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Chang HT, Chan PC, Chiu PY. Non-linear relationship between serum cholesterol levels and cognitive change among older people in the preclinical and prodromal stages of dementia: a retrospective longitudinal study in Taiwan. BMC Geriatr 2024; 24:474. [PMID: 38816835 PMCID: PMC11138028 DOI: 10.1186/s12877-024-05030-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Adverse effects of rigorously lowering low-density lipoprotein cholesterol on cognition have been reported; therefore, we aimed to study the contribution of serum cholesterol in cognitive decline in older people with or without dementia. METHODS Cognitive function was assessed by the Cognitive Abilities Screening Instrument (CASI). We investigated associations between serum cholesterol with cognitive decline using multiple regressions controlling for the effects of demographics, vascular risk factors, and treatments. RESULTS Most associations between cholesterol and CASI scores could be explained by non-linear and inverted U-shaped relationships (R2 = 0.003-0.006, p < 0.016, Šidákcorrection). The relationships were most evident between changes in cholesterol and CASI scores in older people at the preclinical or prodromal stages of dementia (R2 = 0.02-0.064, p values < 0.016). There were no differences in level of changes in CASI scores between individuals in 1st decile and 10th decile groups of changes in cholesterol (p = 0.266-0.972). However, individuals in the 1st decile of triglyceride changes and with stable and normal cognitive functions showed significant improvement in CASI scores compared to those in the 10th decile (t(202) = 2.275, p values < 0.05). CONCLUSION These findings could implicate that rigorously lowering cholesterol may not be suitable for the prevention of cognitive decline among older people, especially among individuals in preclinical or prodromal stages of dementia.
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Affiliation(s)
- Hsin-Te Chang
- Department of Psychology, College of Science, Chung Yuan Christian University, Taoyuan, Taiwan
- Research Assistant Center, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan
| | - Po-Chi Chan
- Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan.
- Department of Applied Mathematics, College of Science, Tunghai University, Taichung, Taiwan.
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Russo V, Napolitano N, Ascrizzi A, Leonardi S, Pisacane F, Di Micco P, Imbalzano E, Sasso FC, D’Andrea A, Caturano A, Mauriello A. The Lipid-Lowering Efficacy of a Nutraceutical Combination Including Leucoselect Phytosome, Red Yeast Rice, Policosanol and Folic Acid in Dyslipidaemia Patients: Real-World Insights. Pharmaceuticals (Basel) 2024; 17:447. [PMID: 38675408 PMCID: PMC11053596 DOI: 10.3390/ph17040447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Cardiovascular disease is a global health concern and reducing plasma LDL-C levels is a major goal in cardiovascular prevention. Our study aimed to evaluate the effectiveness of a nutraceutical formulation including leucoselect® phytosome®, red yeast rice, policosanol and folic acid on LDL-c levels in patients at low cardiovascular risk with dyslipidemia. MATERIALS AND METHODS We prospectively enrolled all consecutive patients with dyslipidemia at low cardiovascular risk who were unresponsive to diet and physical activity. Clinical assessments and laboratory analyses, encompassing lipid profile, hepatic function, and CPK levels, were performed at baseline prior to initiating treatment and repeated at the 12-week mark following administration of the study nutraceutical. RESULTS Sixty (60) consecutive patients (mean age 48.02 ± 10.1 years; 60% male) were included. At the 12-week follow-up, a statistically significant reduction in Total Cholesterol (13.1%) and LDL-c serum level (20.4%) was observed. Hepatic and muscular function remain stable over the time. The adherence to therapy was 99% and the persistence was maximum. CONCLUSIONS The nutraceutical formulation including leucoselect® phytosome® red yeast rice, policosanol and folic acid significantly reduced the LDL-c plasma levels, consistent with previous research showing that the bioactive component in red yeast rice-lovastatin-is effective in addressing problems with lipid metabolism. Importantly, it was safe and well-tolerated among patients with dyslipidemia in a real-world setting.
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Affiliation(s)
- Vincenzo Russo
- Cardiology Unit, Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (N.N.); (A.A.); (A.M.)
| | - Nicola Napolitano
- Cardiology Unit, Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (N.N.); (A.A.); (A.M.)
| | - Antonia Ascrizzi
- Cardiology Unit, Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (N.N.); (A.A.); (A.M.)
| | - Silvia Leonardi
- Clinical Biochemistry Unit, Monaldi Hospital, 80131 Naples, Italy
| | | | - Pierpaolo Di Micco
- Department of Medicine, Presidio Ospedaliero Santa Maria delle Grazie, 80078 Pozzuoli, Italy;
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy (A.C.)
| | - Antonello D’Andrea
- Department of Cardiology, Umberto I Hospital, 84014 Nocera Inferiore, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy (A.C.)
| | - Alfredo Mauriello
- Cardiology Unit, Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy; (N.N.); (A.A.); (A.M.)
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy (A.C.)
