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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}
Pub Date : 2024-01-01DOI: 10.1016/j.arteri.2024.01.001
José Puzo Foncillas
{"title":"Valoración del riesgo aterogénico. ¿Lo podemos mejorar?","authors":"José Puzo Foncillas","doi":"10.1016/j.arteri.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.01.001","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139727248","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.2023.11.002
Francesco Sbrana, Beatrice Dal Pino, Federico Bigazzi, Tiziana Sampietro
“The lower, the better” is the recommended approach in the management of high LDL cholesterol. Unfortunately, this does not always achieve as in the case of a 69-year-old woman referred to our Institute for her lipid profile (LDL cholesterol 412mg/dl), bilateral xanthelasma and cutaneous xanthomas. With a maximized and personalized lipid-lowering therapies (rosuvastatin, ezetimibe, PCSK9i and lipoprotein apheresis), after only six months, the patient showed an impressive regression in her cutaneous xanthomas.
{"title":"Widespread xanthomas regression by personalized lipid lowering therapy in heterozygous familial hypercholesterolemia","authors":"Francesco Sbrana, Beatrice Dal Pino, Federico Bigazzi, Tiziana Sampietro","doi":"10.1016/j.arteri.2023.11.002","DOIUrl":"10.1016/j.arteri.2023.11.002","url":null,"abstract":"<div><p><span>“The lower, the better” is the recommended approach in the management of high LDL cholesterol<span>. Unfortunately, this does not always achieve as in the case of a 69-year-old woman referred to our Institute for her lipid profile (LDL cholesterol 412</span></span> <span>mg/dl), bilateral xanthelasma<span> and cutaneous xanthomas. With a maximized and personalized lipid-lowering therapies (rosuvastatin, ezetimibe, PCSK9i and lipoprotein apheresis), after only six months, the patient showed an impressive regression in her cutaneous xanthomas.</span></span></p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452821","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.2023.07.002
Óscar Fabregat-Andrés , Pilar Pérez-de-Lucía , Victor E. Vallejo-García , Pablo Vera-Ivars , Alfonso A. Valverde-Navarro , José María Tormos
Introduction
Current guidelines recommend cardiovascular risk assessment as a preventive measure for cardiovascular diseases, whose fundamental etiology is arteriosclerosis. One of the tools used to estimate risk in clinical practice are atherogenic indices (AI), ratios between lipid fractions with well-established reference ranges. Despite its widespread use, there is still limited information on its clinical utility. In recent years, some research has reinforced the role of inflammation in the etiology and chronicity of the atherosclerotic process. The inclusion of inflammatory parameters in the AI calculation could improve its diagnostic performance in the detection of arteriosclerosis. We sought to evaluate a new AI as a ratio between C-reactive protein (CRP) values and high-density lipoprotein cholesterol (HDL) values.
Methods
A total of 282 asymptomatic patients with no history of cardiovascular disease were included in the study. Laboratory tests with lipid profile and CRP, and carotid ultrasound to assess the presence of atheromatosis were performed in all of them. The new AI is established as the ratio between non-ultrasensitive CRP value in mg/dL (multiplied by 100) and HDL value in mg/dL. It was compared with the Castelli I and II indices, and the plasma atherogenic index. The optimal cut-off point of the new AI was value = 1 as determined by ROC curve, with an area under the curve of 0.678 (95% CI 0.60-0.75; p < 0.001).
Results
Mean age of patients was 60.4 ± 14.5 years. A total of 118 patients (41.8% of total) had carotid arteriosclerosis. When evaluating the diagnostic performance of different AIs, we found that CRP·100/HDL ratio showed the highest values of sensitivity and positive predictive value (0.73 and 0.68, respectively) compared to the Castelli I and II indices, and the plasma atherogenic index. It was also the only predictor of carotid atheromatosis both when considering its values quantitatively (with OR 1.4 [95% CI 1.1-1.7]; p = 0.005), and qualitatively (with OR 2.9 [95% CI 1.5-5.5]; p < 0.001) in patients with a CRP·100/HDL ratio > 1.
Conclusions
The new PCR·100/HDL index showed the best diagnostic performance in the detection of carotid atheromatosis compared to other classic AIs in this Spanish population of asymptomatic patients.
