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Arnold N, Blaum C, Goßling A, Brunner FJ, Bay B, Zeller T, Ferrario MM, Brambilla P, Cesana G, Leoni V, Palmieri L, Donfrancesco C, Ojeda F, Linneberg A, Söderberg S, Iacoviello L, Gianfagna F, Costanzo S, Sans S, Veronesi G, Thorand B, Peters A, Tunstall-Pedoe H, Kee F, Salomaa V, Schnabel RB, Kuulasmaa K, Blankenberg S, Waldeyer C, Koenig W. Impact of Lipoprotein(a) Level on Low-Density Lipoprotein Cholesterol- or Apolipoprotein B-Related Risk of Coronary Heart Disease. J Am Coll Cardiol 2024; 84:165-177. [PMID: 38960510 DOI: 10.1016/j.jacc.2024.04.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Conventional low-density lipoprotein cholesterol (LDL-C) quantification includes cholesterol attributable to lipoprotein(a) (Lp(a)-C) due to their overlapping densities. OBJECTIVES The purposes of this study were to compare the association between LDL-C and LDL-C corrected for Lp(a)-C (LDLLp(a)corr) with incident coronary heart disease (CHD) in the general population and to investigate whether concomitant Lp(a) values influence the association of LDL-C or apolipoprotein B (apoB) with coronary events. METHODS Among 68,748 CHD-free subjects at baseline LDLLp(a)corr was calculated as "LDL-C-Lp(a)-C," where Lp(a)-C was 30% or 17.3% of total Lp(a) mass. Fine and Gray competing risk-adjusted models were applied for the association between the outcome incident CHD and: 1) LDL-C and LDLLp(a)corr in the total sample; and 2) LDL-C and apoB after stratification by Lp(a) mass (≥/<90th percentile). RESULTS Similar risk estimates for incident CHD were found for LDL-C and LDL-CLp(a)corr30 or LDL-CLp(a)corr17.3 (subdistribution HR with 95% CI) were 2.73 (95% CI: 2.34-3.20) vs 2.51 (95% CI: 2.15-2.93) vs 2.64 (95% CI: 2.26-3.10), respectively (top vs bottom fifth; fully adjusted models). Categorization by Lp(a) mass resulted in higher subdistribution HRs for uncorrected LDL-C and incident CHD at Lp(a) ≥90th percentile (4.38 [95% CI: 2.08-9.22]) vs 2.60 [95% CI: 2.21-3.07]) at Lp(a) <90th percentile (top vs bottom fifth; Pinteraction0.39). In contrast, apoB risk estimates were lower in subjects with higher Lp(a) mass (2.43 [95% CI: 1.34-4.40]) than in Lp(a) <90th percentile (3.34 [95% CI: 2.78-4.01]) (Pinteraction0.49). CONCLUSIONS Correction of LDL-C for its Lp(a)-C content provided no meaningful information on CHD-risk estimation at the population level. Simple categorization of Lp(a) mass (≥/<90th percentile) influenced the association between LDL-C or apoB with future CHD mostly at higher Lp(a) levels.
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Affiliation(s)
- Natalie Arnold
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Blaum
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alina Goßling
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fabian J Brunner
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Bay
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Zeller
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; University Center of Cardiovascular Science at University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Marco M Ferrario
- Research Center in Epidemiology and Preventive Medicine - EPIMED, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Paolo Brambilla
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giancarlo Cesana
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Valerio Leoni
- Laboratory of Clinical Pathology, Hospital Pio XI of Desio, ASST Brianza, School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, Rome, Italy
| | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità-ISS, Rome, Italy
| | - Francisco Ojeda
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Licia Iacoviello
- Department of Medicine and Surgery, LUM University, Casamassima, Italy; Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Francesco Gianfagna
- Research Center in Epidemiology and Preventive Medicine - EPIMED, Department of Medicine and Surgery, University of Insubria, Varese, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Susana Sans
- Catalan Department of Health, Barcelona, Spain
| | - Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine - EPIMED, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Ludwig-Maximilians University of Munich, Munich, Germany; German Center for Cardiovascular Disease Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
| | - Hugh Tunstall-Pedoe
- Cardiovascular Epidemiology Unit, Institute of Cardiovascular Research, University of Dundee, Dundee, Scotland
| | - Frank Kee
- Centre for Public Health, Queens University of Belfast, Belfast, Northern Ireland, United Kingdom
| | - Veikko Salomaa
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Renate B Schnabel
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kari Kuulasmaa
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Stefan Blankenberg
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Waldeyer
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany; Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Koenig
- German Heart Center, Munich, Technical University of Munich, Munich, Germany; Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; German Center for Cardiovascular Disease Research (DZHK), partner site Munich Heart Alliance, Munich, Germany.
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Langsted A, Nordestgaard BG. Worldwide Increasing Use of Nonfasting Rather Than Fasting Lipid Profiles. Clin Chem 2024; 70:911-933. [PMID: 38646857 DOI: 10.1093/clinchem/hvae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/13/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Historically, lipids and lipoproteins were measured in the fasting state for cardiovascular risk prediction; however, since 2009 use of nonfasting lipid profiles has increased substantially worldwide. For patients, nonfasting lipid profiles are convenient and avoid any risk of hypoglycemia. For laboratories, blood sampling in the morning and extra visits for patients who have not fasted are avoided. For patients, clinicians, hospitals, and society, nonfasting sampling allows same-day visits with first blood sampling followed by a short wait for test results before clinical consultation. Therefore, nonfasting compared to fasting lipid profiles will save money and time and may improve patient compliance with cardiovascular prevention programs. CONTENT We report on the progression of endorsement and implementation of nonfasting lipid profiles for cardiovascular risk prediction worldwide and summarize the recommendations from major medical societies and health authorities in different countries. We also describe practical advantages and disadvantages for using nonfasting lipid profiles. Further, we include a description of why fasting has been the standard historically, the barriers against implementation of nonfasting lipid profiles, and finally we suggest the optimal content of a nonfasting lipid profile. SUMMARY Lipid, lipoprotein, and apolipoprotein concentrations vary minimally in response to normal food intake and nonfasting lipid profiles are equal or superior to fasting profiles for cardiovascular risk prediction. Major guidelines and consensus statements in Europe, the United States, Canada, Brazil, Japan, India, and Australia now endorse use of nonfasting lipid profiles in some or all patients; however, there are still gaps in endorsement and implementation of nonfasting lipid profiles worldwide.
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Affiliation(s)
- Anne Langsted
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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3
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Wang Y, Zhang Y, Wang X, Chen S, Tian X, Xu Q, Xia X, Wu S, Liu F, Wang A. Cumulative remnant cholesterol burden increases the risk of cardiovascular disease among young adults. Ann Epidemiol 2024; 94:127-136. [PMID: 38735386 DOI: 10.1016/j.annepidem.2024.05.005] [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: 02/28/2024] [Revised: 04/28/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Previous studies have shown that remnant cholesterol (RC) was associated with cardiovascular disease (CVD) among middle-aged or older adults. However, lack of evidence on long-term exposures to RC and their role in CVD risk among young adults. We thus aimed to explore the association between cumulative RC burden and CVD in young adults. METHODS We enrolled participants younger than 45 years free of CVD history in the Kailuan Study who completed the first three health examinations from 2006 to 2010. Cumulative RC burden included cumulative RC burden score, time-weighted cumulative RC, exposure duration of high RC, and time course of RC accumulation. The outcome was the incidence of CVD. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) between cumulative RC burden and CVD risk. RESULTS A total of 15,219 participants were included (73.70% male, median age 39.13 years). During a median follow-up duration of 8.71 years (interquartile range: 8.4-9.15 years), 502 individuals developed CVD. After adjustment for traditional cardiovascular risk factors, highest risk of CVD was observed in participants with the highest cumulative RC burden score (HR, 1.66; 95% CI, 1.29-2.12), the highest quartile time-weighted cumulative RC (HR,1.50; 95% CI, 1.15-1.96), the longest exposure duration of high RC (HR, 1.71; 95% CI, 1.21-2.42), and those with cumulative RC burden and positive slope (HR, 1.79; 95% CI, 1.35-2.36). CONCLUSIONS Cumulative RC burden increased the risk of CVD among young adults, suggesting that maintaining low RC levels throughout young adulthood may minimize CVD risk. KEY LEARNING POINTS
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Affiliation(s)
- Yi Wang
- Majiagou Hospital of Kailuan, Tangshan, China
| | - Yijun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qin Xu
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xue Xia
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Fen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Anxin Wang
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Zafar M, Malik IR, Mirza MR, Awan FR, Nawrocki A, Hussain M, Khan HN, Abbas S, Choudhary MI, Larsen MR. Mass-spectrometric analysis of APOB polymorphism rs1042031 (G/T) and its influence on serum proteome of coronary artery disease patients: genetic-derived proteomics consequences. Mol Cell Biochem 2024; 479:1349-1361. [PMID: 37410210 DOI: 10.1007/s11010-023-04797-x] [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: 04/05/2023] [Accepted: 06/18/2023] [Indexed: 07/07/2023]
Abstract
Genetic polymorphisms of apolipoprotein B gene (APOB) may result into serum proteomic perturbance in Coronary Artery Disease (CAD). The current case-control cohort of Pakistani subjects was designed to analyze the genetic influence of APOB rs1042031, (G/T) genotype on serum proteome. Subjects were categorized into two groups: CAD patients (n = 480) and healthy individuals (n = 220). For genotyping, tetra ARMS-PCR was carried out and validated through sequencing, whereas LC/MS-based proteomic analysis of serum samples was performed through label-free quantification. In initial step of genotyping, the frequencies of each genotype GG, GT, and TT were 70%, 27%, and 30% in CAD patients, while in control group, the subjects were 52%, 43%, and 5%, respectively, in CAD patients. The genotypic frequencies in patients vs. control groups found significantly different (p = 0.004), and a strong association of dominant alleles GG with the CAD was observed in both dominant (OR: 2.4 (1.71-3.34), p = 0.001) and allelic genetic models (OR: 2.0 (1.45-2.86), p = 0.001). In second step of label-free quantitation, a total of 40 significant proteins were found with altered expression in CAD patients. The enriched Gene Ontology (GO) terms of molecular functions and pathways of these protein showed upregulated pathways as follows: chylomicron remodeling and assembly, complement cascade activation, plasma lipoprotein assembly, apolipoprotein-A receptor binding, and metabolism of fat-soluble vitamins in G allele carrier of rs1042031 (G > T) vs. mutant T-allele carriers. This study provides better understanding of CAD pathobiology by proteogenomics of APOB. It evidences the influence of APOB rs1042031-dominant (GG) genotype with CAD patients.
