers were recorded. Atherogenic indices were calculated, including Castelli risk index I and II (TG/HDL-c and LDL-c/HDL-c, respectively), plasma atherogenic index (PAI; log TG/HDL-c), non-HDL-c (TH-HDL-c) and atherogenic coefficient (AC; non-HDL-HDL-c).
Results
The GDF-15 level and CIMT were significantly higher in HP-positive group when compared to HP-negative group (p ≤ 0.001). There was a significant correlation between serum GDF-15 level and CIMT (r = 0.445; p ≤ 0.001). There was no correlation between other atherosclerosis markers and serum GDF-15 level or CIMT. The bacterial intensity on endoscopic specimen was only correlated with CIMT (p < 0.001). Vitamin B12 and D levels were comparable among groups.
Conclusion
This study suggested that there was a correlation between GDF-15 level and subclinical atherosclerosis development in patients with HP. However, GDF-15 level, which was found to be elevated while atherogenic indices were normal, can be an earlier marker for subclinical atherosclerosis.
{"title":"Evaluation of the relationship between atherosclerosis and Helicobacter pylori infection with measurement of growth differentiation factor 15 and atherosclerosis indicators in adults with no comorbidity","authors":"Osman Başpinar , Ayça Elibol , Derya Koçer , Turgut Tursem Tokmak , Serkan Doğan , Oğuzhan Sıtkı Dizdar","doi":"10.1016/j.arteri.2023.09.002","DOIUrl":"10.1016/j.arteri.2023.09.002","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to investigate presence of subclinical atherosclerosis by measuring carotid intima-media thickness (CIMT) in patients with <span><span>Helicobacter pylori</span></span><span> (HP) and to assess effects of HP on atherosclerosis by evaluating markers of atherosclerosis and blood growth differentiation factor (GDF-15) levels.</span></p></div><div><h3>Materials and methods</h3><p>This cross-sectional study included 59 patients without comorbid disease who had HP and 30 healthy controls without HP in upper endoscopic biopsy. In order to assess atherosclerosis, the CIMT measurement was performed by sonography. Serum GDF-15 level was measured by ELISA method. In all patients, atherosclerosis markers were recorded. Atherogenic indices were calculated, including Castelli risk index I and II (TG/HDL-c and LDL-c/HDL-c, respectively), plasma atherogenic index (PAI; log TG/HDL-c), non-HDL-c (TH-HDL-c) and atherogenic coefficient (AC; non-HDL-HDL-c).</p></div><div><h3>Results</h3><p>The GDF-15 level and CIMT were significantly higher in HP-positive group when compared to HP-negative group (<em>p</em> <!-->≤<!--> <!-->0.001). There was a significant correlation between serum GDF-15 level and CIMT (<em>r</em> <!-->=<!--> <!-->0.445; <em>p</em> <!-->≤<!--> <!-->0.001). There was no correlation between other atherosclerosis markers and serum GDF-15 level or CIMT. The bacterial intensity on endoscopic specimen was only correlated with CIMT (<em>p</em> <!--><<!--> <!-->0.001). Vitamin B12 and D levels were comparable among groups.</p></div><div><h3>Conclusion</h3><p>This study suggested that there was a correlation between GDF-15 level and subclinical atherosclerosis development in patients with HP. However, GDF-15 level, which was found to be elevated while atherogenic indices were normal, can be an earlier marker for subclinical atherosclerosis.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 51-59"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683446","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 : 2024-03-01DOI: 10.1016/j.arteri.2023.11.005
Victoria Marco-Benedí , Ana Cenarro , Martín Laclaustra , Pilar Calmarza , Ana M. Bea , Àlex Vila , Carlos Morillas-Ariño , José Puzo , Juan Diego Mediavilla Garcia , Amalia Inmaculada Fernández Alamán , Manuel Suárez Tembra , Fernando Civeira
Background
Recently, an inverse relationship between the blood concentration of lipoprotein(a) (Lp(a)) and triglycerides (TG) has been demonstrated. The larger the VLDL particle size, the greater the presence of VLDL rich in apoliprotein E and in subjects with the apoE2/E2 genotype, the lower Lp(a) concentration. The mechanism of this inverse association is unknown. The objective of this analysis was to evaluate the Lp(a)–TG association in patients treated at the lipid units included in the registry of the Spanish Society of Atherosclerosis (SEA) by comparing the different dyslipidemias.
Patients and methods
Five thousand two hundred and seventy-five subjects ≥18 years of age registered in the registry before March 31, 2023, with Lp(a) concentration data and complete lipid profile information without treatment were included.