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Hosseinpour‐Niazi S, Afaghi S, Hadaegh P, Mahdavi M, Farhadnejad H, Tohidi M, Mirmiran P, Azizi F, Hadaegh F. The association between metabolic syndrome and insulin resistance with risk of cardiovascular events in different states of cardiovascular health status. J Diabetes Investig 2024; 15:208-218. [PMID: 37873675 PMCID: PMC10804926 DOI: 10.1111/jdi.14101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023] Open
Abstract
AIMS/INTRODUCTION The aim was to examine the joint effect of metabolic syndrome (MetS) and insulin resistance (IR) with ideal cardiovascular health (iCVH) status on incident cardiovascular diseases (CVDs). MATERIALS AND METHODS The study included 6,240 Iranian adults ≥30 years, free of prior cardiovascular disease. Ideal cardiovascular health was determined based on American Heart Association's Life Simple 7. Metabolic syndrome was defined according to the Joint Interim Statement Criteria, and insulin resistance was defined as HOMA-IR ≥1.85 in women and ≥2.17 in men. Multivariable Cox proportional hazard ratios (HRs) were applied to examine the impact of metabolic syndrome, and insulin resistance at various levels of iCVH status. RESULTS During the median follow-up of 14.0 years, 909 cases of cardiovascular disease occurred. Metabolic syndrome and insulin resistance were significantly associated with incident cardiovascular disease events. In the poor and intermediate status, metabolic syndrome increased cardiovascular disease events with HRs of 1.83 and 1.57, respectively; the corresponding values for insulin resistance in the mentioned categories were 1.91 and 1.25, respectively (P values < 0.05). In the intermediate and poor iCVH status, hypertriglyceridemia was linked to a 40% and 35% higher risk of cardiovascular disease, the corresponding values for low HDL-C was 20% and 60%, respectively (P values < 0.05). Although adding metabolic syndrome, its dyslipidemia and insulin resistance to iCVH status in both poor and intermediate status significantly improve the prediction of cardiovascular disease using net reclassification improvement (P values < 0.05), the value of C-index did not change. CONCLUSIONS Metabolic syndrome and the dyslipidemia component had a negligible but significant improvement in the prediction of cardiovascular disease among individuals with non-optimal iCVH status.
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Affiliation(s)
- Somayeh Hosseinpour‐Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Siamak Afaghi
- Department of Internal Medicine, Shahid Modarres HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Parto Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Hossein Farhadnejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
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Buchmann N, Landmesser U, Sinning D. Der koronarkranke Diabetiker: moderne Therapieansätze und Behandlungspfade. AKTUELLE KARDIOLOGIE 2023. [DOI: 10.1055/a-1968-7779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
ZusammenfassungPatienten mit koronarer Herzerkrankung (KHK) und Diabetes mellitus Typ 2 (T2D) weisen ein besonders hohes Risiko für (rezidivierende) kardiovaskuläre Ereignisse (CVE) auf; in der
Sekundärprävention wirkt sich eine suffiziente Kontrolle der kardiovaskulären Risikofaktoren prognostisch besonders günstig aus. Für diese Patientengruppe konnte in den letzten Jahren der
kardioprotektive Nutzen der SGLT2-Inhibitoren und GLP-1-Rezeptor-Agonisten nachgewiesen werden, sodass diese Substanzgruppen mittlerweile bei der Initiierung einer medikamentösen
antidiabetischen Therapie zu bevorzugen sind. Auch lipidmodifizierende Medikamente wie die PCSK9-Inhibitoren oder Icosapent-Ethyl haben sich insbesondere bei Patienten mit KHK und T2D als
vorteilhaft erwiesen. Zudem haben sich zuletzt die Empfehlungen zum Management der Koronarrevaskularisation bei Patienten mit stabiler KHK und T2D verändert. So sollte bei Mehrgefäß-KHK und
komplexer Koronarmorphologie zwar weiterhin eine chirurgische Koronarrevaskularisation (CABG) bevorzugt empfohlen werden; bei einem niedrigen SYNTAX-Score kann die interventionelle
Koronarrevaskularisation jedoch eine gleichwertige Alternative zur CABG darstellen.
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Wan Ahmad WA, Rosman A, Bavanandan S, Mohamed M, Kader MASA, Muthusamy TS, Lam KH, Kasim SS, Hoo FK, Fegade M, Looi ZL, Rahman ARA. Current Insights on Dyslipidaemia Management for Prevention of Atherosclerotic Cardiovascular Disease: A Malaysian Perspective. Malays J Med Sci 2023; 30:67-81. [PMID: 36875188 PMCID: PMC9984111 DOI: 10.21315/mjms2023.30.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/01/2022] [Indexed: 03/05/2023] Open
Abstract
Dyslipidaemia is highly prevalent in the Malaysian population and is one of the main risk factors for atherosclerotic cardiovascular disease (ASCVD). Low-density lipoprotein cholesterol (LDL-C) is recognised as the primary target of lipid-lowering therapy to reduce the disease burden of ASCVD. Framingham General CV Risk Score has been validated in the Malaysian population for CV risk assessment. The Clinical Practice Guidelines (CPG) on the management of dyslipidaemia were last updated in 2017. Since its publication, several newer randomised clinical trials have been conducted with their results published in research articles and compared in meta-analysis. This underscores a need to update the previous guidelines to ensure good quality care and treatment for the patients. This review summarises the benefits of achieving LDL-C levels lower than the currently recommended target of < 1.8mmol/L without any safety concerns. In most high and very high-risk individuals, statins are the first line of therapy for dyslipidaemia management. However, certain high-risk individuals are not able to achieve the LDL-C goal as recommended in the guideline even with high-intensity statin therapy. In such individuals, lower LDL-C levels can be achieved by combining the statins with non-statin agents such as ezetimibe and PCSK9 inhibitors. Emerging non-statin lipid-lowering therapies and challenges in dyslipidaemia management are discussed in this article. The review also summarises the recent updates on local and international guidelines for dyslipidaemia management.