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Affiliation(s)
- Muneeza Zafar
- Department of Biotechnology, University of Sargodha, Sargodha, Pakistan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences ICCBS), University of Karachi, Karachi, 75270, Pakistan
- Diabetes and Cardio-Metabolic Disorders Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Jhang Road, P.O. Box. 577, Faisalabad, Pakistan
| | - Imran Riaz Malik
- Department of Biotechnology, University of Sargodha, Sargodha, Pakistan.
| | - Munazza Raza Mirza
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences ICCBS), University of Karachi, Karachi, 75270, Pakistan.
| | - Fazli Rabbi Awan
- Diabetes and Cardio-Metabolic Disorders Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Jhang Road, P.O. Box. 577, Faisalabad, Pakistan.
- Pakistan Institute of Engineering and Applied Sciences (PIEAS), NIBGE-College, Islamabad, Pakistan.
| | - Arkadiusz Nawrocki
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
| | - Misbah Hussain
- Department of Biotechnology, University of Sargodha, Sargodha, Pakistan
- Diabetes and Cardio-Metabolic Disorders Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Jhang Road, P.O. Box. 577, Faisalabad, Pakistan
| | - Haq Nawaz Khan
- Diabetes and Cardio-Metabolic Disorders Laboratory, Health Biotechnology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Jhang Road, P.O. Box. 577, Faisalabad, Pakistan
- Department of Biological and Biomedical Sciences, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan
| | - Shahid Abbas
- Faisalabad Institute of Cardiology (FIC), Faisalabad, Pakistan
| | - Muhammad Iqbal Choudhary
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences ICCBS), University of Karachi, Karachi, 75270, Pakistan
| | - Martin R Larsen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense, Denmark
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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Liu J, Ginsberg HN, Reyes-Soffer G. Basic and translational evidence supporting the role of TM6SF2 in VLDL metabolism. Curr Opin Lipidol 2024; 35:157-161. [PMID: 38465912 PMCID: PMC11168781 DOI: 10.1097/mol.0000000000000930] [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] [Indexed: 03/12/2024]
Abstract
PURPOSE OF REVIEW Transmembrane 6 superfamily member 2 ( TM6SF2 ) gene was identified through exome-wide studies in 2014. A genetic variant from glutamic acid to lysine substitution at amino acid position 167 (NM_001001524.3:c.499G> A) (p.Gln167Lys/p.E167K, rs58542926) was discovered (p.E167K) to be highly associated with increased hepatic fat content and reduced levels of plasma triglycerides and LDL cholesterol. In this review, we focus on the discovery of TM6SF2 and its role in VLDL secretion pathways. Human data suggest TM6SF2 is linked to hepatic steatosis and cardiovascular disease (CVD), hence understanding its metabolic pathways is of high scientific interest. RECENT FINDINGS Since its discovery, completed research studies in cell, rodent and human models have defined the role of TM6SF2 and its links to human disease. TM6SF2 resides in the endoplasmic reticulum (ER) and the ER-Golgi interface and helps with the lipidation of nascent VLDL, the main carrier of triglycerides from the liver to the periphery. Consistent results from cells and rodents indicated that the secretion of triglycerides is reduced in carriers of the p.E167K variant or when hepatic TM6SF2 is deleted. However, data for secretion of APOB, the main protein of VLDL particles responsible for triglycerides transport, are inconsistent. SUMMARY The identification of genetic variants that are highly associated with human disease presentation should be followed by the validation and investigation into the pathways that regulate disease mechanisms. In this review, we highlight the role of TM6SF2 and its role in processing of liver triglycerides.
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Affiliation(s)
- Jing Liu
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
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7
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Kamstrup PR, Neely RDG, Nissen S, Landmesser U, Haghikia A, Costa-Scharplatz M, Abbas C, Nordestgaard BG. Lipoprotein(a) and cardiovascular disease: sifting the evidence to guide future research. Eur J Prev Cardiol 2024; 31:903-914. [PMID: 38253342 DOI: 10.1093/eurjpc/zwae032] [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: 11/17/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024]
Abstract
Lipoprotein(a) (Lp(a)) is a genetically determined causal risk factor for cardiovascular disease including coronary heart disease, peripheral arterial disease, ischaemic stroke, and calcific aortic valve stenosis. Clinical trials of specific and potent Lp(a)-lowering drugs are currently underway. However, in clinical practice, widespread assessment of Lp(a) is still lacking despite several guideline recommendations to measure Lp(a) at least once in a lifetime in all adults to identify those at high or very high risk due to elevated levels. The present review provides an overview of key findings from observational and genetic Lp(a) studies, highlights the main challenges in observational Lp(a) studies, and proposes a minimum set of requirements to enhance the quality and harmonize the collection of Lp(a)-related data. Adherence to the recommendations set forth in the present manuscript is intended to enhance the quality of future observational Lp(a) studies, to better define thresholds for increased risk, and to better inform clinical trial design. The recommendations can also potentially assist in the interpretation and generalization of clinical trial findings, to improve care of patients with elevated Lp(a) and optimize treatment and prevention of cardiovascular disease.
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Affiliation(s)
- Pia R Kamstrup
- Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 73, 2730 Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - R Dermot G Neely
- Academic Health Science Network North East and North Cumbria (AHSN), Room 2.13, Biomedical Research Building, The Campus for Ageing and Vitality, Nun's Moor Road, Newcastle, NE4 5PL
| | - Steven Nissen
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ulf Landmesser
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, Berlin 12203, Germany
- DZHK (German Centre for Cardiovascular Research) partner Site Berlin, Berlin 12203, Germany
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin 10117, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, Berlin 10178, Germany
| | - Arash Haghikia
- Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Hindenburgdamm 30, Berlin 12203, Germany
- DZHK (German Centre for Cardiovascular Research) partner Site Berlin, Berlin 12203, Germany
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin 10117, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, Berlin 10178, Germany
| | | | - Cheryl Abbas
- Novartis Pharmaceuticals Corporation, US Medical, East Hanover, NJ, USA
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte, Borgmester Ib Juuls Vej 73, 2730 Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Guardiola M, Rehues P, Amigó N, Arrieta F, Botana M, Gimeno-Orna JA, Girona J, Martínez-Montoro JI, Ortega E, Pérez-Pérez A, Sánchez-Margalet V, Pedro-Botet J, Ribalta J. Increasing the complexity of lipoprotein characterization for cardiovascular risk in type 2 diabetes. Eur J Clin Invest 2024:e14214. [PMID: 38613414 DOI: 10.1111/eci.14214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 04/15/2024]
Abstract
The burden of cardiovascular disease is particularly high among individuals with diabetes, even when LDL cholesterol is normal or within the therapeutic target. Despite this, cholesterol accumulates in their arteries, in part, due to persistent atherogenic dyslipidaemia characterized by elevated triglycerides, remnant cholesterol, smaller LDL particles and reduced HDL cholesterol. The causal link between dyslipidaemia and atherosclerosis in T2DM is complex, and our contention is that a deeper understanding of lipoprotein composition and functionality, the vehicle that delivers cholesterol to the artery, will provide insight for improving our understanding of the hidden cardiovascular risk of diabetes. This narrative review covers three levels of complexity in lipoprotein characterization: 1-the information provided by routine clinical biochemistry, 2-advanced nuclear magnetic resonance (NMR)-based lipoprotein profiling and 3-the identification of minor components or physical properties of lipoproteins that can help explain arterial accumulation in individuals with normal LDLc levels, which is typically the case in individuals with T2DM. This document highlights the importance of incorporating these three layers of lipoprotein-related information into population-based studies on ASCVD in T2DM. Such an attempt should inevitably run in parallel with biotechnological solutions that allow large-scale determination of these sets of methodologically diverse parameters.