Results
The mean age was 53.0 ± 14.0 years, with 48% women. The 9.5% of subjects (n = 502) had diabetes and the 22.4% (n = 1184) were obese. The median TG level was 130 mg/dL (IQR 88.0–210) and Lp(a) 55.0 nmol/L (IQR 17.9–156). Lp(a) concentration showed a negative association with TG concentration when TG values exceeded 300 mg/dL. Subjects with TG > 1000 mg/dL showed the lowest level of Lp(a), 17.9 nmol/L, and subjects with TG < 300 mg/dL had a mean Lp(a) concentration of 60.1 nmol/L. In subjects without diabetes or obesity, the inverse association of Lp(a)–TG was especially important (p < 0.001). The median Lp(a) was 58.3 nmol/L in those with TG < 300 mg/dL and 22.0 nmol/L if TG > 1000 mg/dL. No association was found between TG and Lp(a) in subjects with diabetes and obesity, nor in subjects with familial hypercholesterolemia. In subjects with multifactorial combined hyperlipemia with TG < 300 mg/dL, Lp(a) was 64.6 nmol/L; in the range of 300–399 mg/dL of TG, Lp(a) decreased to 38. 8 nmol/L, and up to 22.3 nmol/L when TG > 1000 mg/dL.
Conclusions
Our results show an inverse Lp(a)–TG relationship in TG concentrations > 300 mg/dL in subjects without diabetes, obesity and without familial hypercholesterolemia. Our results suggest that, in those hypertriglyceridemias due to hepatic overproduction of VLDL, the formation of Lp(a) is reduced, unlike those in which the peripheral catabolism of TG-rich lipoproteins is reduced.
{"title":"Influencia de la concentración de triglicéridos en la lipoproteína(a) en función de la dislipidemia","authors":"Victoria Marco-Benedí , Ana Cenarro , Martín Laclaustra , Pilar Calmarza , Ana M. Bea , Àlex Vila , Carlos Morillas-Ariño , José Puzo , Juan Diego Mediavilla Garcia , Amalia Inmaculada Fernández Alamán , Manuel Suárez Tembra , Fernando Civeira","doi":"10.1016/j.arteri.2023.11.005","DOIUrl":"10.1016/j.arteri.2023.11.005","url":null,"abstract":"<div><h3>Background</h3><p>Recently, an inverse relationship between the blood concentration of lipoprotein(a) (Lp(a)) and triglycerides (TG) has been demonstrated. The larger the VLDL particle size, the greater the presence of VLDL rich in apoliprotein E and in subjects with the apoE2/E2 genotype, the lower Lp(a) concentration. The mechanism of this inverse association is unknown. The objective of this analysis was to evaluate the Lp(a)–TG association in patients treated at the lipid units included in the registry of the Spanish Society of Atherosclerosis (SEA) by comparing the different dyslipidemias.</p></div><div><h3>Patients and methods</h3><p>Five thousand two hundred and seventy-five subjects ≥18 years of age registered in the registry before March 31, 2023, with Lp(a) concentration data and complete lipid profile information without treatment were included.</p></div><div><h3>Results</h3><p>The mean age was 53.0 ± 14.0 years, with 48% women. The 9.5% of subjects (<em>n</em> = 502) had diabetes and the 22.4% (<em>n</em> = 1184) were obese. The median TG level was 130 mg/dL (IQR 88.0–210) and Lp(a) 55.0 nmol/L (IQR 17.9–156). Lp(a) concentration showed a negative association with TG concentration when TG values exceeded 300 mg/dL. Subjects with TG > 1000 mg/dL showed the lowest level of Lp(a), 17.9 nmol/L, and subjects with TG < 300 mg/dL had a mean Lp(a) concentration of 60.1 nmol/L. In subjects without diabetes or obesity, the inverse association of Lp(a)–TG was especially important (<em>p</em> < 0.001). The median Lp(a) was 58.3 nmol/L in those with TG < 300 mg/dL and 22.0 nmol/L if TG > 1000 mg/dL. No association was found between TG and Lp(a) in subjects with diabetes and obesity, nor in subjects with familial hypercholesterolemia. In subjects with multifactorial combined hyperlipemia with TG < 300 mg/dL, Lp(a) was 64.6 nmol/L; in the range of 300–399 mg/dL of TG, Lp(a) decreased to 38. 8 nmol/L, and up to 22.3 nmol/L when TG > 1000 mg/dL.</p></div><div><h3>Conclusions</h3><p>Our results show an inverse Lp(a)–TG relationship in TG concentrations > 300 mg/dL in subjects without diabetes, obesity and without familial hypercholesterolemia. Our results suggest that, in those hypertriglyceridemias due to hepatic overproduction of VLDL, the formation of Lp(a) is reduced, unlike those in which the peripheral catabolism of TG-rich lipoproteins is reduced.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 71-77"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075418","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 : 2024-03-01DOI: 10.1016/j.arteri.2024.02.002
Manuel Vázquez-Carrera
{"title":"Is Helicobacter pylori a new kid on the block?","authors":"Manuel Vázquez-Carrera","doi":"10.1016/j.arteri.2024.02.002","DOIUrl":"10.1016/j.arteri.2024.02.002","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 78-79"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916824000184/pdfft?md5=b84713e5c43be2a88e62f50a1aa2b3e1&pid=1-s2.0-S0214916824000184-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944537","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 : 2024-03-01DOI: 10.1016/j.arteri.2023.10.001
Oyesanmi A. Fabunmi , Phiwayinkosi V. Dludla , Bongani B. Nkambule
Background
Combined oral contraceptives (COCs), use in individuals are associated with increased risk of thrombotic events. This highlights the significance of assessing the impact of COC on promoting coagulation and endothelial activation in high-fat diet (HFD)-fed Sprague Dawley rats.