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Affiliation(s)
- Wan Azman Wan Ahmad
- Department of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Azhari Rosman
- Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
| | - Sunita Bavanandan
- Department of Nephrology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Mafauzy Mohamed
- Department of Endocrinology, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | | | | | - Kai Huat Lam
- Cardiology, Assunta Hospital, Selangor, Malaysia
| | - Sazzli Shahlan Kasim
- Faculty of Medicine, Cardiac Vascular and Lung Research Institute, Universiti Teknologi MARA, Selangor, Malaysia
| | - Fan Kee Hoo
- Department of Medicine, Faculty of Medicine, University Putra Malaysia, Selangor, Malaysia
| | - Mayuresh Fegade
- Novartis Corporation (Malaysia) Sdn. Bhd., Selangor, Malaysia
| | - Zhi Ling Looi
- Novartis Corporation (Malaysia) Sdn. Bhd., Selangor, Malaysia
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de Souza NMP, Machado BH, Koche A, da Silva Furtado LBF, Becker D, Corbellini VA, Rieger A. Discrimination of dyslipidemia types with ATR-FTIR spectroscopy and chemometrics associated with multivariate analysis of the lipid profile, anthropometric, and pro-inflammatory biomarkers. Clin Chim Acta 2023; 540:117231. [PMID: 36682440 DOI: 10.1016/j.cca.2023.117231] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/20/2022] [Accepted: 01/13/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Obesity, dyslipidemia, and low-grade inflammatory state form a triad of self-sustaining metabolic dysfunction. Attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy is a simple, rapid, and non-destructive technique that generates spectral fingerprints of biomolecules that can be correlated with metabolic changes. We verified the efficiency of ATR-FTIR spectroscopy in blood plasma (n = 74) to discriminate the types of dyslipidemias and suggest metabolic inflammatory changes. METHODS Principal Component Analysis (PCA) was performed on the biochemical and anthropometric data to verify whether the dyslipidemia types share a similar biochemical profile plausible of discrimination in chemometric modeling. To discriminate the types of dyslipidemias based on spectral data, Orthogonal Partial Least-Squares Discriminant Analysis (OPLS-DA) was used and validated with leave-one-out cross-validation. RESULTS Although no significant difference was obtained between the types of dyslipidemia and normal subjects by CRP, leptin, and cfDNA, there was a significant difference between normal subjects vs combined hyperlipidemia (CH) + hypercholesterolemia (HCL) + hypertriglyceridemia (HTG) (p < 0.05) by the 1245 cm-1 peak [νas(PO2-)] (possible indication of chronic inflammation by increased cfDNA). The area under the curve of the region between 1770 and 1720 cm-1 was significantly increased for CH in relation to other dyslipidemias and normal subjects. Furthermore, there were significant differences for the main representative peaks of lipids, proteins, carbohydrates, and nucleic acids between the types of dyslipidemias and between the types of dyslipidemias and normal subjects. The OPLS-DA model achieved 100 % accuracy with 1 latent variable and Standard Error of Cross-Validation (SECV) < 0.004 for all types of dyslipidemia and the control group. CONCLUSIONS Our results suggest that ATR-FTIR spectroscopy associated with chemometric modeling is a plausible applicant for screening the types of dyslipidemias. However, more extensive studies should be conducted to verify the real applicability in clinical analysis laboratories or medical clinics.