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Affiliation(s)
- Montse Guardiola
- Departament de Medicina i Cirurgia, Unitat de Recerca en Lípids i Arteriosclerosi (URLA), Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Pere Rehues
- Departament de Medicina i Cirurgia, Unitat de Recerca en Lípids i Arteriosclerosi (URLA), Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Núria Amigó
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Departament de Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, Reus, Spain
- Biosfer Teslab, Reus, Spain
| | | | - Manuel Botana
- Departamento de Endocrinología y Nutrición, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - José A Gimeno-Orna
- Endocrinology and Nutrition Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Josefa Girona
- Departament de Medicina i Cirurgia, Unitat de Recerca en Lípids i Arteriosclerosi (URLA), Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - José Ignacio Martínez-Montoro
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
| | - Emilio Ortega
- Department of Endocrinology and Nutrition, Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Antonio Pérez-Pérez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Víctor Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, Seville, Spain
| | - Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
- Department of Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Josep Ribalta
- Departament de Medicina i Cirurgia, Unitat de Recerca en Lípids i Arteriosclerosi (URLA), Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Singh K, Prabhakaran D. Apolipoprotein B - An ideal biomarker for atherosclerosis? Indian Heart J 2024; 76 Suppl 1:S121-S129. [PMID: 38599726 PMCID: PMC11019329 DOI: 10.1016/j.ihj.2023.12.001] [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: 10/31/2023] [Accepted: 12/02/2023] [Indexed: 04/12/2024] Open
Abstract
This review article describes the pathophysiological mechanisms linking Apolipoprotein B (Apo-B) and atherosclerosis, summarizes the existing evidence on Apo B as a predictor of atherosclerotic cardiovascular disease and recommendations of (inter)national treatment guidelines regarding Apo B in dyslipidemia management. A single Apo B molecule is present in every particle of very low-density lipoprotein, intermediate density lipoprotein, low density lipoprotein, and lipoprotein(a). This unique single Apo B per particle ratio makes plasma Apo B concentration a direct measure of the number of circulating atherogenic lipoproteins. This review of global evidence on Apo B as a biomarker for atherosclerosis confirms that Apo B is a single atherogenic lipid marker present in all lipids sub-fractions except HDL-C, and thus, Apo B integrates and extends the information from triglycerides and cholesterol, which could simplify and improve care for atherosclerotic cardiovascular disease.
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Affiliation(s)
- Kavita Singh
- Public Health Foundation of India, Gurugram, Haryana, India; Heidelberg Institute of Global Health, Heidelberg University, Germany
| | - Dorairaj Prabhakaran
- Public Health Foundation India, Gurugram, Haryana, India; Centre for Chronic Disease Control, New Delhi, India; London School of Hygiene & Tropical Medicine, United Kingdom.
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10
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Gómez-Barrado JJ, Gómez-Turégano P, Beltrán Moreno M, Fernández-Chamorro AI, Roque Rodríguez B, Kounka Z. Lipoprotein (a) is a predictor of non-achievement of LDL-C goals in patients with chronic heart disease. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2024:S0214-9168(24)00006-8. [PMID: 38402025 DOI: 10.1016/j.arteri.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION AND OBJECTIVES Lipoprotein (a) [Lp(a)] concentration influences serum low-density lipoprotein cholesterol (LDL-C) levels. How it influences the achievement of LDL-C targets established in the guidelines is not well studied. Our aim was to know the prevalence of elevated Lp(a) levels in patients with coronary artery disease, and to assess its influence on the achievement of LDL-C targets. METHOD We conducted a cross-sectional study in a cardiology department in Spain. A total of 870 patients with stable coronary artery disease had their lipid profile determined, including Lp(a). Patients were stratified into 2 groups according to Lp(a)>50mg/dL and Lp(a)≤50mg/dL. The association of Lp(a)>50mg/dL with achievement of LDL-C targets was assessed by logistic regression analysis. RESULTS The prevalence of Lp(a)>50mg/dL was 30.8%. Patients with Lp(a)>50mg/dL had higher baseline (142.30±47.54 vs. 130.47±40.75mg/dL; p=0.0001) and current (72.91±26.44 vs. 64.72±25.30mg/dL; p=0.0001), despite the fact that they were treated with more high-potency statins (77.2 vs. 70.9%; p=0.058) and more combination lipid-lowering therapy (37.7 vs. 25.7%; p=0.001). The proportion of patients achieving target LDL-C was lower in those with Lp(a)>50mg/dL. Independent predictors of having elevated Lp(a) levels>50mg/dL were the use of high-potency statins (OR 1.5; 95% CI 1.08-2.14), combination lipid-lowering therapy with ezetimibe (OR 2.0; 95% CI 1.45-2.73) and failure to achieve a LDL-C ≤55mg/dL (OR 2.3; 95% CI 1.63-3.23). CONCLUSIONS Elevated Lp(a) levels influence LDL-C levels and hinder the achievement of targets in patients at very high cardiovascular risk. New drugs that act directly on Lp(a) are needed in these patients.
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Affiliation(s)
| | - Paula Gómez-Turégano
- Departamento de Cardiología, Hospital Universitario San Pedro de Alcántara, Cáceres, España
| | - María Beltrán Moreno
- Departamento de Cardiología, Hospital Universitario San Pedro de Alcántara, Cáceres, España
| | | | | | - Zineb Kounka
- Departamento de Cardiología, Hospital Universitario San Pedro de Alcántara, Cáceres, España
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11
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Welsh P, Al Zabiby A, Byrne H, Benbow HR, Itani T, Farries G, Costa-Scharplatz M, Ferber P, Martin L, Brown R, Fonseca AF, Sattar N. Elevated lipoprotein(a) increases risk of subsequent major adverse cardiovascular events (MACE) and coronary revascularisation in incident ASCVD patients: A cohort study from the UK Biobank. Atherosclerosis 2024; 389:117437. [PMID: 38219651 DOI: 10.1016/j.atherosclerosis.2023.117437] [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: 07/06/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIMS Elevated lipoprotein(a) [Lp(a)] is a genetic driver for atherosclerotic cardiovascular disease (ASCVD). We aimed to provide novel insights into the associated risk of elevated versus normal Lp(a) levels on major adverse cardiovascular events (MACE) in an incident ASCVD cohort. METHODS This was an observational cohort study of incident ASCVD patients. MACE counts and incidence rates (IRs) per 100-person-years were reported for patients with normal (<65 nmol/L) and elevated (>150 nmol/L) Lp(a) within the first year after incident ASCVD diagnosis and overall follow-up. Cox proportional hazard models quantified the risk of MACE associated with a 100 nmol/L increase in Lp(a). RESULTS The study cohort included 32,537 incident ASCVD patients; 5204 with elevated and 22,257 with normal Lp(a). Of those with elevated Lp(a), 41.2% had a subsequent MACE, versus 35.61% with normal Lp(a). Within the first year of follow-up, the IRs of composite MACE and coronary revascularisation were significantly higher (p < 0.001) in patients with elevated versus normal Lp(a) (IR difference 6.79 and 4.66). This trend was also observed in the overall follow-up (median 4.7 years). Using time to first subsequent MACE, a 100 nmol/L increase in Lp(a) was associated with an 8.0% increased risk of composite MACE, and 18.6% increased risk of coronary revascularisation during the overall follow-up period. CONCLUSIONS The association of elevated Lp(a) with increased risk of subsequent MACE and coronary revascularisation highlights a population who may benefit from earlier and more targeted intervention for cardiovascular risk including Lp(a), particularly within the first year after ASCVD diagnosis. Proactive Lp(a) testing as part of routine clinical practice can help identify and better manage these higher-risk individuals.
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Affiliation(s)
- Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
| | | | | | | | | | | | | | | | | | - Rosemary Brown
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | | | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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12
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Vasse J, Lassartesse A, Marmontel O, Charrière S, Bouveyron C, Marrié N, Moulin P, Di Filippo M. Assessment of three equations to calculate plasma LDL cholesterol concentration in fasting and non-fasting hypertriglyceridemic patients. Clin Chem Lab Med 2024; 62:270-279. [PMID: 37678263 DOI: 10.1515/cclm-2023-0360] [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: 04/09/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Low-density lipoprotein cholesterol (LDL-C) concentration was calculated for many years using the Friedewald equation, but those from Sampson and extended-Martin-Hopkins perform differently. Their accuracy in fasting hypertriglyceridemia and non-fasting state were compared and the clinical impact of implementing these equations on risk classification and on the setting of lipid treatment goals was assessed. METHODS Seven thousand six standard lipid profiles and LDL-C concentrations measured after ultracentrifugation (uLDL-C) were retrospectively included. uLDL-C were compared to calculated LDL-C in terms of correlation, root mean square error, residual error, mean absolute deviations and cardiovascular stratification. RESULTS In fasting state (n=5,826), Sampson equation was the most accurate, exhibited the highest percentage of residual error lower than 0.13 mmol/L (67 vs. 57 % and 63 % using Friedewald, or extended-Martin-Hopkins equations respectively) and the lowest misclassification rate. However, the superiority of this equation was less pronounced when triglyceride concentration (TG) <4.5 mmol/L were considered. In post-prandial state (n=1,180), extended-Martin-Hopkins was the most accurate equation, exhibited the highest percentage of residual error lower than 0.13 mmol/L (73 vs. 39 % and 57 % using Friedewald and Sampson equation respectively). Overall, the negative bias with Sampson equation may lead to undertreatment. Conversely, a positive bias was observed with extended Martin-Hopkins. CONCLUSIONS None of the equations tested are accurate when TG>4.52 mmol/L. When TG<4.52 mmol/L both Sampson and Martin-Hopkins equations performed better than Friedewald. The switch to one or the other should take in account their limitations, their ease of implementation into the lab software and the proportion of non-fasting patients.