导言:现行指南建议将心血管风险评估作为心血管疾病的预防措施,而心血管疾病的根本病因是动脉硬化。在临床实践中,用于评估风险的工具之一是致动脉粥样硬化指数(AI),即具有明确参考范围的脂质组分之间的比率。尽管其应用广泛,但有关其临床实用性的信息仍然有限。近年来,一些研究强化了炎症在动脉粥样硬化病因和慢性过程中的作用。将炎症参数纳入 AI 计算可提高其在动脉硬化检测中的诊断性能。我们试图评估一种新的 AI,即 C 反应蛋白(CRP)值与高密度脂蛋白胆固醇(HDL)值之间的比值。研究共纳入 282 名无症状、无心血管疾病史的患者,对他们全部进行了血脂和 CRP 实验室检测,并进行了颈动脉超声检查以评估是否存在动脉粥样硬化。新的 AI 值是以毫克/分升为单位的非超敏 CRP 值(乘以 100)与以毫克/分升为单位的 HDL 值之间的比值。它与卡斯特里 I 和 II 指数以及血浆致动脉粥样硬化指数进行了比较。结果 患者平均年龄为(60.4 ± 14.5)岁。共有 118 名患者(占总数的 41.8%)患有颈动脉硬化。在评估不同 AI 的诊断性能时,我们发现 CRP-100/HDL 比值的敏感性和阳性预测值(分别为 0.73 和 0.68)与 Castelli I 和 II 指数以及血浆致动脉粥样硬化指数相比最高。从定量(OR 1.4 [95% CI 1.1-1.7];P = 0.005)和定性(OR 2.9 [95% CI 1.5-5.5];P < 0.结论在西班牙无症状患者群体中,与其他经典 AI 相比,新的 PCR-100/HDL 指数在检测颈动脉粥样硬化方面显示出最佳诊断性能。
{"title":"Nuevo índice aterogénico para la predicción de aterosclerosis carotídea basado en la ratio proteína C reactiva no ultrasensible/HDL","authors":"Óscar Fabregat-Andrés , Pilar Pérez-de-Lucía , Victor E. Vallejo-García , Pablo Vera-Ivars , Alfonso A. Valverde-Navarro , José María Tormos","doi":"10.1016/j.arteri.2023.07.002","DOIUrl":"10.1016/j.arteri.2023.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Current guidelines recommend cardiovascular risk assessment as a preventive measure for cardiovascular diseases, whose fundamental etiology is arteriosclerosis. One of the tools used to estimate risk in clinical practice are atherogenic indices (AI), ratios between lipid fractions with well-established reference ranges. Despite its widespread use, there is still limited information on its clinical utility. In recent years, some research has reinforced the role of inflammation in the etiology and chronicity of the atherosclerotic process. The inclusion of inflammatory parameters in the AI calculation could improve its diagnostic performance in the detection of arteriosclerosis. We sought to evaluate a new AI as a ratio between C-reactive protein (CRP) values and high-density lipoprotein cholesterol (HDL) values.</p></div><div><h3>Methods</h3><p>A total of 282 asymptomatic patients with no history of cardiovascular disease were included in the study. Laboratory tests with lipid profile and CRP, and carotid ultrasound to assess the presence of atheromatosis were performed in all of them. The new AI is established as the ratio between non-ultrasensitive CRP value in mg/dL (multiplied by 100) and HDL value in mg/dL. It was compared with the Castelli I and II indices, and the plasma atherogenic index. The optimal cut-off point of the new AI was value<!--> <!-->=<!--> <!-->1 as determined by ROC curve, with an area under the curve of 0.678 (95% CI 0.60-0.75; p<!--> <!--><<!--> <!-->0.001).</p></div><div><h3>Results</h3><p>Mean age of patients was 60.4<!--> <!-->±<!--> <!-->14.5 years. A total of 118 patients (41.8% of total) had carotid arteriosclerosis. When evaluating the diagnostic performance of different AIs, we found that CRP·100/HDL ratio showed the highest values of sensitivity and positive predictive value (0.73 and 0.68, respectively) compared to the Castelli I and II indices, and the plasma atherogenic index. It was also the only predictor of carotid atheromatosis both when considering its values quantitatively (with OR 1.4 [95% CI 1.1-1.7]; p<!--> <!-->=<!--> <!-->0.005), and qualitatively (with OR 2.9 [95% CI 1.5-5.5]; p<!--> <!--><<!--> <!-->0.001) in patients with a CRP·100/HDL ratio<!--> <!-->><!--> <!-->1.</p></div><div><h3>Conclusions</h3><p>The new PCR·100/HDL index showed the best diagnostic performance in the detection of carotid atheromatosis compared to other classic AIs in this Spanish population of asymptomatic patients.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10070315","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.2023.08.002
Teresa Gijón-Conde , Carolina Ferré Sánchez , Isabel Ibáñez Delgado , Berenice Rodríguez Jiménez , José R. Banegas
Objective
To examine the frequency of severe hypercholesterolemia (HS) and its clinical profile, and the phenotype of familial hypercholesterolemia (FH), in the primary-care setting in a large health area of the Community of Madrid (CAM).