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Affiliation(s)
| | - Brenda Hunter Machado
- International Affairs, International University Centre, Santa Cruz do Sul, RS, Brazil
| | - Andreia Koche
- Department of Life Sciences, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | | | - Débora Becker
- Bachelor of Biological Sciences, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Valeriano Antonio Corbellini
- Department of Sciences, Humanities and, Education, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil; Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil; Postgraduate Program in Environmental Technology, University of Santa Cruz do Sul, RS, Brazil
| | - Alexandre Rieger
- Department of Life Sciences, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil; Postgraduate Program in Health Promotion, University of Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil; Postgraduate Program in Environmental Technology, University of Santa Cruz do Sul, RS, Brazil
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The impact of the PCSK-9/VLDL-Receptor axis on inflammatory cell polarization. Cytokine 2023; 161:156077. [PMID: 36356495 DOI: 10.1016/j.cyto.2022.156077] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Studies have shown that lipoproteins, such as LDL and VLDL, as well as its major protein component ApoE2 impact on macrophage polarization important in atherosclerosis. Proprotein convertase subtilisin/kexin 9 (PCSK9) is a key regulator of lipoprotein receptor expression. The present study investigated the effect of the VLDL/VLDL-receptor (VLDL-R) axis on mononuclear cell polarization, as well as the role of PCSK9 and PCSK9 inhibitors (PCSK9i) within this network. METHODS Human monocytic THP-1 cells and human monocyte-derived macrophages isolated from peripheral blood mononuclear cells (PBMC) were treated with either LPS/IFN-γ to induce a pro-inflammatory phenotype, or with IL-4/IL-13 to induce an anti-inflammatory phenotype. Cells were then subjected to further treatments by lipoproteins, PCSK9, PCSK9i and lipoprotein receptor blockers. RESULTS LPS/IFN-γ treatment promoted a pro-inflammatory state with an increased expression of pro-inflammatory mediators such as TNF-α, CD80 and IL-1β. VLDL co-treatment induced a switch of this pro-inflammatory phenotype to an anti-inflammatory phenotype. In pro-inflammatory cells, VLDL significantly decreased the expression of pro-inflammatory markers e.g., TNF-α, CD80, and IL-1β. These effects were eliminated by PCSK9 and restored by co-incubation with a specific anti-PCSK9 monoclonal antibody (PCSK9i). Migration assays demonstrated that pro-inflammatory cells displayed a significantly higher invasive capacity when compared to untreated cells or anti-inflammatory cells. Moreover, pro-inflammatory cell chemotaxis was significantly decreased by VLDL-mediated acquisition of the anti-inflammatory phenotype. PCSK9 significantly lessened this VLDL-mediated migration inhibition, which was reversed by the PCSK9i. CONCLUSION VLDL promotes mononuclear cell differentiation towards an anti-inflammatory phenotype. PCSK9, via its capacity to inhibit VLDL-R expression, reverses the VLDL-mediated anti-inflammatory action, thereby promoting a pro-inflammatory phenotype. Thus, PCSK9 targeting therapies may exert anti-inflammatory properties within the vessel wall.
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Shaikh K, Ahmed A, Gransar H, Lee J, Leipsic J, Nakanishi R, Alla V, Bax JJ, Chow BJW, Berman DS, Maffei E, Lin FY, Ahmad A, DeLago A, Pontone G, Feuchtner G, Marques H, Min JK, Hausleiter J, Hadamitzky M, Kaufmann PA, de Araújo Gonçalves P, Cury RC, Kim YJ, Chang HJ, Rubinshtein R, Villines TC, Lu Y, Shaw LJ, Acenbach S, Al Mallah MH, Andreini D, Cademartiri F, Callister TQ, Budoff MJ. Extent of subclinical atherosclerosis on coronary computed tomography and impact of statins in patients with diabetes without known coronary artery disease: Results from CONFIRM registry. J Diabetes Complications 2022; 36:108309. [PMID: 36444796 DOI: 10.1016/j.jdiacomp.2022.108309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 09/06/2022] [Accepted: 09/13/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Absence of subclinical atherosclerosis is considered safe to defer statin therapy in general population. However, impact of statins on atherosclerotic cardiovascular disease in patients with diabetes stratified by coronary artery calcium (CAC) scores and extent of non-obstructive CAD on coronary computed tomography angiography (CCTA) has not been evaluated. METHODS CONFIRM (Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multi-center Registry) study enrolled consecutive adults 18 years of age between 2005 and 2009 who underwent 364-detector row CCTA for suspected CAD. The long-term registry includes data on 12,086 subjects who underwent CCTA at 17 centers in 9 countries. In this sub-study of CONFIRM registry, patients with diabetes mellitus (DM) and without diabetes mellitus with normal CCTA or non-obstructive plaque (<50 % diameter stenosis) for whom data on baseline statin use was available were included. CAC score was calculated using Agatston score. The magnitude of non-obstructive coronary artery disease on CCTA was quantified using segment involvement score (SIS). Primary outcome was major cardiovascular events (MACE) which included all-cause mortality, myocardial infarction, and target vessel re-vascularization. RESULTS A total of 7247 patients (Mean age 56.8 years) with a median follow up of 5 years were included. For DM patients, baseline statin therapy significantly reduced MACE for patients with CAC ≥100 (HR: 0.24; 95 % CI 0.07-0.87; p = 0.03) and SIS≥3 (HR: 0.23; 95 % CI 0.06-0.83; p = 0.024) compared to those not on statin therapy. Among Diabetics with lower CAC (<100) and SIS (≤3) scores, MACE was similar in statin and non-statin groups. In contrast, among non-DM patients, MACE was similar in statin and no statin groups irrespective of baseline CAC (1-99 or ≥100) and SIS. CONCLUSION In this large multicenter cohort of patients, the presence and extent of subclinical atherosclerosis as assessed by CAC and SIS identified patients most likely to derive benefit from statin therapy.