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Affiliation(s)
- Joséphine Vasse
- UF Dyslipidémies, Service de Biochimie et de Biologie Moléculaire, Laboratoire de Biologie Médicale MultiSites, Hospices Civils de Lyon Bron, France
| | - Audrey Lassartesse
- UF Dyslipidémies, Service de Biochimie et de Biologie Moléculaire, Laboratoire de Biologie Médicale MultiSites, Hospices Civils de Lyon Bron, France
| | - Oriane Marmontel
- UF Dyslipidémies, Service de Biochimie et de Biologie Moléculaire, Laboratoire de Biologie Médicale MultiSites, Hospices Civils de Lyon Bron, France
- CarMen Laboratory, INSERM, INRA, Université Claude Bernard Lyon 1, Pierre-Bénite, France
| | - Sybil Charrière
- CarMen Laboratory, INSERM, INRA, Université Claude Bernard Lyon 1, Pierre-Bénite, France
- Hospices Civils de Lyon, Fédération d'endocrinologie, maladies métaboliques, diabète et nutrition, Hôpital Louis Pradel, Bron, France
| | - Caroline Bouveyron
- UF Dyslipidémies, Service de Biochimie et de Biologie Moléculaire, Laboratoire de Biologie Médicale MultiSites, Hospices Civils de Lyon Bron, France
| | - Nathanaël Marrié
- UF Dyslipidémies, Service de Biochimie et de Biologie Moléculaire, Laboratoire de Biologie Médicale MultiSites, Hospices Civils de Lyon Bron, France
| | - Philippe Moulin
- CarMen Laboratory, INSERM, INRA, Université Claude Bernard Lyon 1, Pierre-Bénite, France
- Hospices Civils de Lyon, Fédération d'endocrinologie, maladies métaboliques, diabète et nutrition, Hôpital Louis Pradel, Bron, France
| | - Mathilde Di Filippo
- UF Dyslipidémies, Service de Biochimie et de Biologie Moléculaire, Laboratoire de Biologie Médicale MultiSites, Hospices Civils de Lyon Bron, France
- CarMen Laboratory, INSERM, INRA, Université Claude Bernard Lyon 1, Pierre-Bénite, France
- Hospices Civils de Lyon, Groupement Hospitalier Est, Centre de Biologie et de Pathologies Est (Aile A3), Bron Cedex, France
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Hansen MK, Mortensen MB, Warnakula Olesen KK, Thrane PG, Maeng M. Non-HDL cholesterol and residual risk of cardiovascular events in patients with ischemic heart disease and well-controlled LDL cholesterol: a cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 36:100774. [PMID: 38019978 PMCID: PMC10652132 DOI: 10.1016/j.lanepe.2023.100774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
Background Identifying patients at high residual risk of atherosclerotic cardiovascular disease (ASCVD) despite statin-treatment is of paramount clinical importance. We aim to investigate if non-high-density lipoprotein cholesterol (non-HDL-C) identifies residual risk of ASCVD and death in statin-treated patients with ischemic heart disease and low-density lipoprotein cholesterol (LDL-C) ≤ 1.8 mmol/L. Methods Leveraging Danish regional and national registries, we identified statin-treated patients with ischemic heart disease who underwent coronary angiography (CAG) and attained LDL-C ≤ 1.8 mmol/L within a year post-CAG. Outcomes were myocardial infarction (MI), ASCVD (MI or ischemic stroke), and all-cause death occurring from one year after CAG to end of follow-up. Cox regression analyses obtained adjusted hazard ratios (HR). Findings Between January 1, 2011, and December 31, 2020, we included 23,641 statin-treated patients with ischemic heart disease and LDL-C ≤ 1.8 mmol/L. During median follow-up of 4.1 years (IQR 2.4-6.1), 893 (3.8%) patients developed MI, 1207 (5.1%) ASCVD, and 3054 (12.9%) patients died. For ASCVD the adjusted HRs (95% confidence interval) for non-HDL-C < 25th percentile (<1.7 mmol/L) versus 25th-74th (1.7-2.1 mmol/L), 75th-94th (2.2-2.6 mmol/L), and ≥95th (≥2.7 mmol/L) percentile were 1.1 (0.9-1.3), 1.4 (1.1-1.7), and 1.8 (1.4-2.4), and for all-cause death 1.0 (0.9-1.1), 1.2 (1.1-1.4), and 1.4 (1.2-1.7), respectively. Interpretation In a contemporary secondary prevention cohort of patients with well-managed LDL-C, non-HDL-C emerges as an easily accessible marker to detect patients facing high residual risk of ASCVD and death. These findings are important for preventive strategies extending beyond LDL-C targets. Funding Research grant from the Novo Nordisk Foundation.
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Affiliation(s)
- Malene Kærslund Hansen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - Martin Bødtker Mortensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
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Sopic M, Vilne B, Gerdts E, Trindade F, Uchida S, Khatib S, Wettinger SB, Devaux Y, Magni P. Multiomics tools for improved atherosclerotic cardiovascular disease management. Trends Mol Med 2023; 29:983-995. [PMID: 37806854 DOI: 10.1016/j.molmed.2023.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023]
Abstract
Multiomics studies offer accurate preventive and therapeutic strategies for atherosclerotic cardiovascular disease (ASCVD) beyond traditional risk factors. By using artificial intelligence (AI) and machine learning (ML) approaches, it is possible to integrate multiple 'omics and clinical data sets into tools that can be utilized for the development of personalized diagnostic and therapeutic approaches. However, currently multiple challenges in data quality, integration, and privacy still need to be addressed. In this opinion, we emphasize that joined efforts, exemplified by the AtheroNET COST Action, have a pivotal role in overcoming the challenges to advance multiomics approaches in ASCVD research, with the aim to foster more precise and effective patient care.
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Affiliation(s)
- Miron Sopic
- Cardiovascular Research Unit, Department of Precision Health, 1A-B rue Edison, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg; Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, 11000, Serbia
| | - Baiba Vilne
- Bioinformatics Laboratory, Rīga Stradiņš University, Rīga, LV-1007, Latvia
| | - Eva Gerdts
- Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, Bergen, 5020, Norway
| | - Fábio Trindade
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, 4099-002, Portugal
| | - Shizuka Uchida
- Center for RNA Medicine, Department of Clinical Medicine, Aalborg University, Copenhagen, SV, DK-2450, Denmark
| | - Soliman Khatib
- Natural Compounds and Analytical Chemistry Laboratory, MIGAL-Galilee Research Institute, Kiryat Shemona, 11016, Israel; Department of Biotechnology, Tel-Hai College, Upper Galilee 12210, Israel
| | - Stephanie Bezzina Wettinger
- Department of Applied Biomedical Science, Faculty of Health Sciences, University of Malta, Msida, 2080, Malta
| | - Yvan Devaux
- Cardiovascular Research Unit, Department of Precision Health, 1A-B rue Edison, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg.
| | - Paolo Magni
- Department of Pharmacological and Biomolecular Sciences 'Rodolfo Paoletti', Università degli Studi di Milano, Via G. Balzaretti 9, 20133 Milano, Italy; IRCCS MultiMedica, Via Milanese 300, 20099 Sesto S. Giovanni, Milan, Italy.