Material and methods
Multicenter study of subjects with a health card assigned to 69 health centers (Northwest/CAM area). HS was defined as cholesterol ≥ 300 mg/dL or LDL-cholesterol ≥ 220 mg/dL in any analysis performed (1-1-2018 to 12-30-2021); and FH phenotype as c-LDL ≥ 240 mg/dL (≥ 160 mg/dL if lipid-lowering treatment) with triglycerides < 200 mg/dL and TSH < 5 μIU/mL.
Results
156,082 adults ≥ 18 years with an available lipid profile were analyzed. 6187 subjects had HS (3.96% of the laboratory tests studied, 95% CI: 3.87-4.06%). The mean evolution time of the diagnosis of hyperlipidemia in the computerized clinical record was 10.8 years, 36.5% had hypertension, 9.5% diabetes and 62.9% overweight/obesity. 83.7% were taking lipid-lowering drugs (65.7% low/moderate and 28.6% high/very high intensity). 6.1% had cardiovascular disease (94.2% treated with lipid-lowering agents), with LDL-cholesterol < 55, < 70 and < 100 mg/dL of 1.8%, 5.8% and 20.2%, respectively (vs. 1%, 2.3% and 11.2% if no cardiovascular disease). 1600 subjects had FH phenotype (95% CI: 1.03%, 0.98-1.08%).
Conclusions
Four out of 100 patients analyzed in primary care have HS, with high treatment level, but insufficient intensity, and poor achievement of treatment goals. One in 100 have the FH phenotype. The identification of both dyslipidemias by computerized records would allow their more precise and early detection and establish cardiovascular preventive strategies.
{"title":"Perfil clínico de la hipercolesterolemia severa en 156.000 adultos en atención primaria","authors":"Teresa Gijón-Conde , Carolina Ferré Sánchez , Isabel Ibáñez Delgado , Berenice Rodríguez Jiménez , José R. Banegas","doi":"10.1016/j.arteri.2023.08.002","DOIUrl":"10.1016/j.arteri.2023.08.002","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the frequency of severe hypercholesterolemia (HS) and its clinical profile, and the phenotype of familial hypercholesterolemia (FH), in the primary-care setting in a large health area of the Community of Madrid (CAM).</p></div><div><h3>Material and methods</h3><p>Multicenter study of subjects with a health card assigned to 69 health centers (Northwest/CAM area). HS was defined as cholesterol ≥<!--> <!-->300<!--> <!-->mg/dL or LDL-cholesterol ≥<!--> <!-->220<!--> <!-->mg/dL in any analysis performed (1-1-2018 to 12-30-2021); and FH phenotype as c-LDL ≥<!--> <!-->240<!--> <!-->mg/dL (≥<!--> <!-->160<!--> <!-->mg/dL if lipid-lowering treatment) with triglycerides <<!--> <!-->200<!--> <!-->mg/dL and TSH <<!--> <!-->5<!--> <!-->μIU/mL.</p></div><div><h3>Results</h3><p>156,082 adults ≥<!--> <!-->18<!--> <!-->years with an available lipid profile were analyzed. 6187 subjects had HS (3.96% of the laboratory tests studied, 95%<!--> <!-->CI: 3.87-4.06%). The mean evolution time of the diagnosis of hyperlipidemia in the computerized clinical record was 10.8<!--> <!-->years, 36.5% had hypertension, 9.5% diabetes and 62.9% overweight/obesity. 83.7% were taking lipid-lowering drugs (65.7% low/moderate and 28.6% high/very high intensity). 6.1% had cardiovascular disease (94.2% treated with lipid-lowering agents), with LDL-cholesterol <<!--> <!-->55, <<!--> <!-->70 and <<!--> <!-->100<!--> <!-->mg/dL of 1.8%, 5.8% and 20.2%, respectively (vs. 1%, 2.3% and 11.2% if no cardiovascular disease). 1600 subjects had FH phenotype (95%<!--> <!-->CI: 1.03%, 0.98-1.08%).</p></div><div><h3>Conclusions</h3><p>Four out of 100 patients analyzed in primary care have HS, with high treatment level, but insufficient intensity, and poor achievement of treatment goals. One in 100 have the FH phenotype. The identification of both dyslipidemias by computerized records would allow their more precise and early detection and establish cardiovascular preventive strategies.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139487","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.2023.08.001