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Affiliation(s)
- Kashif Shaikh
- Lundquist Institute of Biomedical Sciences at Harbor-UCLA Medical Center, USA; University of Tennessee, Department of Medicine, Division of Cardiology, Knoxville, USA.
| | - Arslan Ahmed
- Creighton University Department of Medicine, Division of Cardiology, USA
| | - Heidi Gransar
- Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - JuHwan Lee
- CHA University Gumi CHA Hospital, South Korea
| | - Jonathon Leipsic
- Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Rine Nakanishi
- Lundquist Institute of Biomedical Sciences at Harbor-UCLA Medical Center, USA
| | - Venkata Alla
- Creighton University Department of Medicine, Division of Cardiology, USA
| | - Jeroen J Bax
- Heart Center, University of Turku and Turku University Hospital, Turku, Finland
| | - Benjamin J W Chow
- Department of Medicine and Radiology, University of Ottawa, ON, Canada
| | - Daniel S Berman
- Creighton University Department of Medicine, Division of Cardiology, USA
| | - Erica Maffei
- Department of Radiology, Fondazione Monasterio/CNR, Pisa/Massa, Italy.
| | - Fay Y Lin
- Department of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Aiza Ahmad
- Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Gudrun Feuchtner
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hugo Marques
- UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal
| | - James K Min
- Department of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Joerg Hausleiter
- Medizinische Klinik I der Ludwig-Maximilians-UniversitätMünchen, Munich, Germany
| | - Martin Hadamitzky
- Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, University Hospital, Zurich, Switzerland; University of Zurich, Switzerland
| | | | - Ricardo C Cury
- Department of Radiology, Miami Cardiac and Vascular Institute, Miami, FL, USA
| | - Yong-Jin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Hyuk-Jae Chang
- Department of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Ronen Rubinshtein
- Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Todd C Villines
- Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Yao Lu
- Department of Healthcare Policy and Research, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Leslee J Shaw
- Department of Radiology, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA
| | - Stephen Acenbach
- Department of Cardiology, Friedrich-Alexander-University Erlangen-Nuremburg, Germany
| | - Mouaz H Al Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | | | | | | | - Matthew J Budoff
- Lundquist Institute of Biomedical Sciences at Harbor-UCLA Medical Center, USA
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Lou B, Liu H, Luo Y, Jiang GT, Wu H, Wang C, Wu Y, Zhou B, Yuan Z, She J, Liu J. In-hospital initiation of PCSK9 inhibitor and short-term lipid control in patients with acute myocardial infarction. Lipids Health Dis 2022; 21:105. [PMID: 36280861 PMCID: PMC9590135 DOI: 10.1186/s12944-022-01724-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 10/15/2022] [Indexed: 11/28/2022] Open
Abstract
Background Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to improve cardiovascular outcomes when added to conventional statin therapy. This study aims to investigate the efficacy and safety of in-hospital initiation of PCSK9 inhibitors among patients with acute myocardial infarction (AMI) based on real-world experience. Methods and results Data were collected from the Biobank of the First Affiliated Hospital of Xi’an Jiaotong University between January 2016 and December 2020. A total of 7556 AMI patients were screened for eligibility. Propensity Score Match (PSM) was employed, and covariates were age, sex, admission blood pressure and lipid profiles. Eligible participants were (1) propensity-matched 1:2:2 of statin plus evolocumab (dual therapy) vs. statin vs. statin plus ezetimibe. Ninety-five statin plus evolocumab users achieved significantly decreased low density lipoprotein (LDL) levels (0.92 ± 0.62 mmol/L in the 1st month and 1.17 ± 0.73 in the 3rd month) and a promising attainment rate of LDL (79.5% in the 1st month and 80.0% in the 3rd month) compared to the other two groups. (2) Propensity-matched 1:2:2 of statin plus ezetimibe evolocumab (triple therapy) vs. statin vs. statin plus ezetimibe. Similarly, 75 triple medication users achieved significantly decreased LDL levels and a promising attainment rate of LDL compared to the other two groups. In-hospital mortality and readmission rates within 3 months were then analyzed, and a decreased readmission rate was observed with PCSK9i therapy. Conclusions Based on the present single-center real-world PSM-adjusted study, PCSK9i has been effective in short-term lipid control among AMI patients. The long-term effectiveness for reducing major cardiovascular events among AMI patients based on real-world experience remains to be explored. Trial registration The study was registered at ClinicalTrials.gov, ClinicalTrials.gov ID: NCT05184530 Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12944-022-01724-9.