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15
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Tokgözoğlu L, Pirillo A, Catapano AL. Disconnect between triglyceride reduction and cardiovascular outcomes: lessons from the PROMINENT and CLEAR Outcomes trials. Eur Heart J 2023:ehad485. [PMID: 37936268 DOI: 10.1093/eurheartj/ehad485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Affiliation(s)
- Lale Tokgözoğlu
- Department of Cardiology, Hacettepe University Medical Faculty, Sihhiye, 06100, Ankara, Turkey
| | - Angela Pirillo
- Center for the Study of Atherosclerosis, E. Bassini Hospital, via M. Gorki 50, 20092, Cinisello Balsamo, Milan, Italy
- IRCCS MultiMedica, via Milanese 300, 20099, Sesto San Giovanni, Milan, Italy
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Chen Y, Chen S, Han Y, Xu Q, Zhao X. Elevated ApoB/apoA-1 is Associated with in-Hospital Mortality in Elderly Patients with Acute Myocardial Infarction. Diabetes Metab Syndr Obes 2023; 16:3501-3512. [PMID: 37942174 PMCID: PMC10629450 DOI: 10.2147/dmso.s433876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/21/2023] [Indexed: 11/10/2023] Open
Abstract
Background Apolipoprotein B/apolipoprotein A-1 (apoB/apoA-1) has been shown to be strongly associated with the risk of future cardiovascular disease, but the association between apoB/apoA-1 and the risk of in-hospital death in elderly patients with acute myocardial infarction(AMI) is inconclusive. Aim To investigate the association between apoB/apoA-1 and the risk of in-hospital death in elderly patients with AMI. Methods From December 2015 to December 2021, a total of 1495 elderly AMI patients (aged ≥ 60 years) with complete clinical history data were enrolled in the Second Hospital of Dalian Medical University. Outcome was defined as all-cause mortality during hospitalization. Multivariate logistic regression and restricted spline cubic (RCS) models were used to evaluate the association between apoB/apoA-1 and in-hospital mortality risk, respectively. Receiver operating characteristic(ROC) curves were used to evaluate the predictive value of apoB/apoA-1 for in-hospital mortality events. Discordance analysis was performed when apoB/apoA-1 and LDL-C/HDL-C were not in concordance. Results (1) A total of 128 patients (8.6%) died during hospitalization. Patients in the death group had higher apoB/apoA-1 than those in the non-death group, but lower apoA-1 levels than those in the non-death group, and the difference was statistically significant (P < 0.05); (2) Multivariate logistic regression analysis showed that apoB/apoA-1 was associated with the risk of in-hospital death in elderly AMI patients [Model 3 OR = 3.524 (1.622-7.659), P = 0.001]; (3) ROC curve analysis showed that apoB/apoA-1 (AUC = 0.572, P = 0.011) had some predictive value for the risk of in-hospital death in elderly AMI patients; (4) RCS models showed a linear dose-response relationship between apoB/apoA-1 and in-hospital death after adjusting for confounders (P for non-linearity = 0.762). Conclusion ApoB/apoA-1 is associated with the risk of in-hospital death in elderly patients with AMI, and is superior to other blood lipid parameters and blood lipid ratio.
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Affiliation(s)
- Yan Chen
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Shengyue Chen
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Yuanyuan Han
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Qing Xu
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Xin Zhao
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
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17
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Holven KB, Roeters van Lennep J. Sex differences in lipids: A life course approach. Atherosclerosis 2023; 384:117270. [PMID: 37730457 DOI: 10.1016/j.atherosclerosis.2023.117270] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/18/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023]
Abstract
Differences between men and women in lipids and lipoproteins are observed in distribution and trajectory from infancy to adulthood in the general population. However, these differences are more pronounced in hereditary lipid disorders such as familial hypercholesterolemia (FH) when absolute cholesterol levels are higher from birth onwards. In the early life course, girls compared to boys have higher low-density lipoprotein cholesterol (LDL-C) levels and total cholesterol, while high-density lipoprotein cholesterol (HDL-C) levels are similar. In early adulthood to middle-age, women have lower LDL-C and higher HDL-C levels, as LDL-C levels increase and HDLC levels decrease in men. In the elderly, all lipids - total cholesterol, LDL-C, HDL-C and triglyceride levels decrease but are more pronounced in men. Lipid levels are also affected by specific transitions in girls/women such as the menstrual cycle, pregnancy, breastfeeding and menopause. Lipid levels fluctuate during the menstrual cycle. During pregnancy a physiological increase of LDL-C and even a larger increase in triglyceride levels are observed. Pregnancy has a double impact on LDL-C accumulation in women with FH as they have to stop statins, and the absolute increase in LDL-C is higher than in women without FH. In the menopausal transition, women develop a more adverse lipid profile. Therefore, it is important to take into account both sex and the life course when assessing a lipid profile.
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Affiliation(s)
- Kirsten B Holven
- Department of Nutrition, Institute for Basic Medical Science, University of Oslo, Oslo, Norway; National Advisory Unit on FH, Oslo University Hospital, Oslo, Norway.
| | - Jeanine Roeters van Lennep
- Cardiovascular Institute, Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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18
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März W, Scharnagl H, Kleber M, Silbernagel G, Nauck M, Müller-Wieland D, von Eckardstein A. [Laboratory diagnostics of lipid metabolism disorders]. Dtsch Med Wochenschr 2023; 148:e120-e146. [PMID: 37949074 PMCID: PMC10637831 DOI: 10.1055/a-1516-2511] [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] [Indexed: 11/12/2023]
Abstract
Clinically, disorders of lipid metabolism often remain without symptoms. Typical skin lesions, however, can be indicative. Secondary hyperlipoproteinemias (HLP) are more common than primary hyperlipoproteinemias; they can (partially) be improved by treating the underlying disease. Basic diagnostics consist of the determination of cholesterol, triglycerides, LDL cholesterol and HDL cholesterol. To exclude secondary HLP, glucose, HbA1C, TSH, transaminases, creatinine, urea, protein and protein in the urine are useful. Since virtually all routine methods for LDL-C are biased by high triglycerides, lipoprotein electrophoresis is indicated for triglycerides above 400 mg/dl (4.7 mmol/l). Primary HLPs have known or yet unknown genetic causes. Primary hyperlipidemias should be taken into consideration especially in young patients with an LDL cholesterol concentration are above 190 mg/dl (4.9 mmol/l) and/or triglycerides above 400 mg/dl (10 mmol/l) and secondary HLP (obesity, alcohol, diabetes mellitus, kidney disease) is excluded. The basic diagnostics is meaningfully extended by the measurement of lipoprotein (a) (Lp(a)). It is indicated in moderate and high risk of vascular disease, progression of atherosclerosis in "well-controlled" LDL cholesterol, familial clustering of atherosclerosis or high Lp(a), evidence for elevated Lp(a) coming from lipoprotein electrophoresis, aortic stenosis and in patients in whom statins have a poor effect. Genetic diagnostics needs to be considered if primary HLP is suspected. It is most frequently conducted for suspected familial hypercholesterolemia and has already been recommended in guidelines.
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Affiliation(s)
- Winfried März
- Korrespondenzadresse Univ. Prof. Dr. med. Winfried März SYNLAB AkademieP5,7D-68167 Mannheim+49/6 21/43 17 94 32+49/6 21/4 31 94 33
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19
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Raja V, Aguiar C, Alsayed N, Chibber YS, ElBadawi H, Ezhov M, Hermans MP, Pandey RC, Ray KK, Tokgözoglu L, Zambon A, Berrou JP, Farnier M. Non-HDL-cholesterol in dyslipidemia: Review of the state-of-the-art literature and outlook. Atherosclerosis 2023; 383:117312. [PMID: 37826864 DOI: 10.1016/j.atherosclerosis.2023.117312] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023]
Abstract
Dyslipidemia refers to unhealthy changes in blood lipid composition and is a risk factor for atherosclerotic cardiovascular diseases (ASCVD). Usually, low-density lipoprotein-cholesterol (LDL-C) is the primary goal for dyslipidemia management. However, non-high-density lipoprotein cholesterol (non-HDL-C) has gained attention as an alternative, reliable goal. It encompasses all plasma lipoproteins like LDL, triglyceride-rich lipoproteins (TRL), TRL-remnants, and lipoprotein a [Lp(a)] except high-density lipoproteins (HDL). In addition to LDL-C, several other constituents of non-HDL-C have been reported to be atherogenic, aiding the pathophysiology of atherosclerosis. They are acknowledged as contributors to residual ASCVD risk that exists in patients on statin therapy with controlled LDL-C levels. Therefore, non-HDL-C is now considered an independent risk factor or predictor for CVD. The popularity of non-HDL-C is attributed to its ease of estimation and non-dependency on fasting status. It is also better at predicting ASCVD risk in patients on statin therapy, and/or in those with obesity, diabetes, and metabolic disorders. In addition, large follow-up studies have reported that individuals with higher baseline non-HDL-C at a younger age (<45 years) were more prone to adverse CVD events at an older age, suggesting a predictive ability of non-HDL-C over the long term. Consequently, non-HDL-C is recommended as a secondary goal for dyslipidemia management by most international guidelines. Intriguingly, geographical patterns in recent epidemiological studies showed remarkably high non-HDL-C attributable mortality in high-risk countries. This review highlights the independent role of non-HDL-C in ASCVD pathogenesis and prognosis. In addition, the need for a country-specific approach to dyslipidemia management at the community/population level is discussed. Overall, non-HDL-C can become a co-primary or primary goal in dyslipidemia management.