Methods
Twenty (20) five-weeks-old female Sprague Dawley rats weighing between 150 and 200 g were subjected to both LFD and HFD-feeding for 8-weeks to determine its influence on basic metabolic status, hemostatic profile, hemodynamic parameters (blood pressure and heart rate), as well as selected biomarkers of coagulation (tissue factor and D-dimer) and endothelial activation (Von Willebrand factor and nitric oxide). Thereafter HFD-fed animals were treated with receive high dose combined oral contraceptive (HCOC) and low dose combine oral contraceptive (LCOC) for 6 weeks.
Results
Our results showed that beyond weight gain, HFD-feeding was associated with hyperglycemia, increased mean arterial pressure, and reduced nitric oxide levels when compared with LFD group (p < 0.05). Interestingly, treatment with high dose of COC for 6-weeks did not significantly alter atherothrombotic markers (p > 0.05). However, this study is not without limitation as regulation of these markers remains to be confirmed within the cardiac tissues or endothelial cells of these animals.
Conclusion
HFD-feeding orchestrate the concomitant release of pro-coagulants and endothelial activation markers in rats leading to haemostatic imbalance and endothelial dysfunction. Short-term treatment with COC shows no detrimental effects in these HFD-fed rats. Although in terms of clinical relevance, our findings depict the notion that the risk of CVD in association with COC may depend on the dosage and duration of use among other factors especially in certain conditions. However, additional studies are required to confirm these findings, especially long-term effects of this treatment within the cardiac tissues or endothelial cells of these animals in certain conditions relating to postmenopausal state.
{"title":"High-fat diet promotes coagulation and endothelial activation in Sprague Dawley rats: Short-term effects of combined oral contraceptives","authors":"Oyesanmi A. Fabunmi , Phiwayinkosi V. Dludla , Bongani B. Nkambule","doi":"10.1016/j.arteri.2023.10.001","DOIUrl":"10.1016/j.arteri.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Combined oral contraceptives (COCs), use in individuals are associated with increased risk of thrombotic events. This highlights the significance of assessing the impact of COC on promoting coagulation and endothelial activation in high-fat diet (HFD)-fed Sprague Dawley rats.</p></div><div><h3>Methods</h3><p>Twenty (20) five-weeks-old female Sprague Dawley rats weighing between 150 and 200<!--> <!-->g were subjected to both LFD and HFD-feeding for 8-weeks to determine its influence on basic metabolic status, hemostatic profile, hemodynamic parameters (blood pressure and heart rate), as well as selected biomarkers of coagulation (tissue factor and D-dimer) and endothelial activation (Von Willebrand factor and nitric oxide). Thereafter HFD-fed animals were treated with receive high dose combined oral contraceptive (HCOC) and low dose combine oral contraceptive (LCOC) for 6 weeks.</p></div><div><h3>Results</h3><p>Our results showed that beyond weight gain, HFD-feeding was associated with hyperglycemia, increased mean arterial pressure, and reduced nitric oxide levels when compared with LFD group (<em>p</em> <!--><<!--> <!-->0.05). Interestingly, treatment with high dose of COC for 6-weeks did not significantly alter atherothrombotic markers (<em>p</em> <!-->><!--> <!-->0.05). However, this study is not without limitation as regulation of these markers remains to be confirmed within the cardiac tissues or endothelial cells of these animals.</p></div><div><h3>Conclusion</h3><p>HFD-feeding orchestrate the concomitant release of pro-coagulants and endothelial activation markers in rats leading to haemostatic imbalance and endothelial dysfunction. Short-term treatment with COC shows no detrimental effects in these HFD-fed rats. Although in terms of clinical relevance, our findings depict the notion that the risk of CVD in association with COC may depend on the dosage and duration of use among other factors especially in certain conditions. However, additional studies are required to confirm these findings, especially long-term effects of this treatment within the cardiac tissues or endothelial cells of these animals in certain conditions relating to postmenopausal state.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 60-70"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211170","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 : 2024-01-01DOI: 10.1016/j.arteri.2023.06.001
Heidy M. Roncancio , Julián R. Lugo-Peña , Ángel A. García , Janeth Leal , Carlos A. Hoyos , Johnny A. Beltrán , César L. Cruz , Carol Paez-Cano , Mariana Pineda-Posada , Eduardo Contreras
Background
Cardiovascular disease (CVD) represents the primary cause of death and disability globally, with elevated cholesterol as one of the leading risk factors for CVD. We describe the clinical characteristics, treatment patterns, and effectiveness of evolocumab in treating hyperlipidemia.