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Affiliation(s)
- Bowen Lou
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Hui Liu
- grid.452438.c0000 0004 1760 8119Biobank, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi China
| | - Yongbai Luo
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Gulinigaer Tuerhong Jiang
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Haoyu Wu
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Chen Wang
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Yue Wu
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Bo Zhou
- grid.452438.c0000 0004 1760 8119Respiratory Department, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi China
| | - Zuyi Yuan
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Jianqing She
- grid.452438.c0000 0004 1760 8119Cardiovascular Department, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an, 710061 Shaanxi China ,grid.43169.390000 0001 0599 1243Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an, 710061 Shaanxi China
| | - Junhui Liu
- grid.452438.c0000 0004 1760 8119Diagnostic Department, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi China
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10
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Reyes-Soffer G, Ginsberg HN, Berglund L, Duell PB, Heffron SP, Kamstrup PR, Lloyd-Jones DM, Marcovina SM, Yeang C, Koschinsky ML. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol 2022; 42:e48-e60. [PMID: 34647487 PMCID: PMC9989949 DOI: 10.1161/atv.0000000000000147] [Citation(s) in RCA: 191] [Impact Index Per Article: 95.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
High levels of lipoprotein(a) [Lp(a)], an apoB100-containing lipoprotein, are an independent and causal risk factor for atherosclerotic cardiovascular diseases through mechanisms associated with increased atherogenesis, inflammation, and thrombosis. Lp(a) is predominantly a monogenic cardiovascular risk determinant, with ≈70% to ≥90% of interindividual heterogeneity in levels being genetically determined. The 2 major protein components of Lp(a) particles are apoB100 and apolipoprotein(a). Lp(a) remains a risk factor for cardiovascular disease development even in the setting of effective reduction of plasma low-density lipoprotein cholesterol and apoB100. Despite its demonstrated contribution to atherosclerotic cardiovascular disease burden, we presently lack standardization and harmonization of assays, universal guidelines for diagnosing and providing risk assessment, and targeted treatments to lower Lp(a). There is a clinical need to understand the genetic and biological basis for variation in Lp(a) levels and its relationship to disease in different ancestry groups. This scientific statement capitalizes on the expertise of a diverse basic science and clinical workgroup to highlight the history, biology, pathophysiology, and emerging clinical evidence in the Lp(a) field. Herein, we address key knowledge gaps and future directions required to mitigate the atherosclerotic cardiovascular disease risk attributable to elevated Lp(a) levels.
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11
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Ferrières J, Roubille F, Farnier M, Jourdain P, Angoulvant D, Boccara F, Danchin N. Control of Low-Density Lipoprotein Cholesterol in Secondary Prevention of Coronary Artery Disease in Real-Life Practice: The DAUSSET Study in French Cardiologists. J Clin Med 2021; 10:jcm10245938. [PMID: 34945235 PMCID: PMC8707804 DOI: 10.3390/jcm10245938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/03/2021] [Accepted: 12/13/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Patients with established coronary artery disease (CAD) are at very high risk for cardiovascular events. Methods: The DAUSSET study is a national, multicenter, non-interventional study that included very high-risk CAD patients followed by French cardiologists. It aimed to describe real-life clinical practices for low-density lipoprotein (LDL) cholesterol control in the secondary prevention of CAD. Results: A total of 912 patients (mean age, 65.4 years; men, 76.1%; myocardial infarction, 69.4%; first episode, 80.1%) were analyzed. The LDL cholesterol goal was 70 mg/dL in most cases (84.9%). The LDL cholesterol goal <70 mg/dL was achieved in 41.7% of patients. Of the 894 (98.0%) patients who received lipid-lowering therapy, 81.2% had been treated more intensively after the cardiac event, 27.0% had been treated less intensively and 13.1% had been maintained. Participating cardiologists were very satisfied or satisfied with treatment response in 72.6% of patients. Moderate satisfaction or dissatisfaction with lipid-lowering therapy was related to not achieving objectives (100%), treatment inefficacy (53.7%), treatment intolerance (23.4%) and poor adherence (12.3%). Conclusion: These real-world results show that lipid control in very high-risk patients remains insufficient. More than half of the patients did not achieve the LDL cholesterol goal. Prevention of cardiovascular events in these very high-risk patients could be further improved by better education and more intensive lipid-lowering therapy.
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Affiliation(s)
- Jean Ferrières
- Department of Cardiology, Toulouse Rangueil University Hospital, INSERM UMR 1295, Toulouse University School of Medicine, 31059 Toulouse, France
- Correspondence:
| | - François Roubille
- PhyMedExp, INSERM, CNRS, Cardiology Department, INI-CRT, CHU de Montpellier, Université de Montpellier, 34090 Montpellier, France;
| | - Michel Farnier
- Equipe PEC2, EA 7460, Service de Cardiologie, CHU Dijon Bourgogne, Université de Bourgogne Franche-Comté, 21000 Dijon, France;
| | - Patrick Jourdain
- CHU Bicêtre AP-HP, Inserm U999, Université Paris-Saclay, 91190 Gif-sur-Yvette, France;
| | - Denis Angoulvant
- Service de Cardiologie, Hôpital Trousseau, CHRU de Tours, EA4245 T2i Faculté de médecine et Université de Tours, 37000 Tours, France;