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Affiliation(s)
- Vikrama Raja
- Abbott Products Operations AG, Basel, Switzerland
| | - Carlos Aguiar
- Department of Cardiology, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | | | | | - Hussein ElBadawi
- Internal Medicine Department, Wayne State University, Detroit, MI, USA; Metabolic Unit, My Clinic International, Jeddah, Saudi Arabia
| | - Marat Ezhov
- National Medical Research Center of Cardiology n.a. ac. E.I. Chazov, Moscow, Russia
| | | | | | - Kausik K Ray
- Imperial Centre for Cardiovascular Disease Prevention, Imperial College London, UK
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20
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Romaszko J, Gromadziński L, Buciński A. Friedewald formula may be used to calculate non-HDL-C from LDL-C and TG. Front Med (Lausanne) 2023; 10:1247126. [PMID: 37790128 PMCID: PMC10543427 DOI: 10.3389/fmed.2023.1247126] [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: 06/25/2023] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Background The Friedewald formula (FF) was originally designed 50 years ago and has been in use to this day despite better methods for estimating LDL cholesterol (LDL-C). Its success was mainly due to its simplicity. Nowadays most laboratories determine or can determine LDL-C by the direct method. The SCORE2 tables, recommended by the European Society of Cardiology, are based on non-HDL cholesterol (non-HDL-C). To calculate its value, one needs to know the values of total cholesterol (TC) and HDL-C. The presented idea is to use the FF to calculate non-HDL-C based on the values of LDL-C and TG instead of TC and HDL-C. Methods and findings Based on database of 26,914 laboratory results, covering the complete lipid panel, the error regarding non-HDL-C values calculated in both ways (recommended and proposed) was determined. The average error in the LDL-C value calculated with the FF compared to the LDL-C value measured in the laboratory is 9.77%, while for non-HDL-C the error between the calculated and laboratory-determined value amounts to 8.88%. The proposed transformation of the FF also yields a much lower percentage of error calculations. Both LDL-C and non-HDL-C (calculated) in our material are strongly correlated with LDL-C and non-HDL-C (measured) values of r = 0.965 (p < 0.000) and r = 0.962 (p < 0.000), respectively. Conclusion Non-HDL-C may be calculated based on the values of LDL-C and TG (without the need to determine the levels of TC and HDL-C). The proposed calculation may greatly reduce the cost of testing, given the price of a complete lipid profile.
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Affiliation(s)
- Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Adam Buciński
- Department of Biopharmacy, Faculty of Pharmacy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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21
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Carlos Obaya J, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories: What parameters should a basic lipid profile include? Rev Clin Esp 2023; 223:440-449. [PMID: 37302464 DOI: 10.1016/j.rceng.2023.06.001] [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: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/13/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicinade Laboratorio (SEQCML), Laboratoriode Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain. Investigador Asociado, Facultad de Cienciasdela Salud, Universidad Autónomade Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidadde Medicina Interna, Hospital Universitario Fundaciónde Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidadde Cardiología, Hospital Universitario Fundaciónde Alcorcón, Asociaciónde Riesgo vasculary Rehabilitación Cardiacadela Sociedad Española de Cardiología, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiologíay CirugíaVascular (SEACV), Unidad Intercentros Cádiz-Jerezde Angiologíay Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovasculary Endovascular (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Serviciode Endocrinologíay Nutrición, Hospital de la Santa Creui Sant Pau, Barcelona, Spain
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinologíay Nutrición (SEEN), Secciónde Endocrinología, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatologíay Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantily Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, Spain
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Sociedad Española de Medicinade Familiay Comunitaria (SEMFyC), Medicina Familiary Comunitaria, CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Sociedad Española de MedicinaInterna (SEMI), Unidad de Hipertensión, Lípidosy Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Uniónde Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Islade Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, A Coruña, Spain
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, Spain
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22
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Botana López AM, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories. ENDOCRINOL DIAB NUTR 2023; 70:501-510. [PMID: 37268528 DOI: 10.1016/j.endien.2023.05.012] [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: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/04/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Antonio Buño Soto
- Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
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23
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Nomikos T, Georgoulis M, Chrysohoou C, Damigou E, Barkas F, Skoumas I, Liberopoulos E, Pitsavos C, Tsioufis C, Sfikakis PP, Tselepis A, Panagiotakos DB. Comparative performance of equations to estimate low-density lipoprotein cholesterol levels and cardiovascular disease incidence: The ATTICA study (2002-2022). Lipids 2023; 58:159-170. [PMID: 37153959 DOI: 10.1002/lipd.12371] [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: 03/09/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
Accurate estimation of low-density lipoprotein cholesterol (LDL-C) is important for monitoring cardiovascular disease (CVD) risk and guiding lipid-lowering therapy. This study aimed to evaluate the magnitude of discordance of LDL-C levels calculated by different equations and its effect on CVD incidence. The study sample consisted of 2354 CVD-free individuals (49% males, mean age 45 ± 14 years); 1600 were re-evaluated at 10 years and 1570 at 20 years. LDL-C was estimated using the Friedewald, Martin/Hopkins, and Sampson equations. Participants were categorized as discordant if estimated LDL-C was below the CVD-risk specific cut-off for one equation and equal/above for its comparator. The Friedewald and Martin/Hopkins equations presented a similar performance in estimating LDL-C; however, both yielded lower values compared to the Sampson. In all pairwise comparisons, differences were more pronounced at lower LDL-C levels, while the Friedewald equation significantly underestimated LDL-C in hypertriglyceridemic participants. Discordance was evident in 11% of the study population, and more specifically 6%, 22%, and 20% for Friedewald versus Martin/Hopkins, Friedewald versus Sampson and Martin/Hopkins versus Sampson equations, respectively. Among discordant participants, median (1st, 3rd quartile) difference in LDL-C was -4.35 (-10.1, 1.95), -10.6 (-12.3, -9.53) and -11.3 (-11.9, -10.6) mg/dL for Friedewald versus Martin/Hopkins, Friedewald versus Sampson and Martin/Hopkins versus Sampson equations, respectively. The 10- and 20-year CVD survival model that included LDL-C values of the Martin-Hopkins equation outperformed the predictive ability of those based on the Friedewald or Sampson equations. Significant differences in estimated LDL-C exist among equations, which may result in LDL-C underestimation and undertreatment.
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Affiliation(s)
- Tzortzis Nomikos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
| | - Fotios Barkas
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Ioannis Skoumas
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Alexandros Tselepis
- Department of Chemistry, Atherothrombosis Research Centre/Laboratory of Biochemistry, University of Ioannina, Ioannina, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, Athens, Greece
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24
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Velilla TA, Guijarro C, Ruiz RC, Piñero MR, Francisco Valderrama Marcos J, López AMB, López AM, Antonio García Donaire J, Obaya JC, Castilla Guerra L, Carratalá VP, Cabello IE, Lazo MS, Rodrigo MMC, María Mostaza Prieto J, Doblas JJG, Soto AB. Consensus document for lipid profile determination and reporting in Spanish clinical laboratories. What parameters should be included in a basic lipid profile? Nefrologia 2023; 43:474-483. [PMID: 37813740 DOI: 10.1016/j.nefroe.2023.08.002] [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: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 10/11/2023] Open
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain.
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Sevilla, Spain, Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain q Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
| | - Antonio Buño Soto
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain q Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
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Pintó X, Fanlo M, Esteve V, Millán J. Remnant cholesterol, vascular risk, and prevention of atherosclerosis. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:206-217. [PMID: 36889989 DOI: 10.1016/j.arteri.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
In patients who have achieved optimal LDL-C control, there remains a residual risk of atherothrombotic cardiovascular disease (ACVD) related to alterations in lipid metabolism, where alterations in triglyceride-rich lipoproteins and the cholesterol they contain, called remnant cholesterol, play a major role. Remnant cholesterol has an association with residual risk of ACVD that is independent of LDL-C and has been demonstrated in epidemiological and Mendelian randomisation studies, and in analyses of clinical trials of lipid-lowering drugs. Remnant triglyceride-rich lipoproteins particles are highly atherogenic, due to their ability to enter and be retained in the arterial wall, their high cholesterol content, and their ability to generate "foam cells" and an inflammatory response. Assessment of remnant cholesterol may provide information on residual risk of ACVD beyond the information provided by LDL-C, Non-HDL-C, and apoB, particularly in individuals with hypertriglyceridaemia, type 2 diabetes, or metabolic syndrome. In the REDUCE-IT study, icosapent ethyl was shown to have a preventive effect against ACVD in very high cardiovascular risk patients with hypertriglyceridaemia treated with statins and target LDL-C. New lipid-lowering drugs will help to define efficacy and criteria in the treatment of excess remnant cholesterol and hypertriglyceridaemia in the prevention of ACVD.