Methods
Observational study conducted through a chart review of patients with hyperlipidemia receiving evolocumab as part of clinical management in Colombia.
Results
This study included 115 patients treated with evolocumab. A total of 101 patients (87.8%) had a history of CVD, 13 (11.3%) familial hypercholesterolemia (FH), and 23 (20%) type 2 diabetes. Thirty-nine patients reported intolerance to any statin (33.9%). The median value of LDL-C before initiation of evolocumab was 147 mg/dL (IQR: 122.5–183.7 mg/dL). Within the first 3 months of treatment, LDL-C value dropped to a median value of 53 mg/dL (IQR: 34.0–95.5 mg/dL), showing a reduction of 63.9%. The median LDL-C values remained below 45 mg/dL until the end of follow-up. Among the patients with available data, up to 61% achieved an LDL-C level below 55 mg/dL at the 10–12-month follow-up. A total of 72% of patients were persistent with treatment. Safety results showed a low frequency of hospitalizations (≤2%) and treatment-emergent adverse drug reactions (5.2%). No serious adverse events were reported.
Conclusions
Evolocumab was associated with reductions in LDL-C levels, with a relative decrease of 63.9% within the first 3 months of treatment. Low rates of interruptions due to adverse events and adequate medication persistence was reported.
{"title":"Multizonal observational study conducted by clinical practitioners on Repatha® use in patients with hyperlipidemia (ZERBINI): Colombian results","authors":"Heidy M. Roncancio , Julián R. Lugo-Peña , Ángel A. García , Janeth Leal , Carlos A. Hoyos , Johnny A. Beltrán , César L. Cruz , Carol Paez-Cano , Mariana Pineda-Posada , Eduardo Contreras","doi":"10.1016/j.arteri.2023.06.001","DOIUrl":"10.1016/j.arteri.2023.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular disease (CVD) represents the primary cause of death and disability globally, with elevated cholesterol as one of the leading risk factors for CVD. We describe the clinical characteristics, treatment patterns, and effectiveness of evolocumab in treating hyperlipidemia.</p></div><div><h3>Methods</h3><p>Observational study conducted through a chart review of patients with hyperlipidemia receiving evolocumab as part of clinical management in Colombia.</p></div><div><h3>Results</h3><p>This study included 115 patients treated with evolocumab. A total of 101 patients (87.8%) had a history of CVD, 13 (11.3%) familial hypercholesterolemia (FH), and 23 (20%) type 2 diabetes. Thirty-nine patients reported intolerance to any statin (33.9%). The median value of LDL-C before initiation of evolocumab was 147<!--> <!-->mg/dL (IQR: 122.5–183.7<!--> <!-->mg/dL). Within the first 3 months of treatment, LDL-C value dropped to a median value of 53<!--> <!-->mg/dL (IQR: 34.0–95.5<!--> <!-->mg/dL), showing a reduction of 63.9%. The median LDL-C values remained below 45<!--> <!-->mg/dL until the end of follow-up. Among the patients with available data, up to 61% achieved an LDL-C level below 55<!--> <!-->mg/dL at the 10–12-month follow-up. A total of 72% of patients were persistent with treatment. Safety results showed a low frequency of hospitalizations (≤2%) and treatment-emergent adverse drug reactions (5.2%). No serious adverse events were reported.</p></div><div><h3>Conclusions</h3><p>Evolocumab was associated with reductions in LDL-C levels, with a relative decrease of 63.9% within the first 3 months of treatment. Low rates of interruptions due to adverse events and adequate medication persistence was reported.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 1","pages":"Pages 22-32"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916823000517/pdfft?md5=6ea6bc5dc42de8e64538f70e91a0cee9&pid=1-s2.0-S0214916823000517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776691","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}