| | - Franck Boccara
- GRC n°22, CMV-Complications Cardiovasculaires et Métaboliques chez les Patients Vivant avec le Virus de L’immunodéficience Humaine, INSERM UMR_S 938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Hôpital Saint-Antoine Service de Cardiologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, 75012 Paris, France;
| | - Nicolas Danchin
- Département de Cardiologie, Hôpital Européen Georges Pompidou et Université de Paris, 75015 Paris, France;
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12
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Chang HH, Lan YC, Chung SD, Chien CT. Sweet Potato Leaf Feeding Decreases Cholesterol, Oxidative Stress and Thrombosis Formation in Syrian Hamsters with a High-Cholesterol Diet. Life (Basel) 2021; 11:life11080802. [PMID: 34440546 PMCID: PMC8401060 DOI: 10.3390/life11080802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 12/24/2022] Open
Abstract
Nutritional strategies to reduce hyperlipidemia and the risk of cardiovascular disease are gaining more public favor and medical professionals’ attention. The authors of this study explored the effect of sweet potato leaf powder (SPLP) feeding on the parameters of plasma lipids, reactive oxygen species, and time to thrombosis formation in Syrian hamsters fed with high-cholesterol diets. The animals were separated into six groups: a feeding control diet, a control diet containing 0.1% cholesterol, a control diet containing 0.2% cholesterol, a control diet containing 0.1% cholesterol plus 2.5% SPLP, a control diet containing 0.1% cholesterol plus 5% SPLP, and a control diet containing 0.2% cholesterol plus 5% SPLP for six weeks. The levels of serum total cholesterol (51% increase), low-density lipoprotein cholesterol (70.6% increase), very-low-density lipoprotein cholesterol (51.3% increase), and the triglyceride and atherogenic index (LDL-C/HDL-C) significantly increased in the high-cholesterol diet groups. Concomitant 5% sweet potato leaf powder ingestion significantly decreased the lipid profiles, with a 20.6% total cholesterol reduction in the 0.1% cholesterol diet groups, a 17.2% reduction in the 0.2% group, a 48.7% LDL reduction in the 0.1% cholesterol group, and a 30.3% reduction in the 0.2% group, with a consequent decrease in the atherogenic index. SPLP feeding was found to be associated with increased fecal sterol contents, with a 188.6% increase in the 0.1% cholesterol-fed group and a 177.3% increase in the 0.2% group. The SPLP-fed groups had depressed ROS levels, elongated FeCl3-induced times to thrombosis formation, and increased liver superoxide dismutase contents and SREBP-1 protein expression. Sweet potato leaf intake could reduce plasma total cholesterol, LDL, and oxidative stress. We suggest sweet potato leaf intake as a choice of nutritional strategy for hyperlipidemia and cardiovascular disease prevention.
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Affiliation(s)
- Hao-Hsiang Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei 10016, Taiwan;
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 10016, Taiwan
| | - Yi-Chan Lan
- Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 30060, Taiwan;
| | - Shiu-Dong Chung
- Department of Surgery, Division of Urology, Far-Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Graduate Program in Biomedical Informatics, College of Informatics, Yuan-Ze University, Taoyuan City 32003, Taiwan
- Correspondence: (S.-D.C.); (C.-T.C.)
| | - Chiang-Ting Chien
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 10016, Taiwan
- Correspondence: (S.-D.C.); (C.-T.C.)
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13
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Giammanco A, Noto D, Barbagallo CM, Nardi E, Caldarella R, Ciaccio M, Averna MR, Cefalù AB. Hyperalphalipoproteinemia and Beyond: The Role of HDL in Cardiovascular Diseases. Life (Basel) 2021; 11:life11060581. [PMID: 34207236 PMCID: PMC8235218 DOI: 10.3390/life11060581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 12/16/2022] Open
Abstract
Hyperalphalipoproteinemia (HALP) is a lipid disorder characterized by elevated plasma high-density lipoprotein cholesterol (HDL-C) levels above the 90th percentile of the distribution of HDL-C values in the general population. Secondary non-genetic factors such as drugs, pregnancy, alcohol intake, and liver diseases might induce HDL increases. Primary forms of HALP are caused by mutations in the genes coding for cholesteryl ester transfer protein (CETP), hepatic lipase (HL), apolipoprotein C-III (apo C-III), scavenger receptor class B type I (SR-BI) and endothelial lipase (EL). However, in the last decades, genome-wide association studies (GWAS) have also suggested a polygenic inheritance of hyperalphalipoproteinemia. Epidemiological studies have suggested that HDL-C is inversely correlated with cardiovascular (CV) risk, but recent Mendelian randomization data have shown a lack of atheroprotective causal effects of HDL-C. This review will focus on primary forms of HALP, the role of polygenic inheritance on HDL-C, associated risk for cardiovascular diseases and possible treatment options.
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Affiliation(s)
- Antonina Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy; (A.G.); (D.N.); (C.M.B.); (E.N.); (M.R.A.)
| | - Davide Noto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy; (A.G.); (D.N.); (C.M.B.); (E.N.); (M.R.A.)
| | - Carlo Maria Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy; (A.G.); (D.N.); (C.M.B.); (E.N.); (M.R.A.)
| | - Emilio Nardi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy; (A.G.); (D.N.); (C.M.B.); (E.N.); (M.R.A.)
| | - Rosalia Caldarella
- Department of Laboratory Medicine, Unit of Laboratory Medicine CoreLab, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (R.C.); (M.C.)
| | - Marcello Ciaccio
- Department of Laboratory Medicine, Unit of Laboratory Medicine CoreLab, University Hospital “P. Giaccone”, 90127 Palermo, Italy; (R.C.); (M.C.)