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Affiliation(s)
- Xavier Pintó
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Fundación para la Investigación y Prevención de Enfermedades Cardiovasculares (FIPEC), Barcelona, España; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Facultad de Medicina, Universidad de Barcelona, Barcelona, España.
| | - Marta Fanlo
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Fundación para la Investigación y Prevención de Enfermedades Cardiovasculares (FIPEC), Barcelona, España; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España
| | - Virginia Esteve
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Fundación para la Investigación y Prevención de Enfermedades Cardiovasculares (FIPEC), Barcelona, España; Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España
| | - Jesús Millán
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, España
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26
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Arrobas Velilla T, Guijarro C, Ruiz RC, Piñero MR, Valderrama Marcos JF, Pérez Pérez A, Botana López AM, López AM, García Donaire JA, Obaya JC, Castilla-Guerra L, Carratalá VP, Cabello IE, Lazo MS, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile testing and reporting in Spanish clinical laboratories: what parameters should a basic lipid profile include? ADVANCES IN LABORATORY MEDICINE 2023; 4:138-156. [PMID: 38075943 PMCID: PMC10701497 DOI: 10.1515/almed-2023-0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/02/2023] [Indexed: 04/05/2024]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Spanish Society of Laboratory Medicine (SEQCML), Laboratory of Clinical Biochemistry, Virgen Macarena University Hospital, Seville, Spain
| | - Carlos Guijarro
- Spanish Society of Arteriosclerosis (SEA), Unit of Internal Medicine, Hospital Alcorcón Foundation University Hospital, Rey Juan Carlos University, Madrid, Spain
| | - Raquel Campuzano Ruiz
- Spanish Society of Cardiology (SEC), Unit of Cardiology, Alcorcón Foundation University Hospital, Association for Vascular Risk and Cardiac Rehabilitation of the Spanish Society of Cardiology, Madrid, Spain
| | - Manuel Rodríguez Piñero
- Spanish Society of Angiology and Vascular Surgery (SEACV), Cross-center Cádiz-Jerez Unit of Angiology and Vascular Surgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - José Francisco Valderrama Marcos
- Spanish Society of Cardiovascular and Endovascular Surgery, Cardiovascular Surgery (SECCE), Regional University Hospital of Malaga, Málaga, Spain
| | - Antonio Pérez Pérez
- Spanish Society of Diabetes (SED), Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Antonio M Botana López
- Spanish Society of Endocrinology and Nutrition (SEEN), Section of Endocrinology, Lucus Augusti University Hospital, Lugo, Spain
| | - Ana Morais López
- Spanish Society of Gastroenterology, Paediatric Hepatology and Nutrition (SEGHNP), Unit of Paediatric Nutrition and Metabolic Diseases, La Paz University Hospital, Madrid, Spain
| | - José Antonio García Donaire
- Spanish Society of Hypertension, Spanish League for the Fight Against Arterial Hypertension (SEH-LELHA), Unit of Arterial Hypertension, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Juan Carlos Obaya
- Spanish Society of Family and Community Family (SEMFyC), CS La Chopera, Alcobendas, Madrid, Spain
| | - Luis Castilla-Guerra
- Spanish Society of Internal Medicine (SEMI), Unit of Hypertension, Lipids and Vascular Risk, Service of Internal Medicine, Seville, Spain
| | - Vicente Pallares Carratalá
- Hospital Virgen Macarena, PCDV Departamento de Medicina, University of Seville, Sevilla, Spain
- Spanish Society of Primary Care Physicians (SEMERGEN), Unit of Health Surveillance, Unión de Mutuas, Department of Medicine, Universitat Jaume I, Castellón, Castellón, Spain
| | - Isabel Egocheaga Cabello
- Spanish Society of General and Family Doctors (SEMG), Family and Community Medicine, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, Spain
| | - Mercedes Salgueira Lazo
- Spanish Society of Nephrology (SEN), Unit of Nephrology, Virgen Macarena University Hospital, Seville, Spain
| | - María Mar Castellanos Rodrigo
- Spanish Society of Neurology (SEN), Service of Neurology, Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, Spain
| | - José María Mostaza Prieto
- Spanish Society of Arteriosclerosis (SEA), Service of Internal Medicine, Hospital La Paz-Carlos III, Madrid, Spain
| | - Juan José Gómez Doblas
- Spanish Society of Cardiology (SEC), Service of Cardiology, Virgen de la Victoria University Hospital, Málaga, Spain
| | - Antonio Buño Soto
- Spanish Society of Laboratory Medicine (SEQCML), Service of Clinical Biochemistry, La Paz University Hospital, Madrid, Spain
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Abstract
PURPOSE OF REVIEW Despite indisputable role of LDL-C lowering, a considerable residual risk for atherosclerotic cardiovascular disease (ASCVD) persists. The precise mechanism(s) underlying this phenomenon remain unclear. Triglyceride-rich lipoproteins (TRL) appear to be one of the main mediators, based on the genetic and epidemiologic data. However, whether this is caused by direct effects of Triglycerides or other components of TRL remains uncertain. The cholesterol component of TRL remnants (Rem-C) has been proposed as a more pertinent mediator of the increased risk associated with high triglycerides. RECENT FINDINGS Several long-term observational studies have shown a significant relationship between Rem-C and ASCVD events, compared with other triglyceride-related parameters. Recent trials have shown that lowering of triglyceride levels by various agents, including fibrates and omega-3 fatty acids, in statin-treated subjects, did not explain the reduction in ASCVD events. In a large clinical trial with pemafibrate, a highly selective PPAR-α agonist, in type 2 diabetes and elevated triglycerides, the reduction in triglycerides was accompanied by a significant increase in LDL-C and Apo-B levels, despite a reduction in Rem-C, and no effect on ASCVD events. SUMMARY Elevated Rem-C as a risk determinant, with LDL-C at goal, requires additional studies in clinical trials. Standardization and accuracy of Rem-C assays (calculated versus direct method) is also needed.
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Affiliation(s)
- Om P Ganda
- Clinical Research and Adult Diabetes sections, Joslin Diabetes Center, Beth- Israel Deaconess Hospital, and Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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28
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Cobos A, Valdivielso P. Quo vadis, LDL cholesterol? ADVANCES IN LABORATORY MEDICINE 2023; 4:133-137. [PMID: 38075940 PMCID: PMC10701488 DOI: 10.1515/almed-2023-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Affiliation(s)
- Andrés Cobos
- UGC de Laboratorio, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Pedro Valdivielso
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Victoria, Departamento de Medicina y Dermatología, Universidad de Málaga e Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma BIONAND), Málaga, Spain
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Zafrir B, Khoury R, Saliba W. Remnant cholesterol and risk of myocardial infarction in patients with coronary artery disease undergoing revascularization. J Clin Lipidol 2023; 17:332-341. [PMID: 37005155 DOI: 10.1016/j.jacl.2023.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/08/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Despite substantial reduction in low-density lipoprotein cholesterol (LDL-C), patients develop recurrent cardiovascular events. Remnant cholesterol (RC), the cholesterol content of triglyceride-rich lipoproteins, is a potential contributor to this residual risk. OBJECTIVES To investigate the association between RC and risk for myocardial infarction (MI) in patients with coronary artery disease, and examine whether the predictive value of RC is retained beyond non-high-density lipoprotein cholesterol (non-HDL-C). METHODS Data on 9451 patients undergoing coronary revascularization in a single center. RC was calculated as total cholesterol minus high-density lipoprotein cholesterol minus LDL-C (estimated using Martin-Hopkins equation). Cox-regression models were used to estimate the association between RC and risk for MI. Discordance analyses were performed to examine the correlation between RC and non-HDL-C (or LDL-C) in relation to MI risk. RESULTS Mean age was 65±11 years; 67% presented with acute coronary syndrome. During median follow-up of 9.6 years, 1690 patients developed MI. After multivariable adjustment including lipid-lowering therapies and non-HDL-C, RC was associated with higher MI risk: hazard ratio (95% confidence interval): 1.36 (1.20-1.56) and 1.58 (1.35-1.85) in those with RC levels ≥75th (32.6 mg/dL) and ≥90th (41.8 mg/dL) percentile, compared to RC <50th percentile (25.5 mg/dL). When RC and non-HDL-C (or LDL-C) levels were discordant, the level of RC better reflected the risk for MI. CONCLUSIONS Elevated RC is a risk factor for MI independent of lipid-lowering therapies and non-HDL-C, providing further support that RC may serve as a residual cardiovascular risk marker and potential treatment target in patients with coronary artery disease.
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Affiliation(s)
- Barak Zafrir
- Department of Cardiology, Lady Davis Carmel Medical Center, 7 Michal St., Haifa, Israel; Faculty of Medicine, Technion, Israel Institute of Medicine, Israel.