J. Ildefonzo Arocha Rodulfo , Gestne Aure Fariñez , Fernando Carrera
Objectives
Sleep disturbances, including disrupted sleep and short sleep duration, are highly prevalent and are prospectively associated with an increased risk for various chronic diseases, including cardiometabolic, neurodegenerative, and autoimmune diseases.
Material and methods
This is a narrative review of the literature based on numerous articles published in peer-reviewed journals since the beginning of this century.
Results
The relationship between sleep disorders and metabolic dysregulation has been clearly established, mainly in the setting of modern epidemic of cardiometabolic disease, a cluster of conditions include obesity, insulin resistance, arterial hypertension, and dyslipidaemia, all of them considered as main risk factor for atherosclerotic cardiovascular disease (ACVD) and its clinical expression such as ischemic ictus, myocardial infarction and type 2 diabetes. Clinically viable tools to measure sleep duration and quality are needed for routine screening and intervention.
Conclusions
In view of what has been exposed in this review, it is evident that the timing, amount, and quality of sleep are critical to reduce the burden of risk factors for several chronic disease, including ACVD and type 2 diabetes, and most relevant in young people. Future research studies should elucidate the effectiveness of multimodal interventions to counteract the risk of short sleep for optimal patient outcomes across the healthcare continuum, especially in young people.
{"title":"Sueño y riesgo cardiometabólico. Revisión narrativa","authors":"J. Ildefonzo Arocha Rodulfo , Gestne Aure Fariñez , Fernando Carrera","doi":"10.1016/j.arteri.2023.08.001","DOIUrl":"10.1016/j.arteri.2023.08.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Sleep disturbances, including disrupted sleep and short sleep duration, are highly prevalent and are prospectively associated with an increased risk for various chronic diseases, including cardiometabolic, neurodegenerative, and autoimmune diseases.</p></div><div><h3>Material and methods</h3><p>This is a narrative review of the literature based on numerous articles published in peer-reviewed journals since the beginning of this century.</p></div><div><h3>Results</h3><p>The relationship between sleep disorders and metabolic dysregulation has been clearly established, mainly in the setting of modern epidemic of cardiometabolic disease, a cluster of conditions include obesity, insulin resistance, arterial hypertension, and dyslipidaemia, all of them considered as main risk factor for atherosclerotic cardiovascular disease (ACVD) and its clinical expression such as ischemic ictus, myocardial infarction and type 2 diabetes. Clinically viable tools to measure sleep duration and quality are needed for routine screening and intervention.</p></div><div><h3>Conclusions</h3><p>In view of what has been exposed in this review, it is evident that the timing, amount, and quality of sleep are critical to reduce the burden of risk factors for several chronic disease, including ACVD and type 2 diabetes, and most relevant in young people. Future research studies should elucidate the effectiveness of multimodal interventions to counteract the risk of short sleep for optimal patient outcomes across the healthcare continuum, especially in young people.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212080","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}