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy
| | - Maurizio Rocco Averna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy; (A.G.); (D.N.); (C.M.B.); (E.N.); (M.R.A.)
| | - Angelo Baldassare Cefalù
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties–University of Palermo, Via del Vespro, 129, 90127 Palermo, Italy; (A.G.); (D.N.); (C.M.B.); (E.N.); (M.R.A.)
- Correspondence:
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14
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Luna-Castillo KP, Lin S, Muñoz-Valle JF, Vizmanos B, López-Quintero A, Márquez-Sandoval F. Functional Food and Bioactive Compounds on the Modulation of the Functionality of HDL-C: A Narrative Review. Nutrients 2021; 13:1165. [PMID: 33916032 PMCID: PMC8066338 DOI: 10.3390/nu13041165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 12/19/2022] Open
Abstract
Cardiovascular diseases (CVD) remain a serious public health problem and are the primary cause of death worldwide. High-density lipoprotein cholesterol (HDL-C) has been identified as one of the most important molecules in the prevention of CVD due to its multiple anti-inflammatories, anti-atherogenic, and antioxidant properties. Currently, it has been observed that maintaining healthy levels of HDL-C does not seem to be sufficient if the functionality of this particle is not adequate. Modifications in the structure and composition of HDL-C lead to a pro-inflammatory, pro-oxidant, and dysfunctional version of the molecule. Various assays have evaluated some HDL-C functions on risk populations, but they were not the main objective in some of these. Functional foods and dietary compounds such as extra virgin olive oil, nuts, whole grains, legumes, fresh fish, quercetin, curcumin, ginger, resveratrol, and other polyphenols could increase HDL functionality by improving the cholesterol efflux capacity (CEC), paraoxonase 1 (PON1), and cholesteryl ester transfer protein (CETP) activity. Nevertheless, additional rigorous research basic and applied is required in order to better understand the association between diet and HDL functionality. This will enable the development of nutritional precision management guidelines for healthy HDL to reduce cardiovascular risk in adults. The aim of the study was to increase the understanding of dietary compounds (functional foods and bioactive components) on the functionality of HDL.
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Affiliation(s)
- Karla Paulina Luna-Castillo
- Doctorado en Ciencias de la Nutrición Traslacional, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.L.-C.); (J.F.M.-V.); (B.V.)
| | - Sophia Lin
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia;
| | - José Francisco Muñoz-Valle
- Doctorado en Ciencias de la Nutrición Traslacional, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.L.-C.); (J.F.M.-V.); (B.V.)
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Barbara Vizmanos
- Doctorado en Ciencias de la Nutrición Traslacional, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.L.-C.); (J.F.M.-V.); (B.V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Andres López-Quintero
- Doctorado en Ciencias de la Nutrición Traslacional, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.L.-C.); (J.F.M.-V.); (B.V.)
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Fabiola Márquez-Sandoval
- Doctorado en Ciencias de la Nutrición Traslacional, Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (K.P.L.-C.); (J.F.M.-V.); (B.V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
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15
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Reyes-Soffer G. Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease risk: current status and treatments. Curr Opin Endocrinol Diabetes Obes 2021; 28:85-89. [PMID: 33481422 DOI: 10.1097/med.0000000000000619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The role of triglyceride-rich lipoproteins (TRLs) in the development of atherosclerotic cardiovascular disease (ASCVD) is at the forefront of current research and treatment development programs. Despite extreme lowering of LDL-cholesterol there remains a high risk of cardiovascular disease and mortality. Recent large epidemiological, genomic wide association studies and Mendelian randomization studies have identified novel mechanisms and targets regulating TRL. This review will focus on recent and ongoing clinical trials that aim to reduce cardiovascular risk by decreasing plasma levels of TRL. RECENT FINDINGS Ongoing efforts of basic and clinical scientist have described novel TRL regulating mechanism. The concentration on lifestyle changes is key to prevention and treatment guidelines. There is continue evidence that supports previous guidelines using fibrates alone and in combination with niacin to reduce TRLs, in special cases. The recent results from the REDUCE-IT study support the use of eicosapentaenoic acid (EPA) for risk reduction and ASCVD, but recently presented data from the Long-Term Outcome Study to Assess Statin Residual Risk Reduction With Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia and Omega-3 Fatty Acids in Elderly Patients With Acute Myocardial Infarction studies do not support the use of combination EPA/docosahexaenoic acid. The latter highlights the need for further studies into the pathways regulating ASCVD risk reduction after EPA administration. The identification of novel targets, such as apolipoprotein C3 and angiopoietin-like protein-3, are driving the development of novel treatments, and is the focus of this review. SUMMARY The current management of elevated triglyceride levels and the effect on cardiovascular outcomes is an emerging area of research. New data from fish oil studies suggest differences in EPA vs. EPA/docosahexaenoic acid cardio protection outcomes. The preliminary data from ongoing clinical trials of novel triglyceride-lowering therapeutics are promising. These programs will ultimately provide foundations for future triglyceride-lowering guidelines.
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Affiliation(s)
- Gissette Reyes-Soffer
- Department of Medicine, Columbia University Medical Center, College of Physicians and Surgeons, New York, New York, USA
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