| | - Razi Khoury
- Department of Cardiology, Lady Davis Carmel Medical Center, 7 Michal St., Haifa, Israel
| | - Walid Saliba
- Faculty of Medicine, Technion, Israel Institute of Medicine, Israel; Department of Community Medicine and Epidemiology, Lady Davis Carmel Medical Center, Haifa, Israel
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Fonseca AF, Byrne H, Laguna A, Itani T, Studer R, Heo J, Dillon A, Ferber P, Costa-Scharplatz M. Burden of lipoprotein(a) for patients with atherosclerotic cardiovascular disease: A retrospective analysis from the United States. J Manag Care Spec Pharm 2023; 29:519-529. [PMID: 37121256 PMCID: PMC10387958 DOI: 10.18553/jmcp.2023.29.5.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND: Lipoprotein(a) (Lp(a)) is an inherited, independent, and causal risk factor for atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: To assess the burden of elevated Lp(a) for patients with ASCVD in a real-world setting in the United States. METHODS: This retrospective cohort study assessed US patients with available Lp(a) measurement and established ASCVD using Optum's Clinformatics Data Mart database (2007-2020). Index date was defined as the first diagnosis of an ASCVD event. Patient demographics, medications, health care resource utilization (HCRU), and occurrence of cardiovascular events were assessed for patients with elevated (≥150 nmol/L) vs normal (≥65 nmol/L) Lp(a) levels, within the first year of index date. HCRU was characterized by inpatient hospitalization, inpatient length of stay (LOS), outpatient visits, and emergency department (ED) visits. All comparative analyses of patients with elevated (≥150 nmol/L) vs normal (≥65 nmol/L) Lp(a) levels within the first year of index date were adjusted for age, sex, baseline statin use, and diabetes. RESULTS: 8,372 patients with ASCVD and Lp(a) measurement in nmol/L were included in this study. Patient demographics and baseline clinical characteristics were similar among those with normal and elevated Lp(a). However, the proportion of patients receiving statins and β-blockers at baseline were significantly higher in the elevated vs normal Lp(a) group (54.76% vs 42.91%, P < 0.0001, and 30.92% vs 27.32%, P = 0.0183, respectively). At 1 year of follow-up, the rates per 100 person-years for ASCVD-related inpatient hospitalizations, outpatient hospitalizations, and ED visits were higher among patients with elevated Lp(a) compared with normal Lp(a) (13.33 vs 9.46, 89.08 vs 85.10, and 2.89 vs 2.29, respectively). The mean LOS per ASCVD-related hospitalization was 7.21 days in the elevated and 6.26 days in the normal Lp(a) group (P = 0.3462). During the 1-year post-index follow-up period, 15% of patients in the elevated Lp(a) group required revascularization compared with 10% of patients in the normal Lp(a) group (P = 0.0002). The odds of composite myocardial infarction, ischemic stroke, and revascularization occurrence of events within the first year of index was significantly higher in the elevated Lp(a) group compared with the normal Lp(a) group (1.46; 95% CI = 1.20-1.77; P < 0.05). CONCLUSIONS: HCRU within the first year of ASCVD diagnosis is substantial among patients with ASCVD and elevated Lp(a). Relatively higher rates of inpatient hospitalizations, increased LOS per hospitalization, and requirement of revascularization procedures within the first year of ASCVD index diagnosis were observed in patients with elevated Lp(a) compared with normal Lp(a) levels. Lp(a) testing in routine clinical practice could help in identification of high-risk patients with ASCVD and play an important role in the overall cardiovascular risk management, aiming to reduce the HCRU associated with ASCVD. DISCLOSURES: Ms Fonseca, Dr Laguna, Dr Itani, Dr Rachel Studer, and Dr Ferber are employees of Novartis Pharma AG, Basel, Switzerland. Ms Byrne is an employee of Novartis AG, Dublin, Ireland. Dr Costa-Scharplatz is an employee of Novartis Sweden AB, Stockholm, Sweden. Dr Heo and Ms Dillon are employees of Genesis Research. Genesis Research was commissioned to conduct the study (data extraction and analysis) on behalf of Novartis Pharma AG.
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. [Consensus document for lipid profile determination and reporting in Spanish clinical laboratories]. HIPERTENSION Y RIESGO VASCULAR 2023; 40:75-84. [PMID: 37121876 PMCID: PMC10176999 DOI: 10.1016/j.hipert.2022.12.002] [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: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 05/02/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicina de Laboratorio (SEQCML), Laboratorio de Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España. Investigador Asociado, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidad de Medicina Interna, Hospital Universitario Fundación de Alcorcón, Universidad Rey Juan Carlos, Madrid, España.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidad de Cardiología, Hospital Universitario Fundación de Alcorcón, Asociación de Riesgo vascular y Rehabilitación Cardiaca de la Sociedad Española de Cardiología, Madrid, España
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiología y Cirugía Vascular (SEACV), Unidad Intercentros Cádiz-Jerez de Angiología y Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, España
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovascular y Endovascular, (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinología y Nutrición (SEEN), Sección de Endocrinología, Hospital Universitario Lucus Augusti, Lugo, España
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantil y Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (SEMFyC), Medicina Familiar y Comunitaria, CS La Chopera, Alcobendas, Madrid, España
| | - Luis Castilla Guerra
- Sociedad Española de Medicina Interna (SEMI), Unidad de Hipertensión, Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, España
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, España
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, España
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, España
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España
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Effect of high-fat diet and morning or evening exercise on lipoprotein subfraction profiles: secondary analysis of a randomised trial. Sci Rep 2023; 13:4008. [PMID: 36899039 PMCID: PMC10006421 DOI: 10.1038/s41598-023-31082-0] [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: 12/16/2022] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
We investigated the effect of a high-fat diet (HFD) on serum lipid subfractions in men with overweight/obesity and determined whether morning or evening exercise affected these lipid profiles. In a three-armed randomised trial, 24 men consumed an HFD for 11 days. One group of participants did not exercise (n = 8, CONTROL), one group trained at 06:30 h (n = 8, EXam), and one group at 18:30 h (n = 8, EXpm) on days 6-10. We assessed the effects of HFD and exercise training on circulating lipoprotein subclass profiles using NMR spectroscopy. Five days of HFD induced substantial perturbations in fasting lipid subfraction profiles, with changes in 31/100 subfraction variables (adjusted p values [q] < 0.05). Exercise training induced a systematic change in lipid subfraction profiles, with little overall difference between EXam and EXpm. Compared with CONTROL, exercise training reduced serum concentrations of > 20% of fasting lipid subfractions. EXpm reduced fasting cholesterol concentrations in three LDL subfractions by ⁓30%, while EXam only reduced concentration in the largest LDL particles by 19% (all q < 0.05). Lipid subfraction profiles changed markedly after 5 days HFD in men with overweight/obesity. Both morning and evening exercise training impacted subfraction profiles compared with no exercise.
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Arrobas Velilla T, Guijarro C, Campuzano Ruiz R, Rodríguez Piñero M, Valderrama Marcos JF, Pérez Pérez A, Botana López MA, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallares Carratalá V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Consensus document for lipid profile determination and reporting in Spanish clinical laboratories. What parameters should be included in a basic lipid profile? CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:91-100. [PMID: 36925360 DOI: 10.1016/j.arteri.2022.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 03/16/2023]
Abstract
Cardiovascular diseases (CVD) continue to be the main cause of death in our country. Adequate control of lipid metabolism disorders is a key challenge in cardiovascular prevention that is far from being achieved in real clinical practice. There is a great heterogeneity in the reports of lipid metabolism from Spanish clinical laboratories, which may contribute to its poor control. For this reason, a working group of the main scientific societies involved in the care of patients at vascular risk, has prepared this document with a consensus proposal on the determination of the basic lipid profile in cardiovascular prevention, recommendations for its realization and unification of criteria to incorporate the lipid control goals appropriate to the vascular risk of the patients in the laboratory reports.
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Affiliation(s)
- Teresa Arrobas Velilla
- Sociedad Española de Medicina de Laboratorio (SEQCML), Laboratorio de Bioquímica Clínica, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España. Investigador Asociado, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - Carlos Guijarro
- Sociedad Española de Arteriosclerosis (SEA), Unidad de Medicina Interna, Hospital Universitario Fundación de Alcorcón, Universidad Rey Juan Carlos, Madrid, España.
| | - Raquel Campuzano Ruiz
- Sociedad Española de Cardiología (SEC), Unidad de Cardiología, Hospital Universitario Fundación de Alcorcón, Asociación de Riesgo vascular y Rehabilitación Cardiaca de la Sociedad Española de Cardiología, Madrid, España
| | - Manuel Rodríguez Piñero
- Sociedad Española de Angiología y Cirugía Vascular (SEACV), Unidad Intercentros Cádiz-Jerez de Angiología y Cirugía Vascular, Hospital Universitario Puerta del Mar, Cádiz, España
| | - José Francisco Valderrama Marcos
- Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE), Cirugía Cardiovascular, Hospital Regional Universitario de Málaga, Málaga, España
| | - Antonio Pérez Pérez
- Sociedad Española de Diabetes (SED), Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Manuel Antonio Botana López
- Sociedad Española de Endocrinología y Nutrición (SEEN), Sección de Endocrinología, Hospital Universitario Lucus Augusti, Lugo, España
| | - Ana Morais López
- Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP), Unidad de Nutrición Infantil y Enfermedades Metabólicas, Hospital Universitario La Paz, Madrid, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA), Unidad de Hipertensión Arterial, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (SEMFyC), Medicina Familiar y Comunitaria, CS La Chopera, Alcobendas, Madrid, España
| | - Luis Castilla Guerra
- Sociedad Española de Medicina Interna (SEMI), Unidad de Hipertensión, Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital Virgen Macarena, PCDV Departamento de Medicina, Universidad de Sevilla, Sevilla, España
| | - Vicente Pallares Carratalá
- Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Unidad de Vigilancia de la Salud, Unión de Mutuas, Departamento de Medicina, Universitat Jaume I, Castellón, Castellón, España
| | - Isabel Egocheaga Cabello
- Sociedad Española de Médicos Generales y de Familia (SEMG), Medicina Familiar y Comunitaria, Centro de Salud Isla de Oza, Servicio Madrileño de Salud, Madrid, España
| | - Mercedes Salgueira Lazo
- Sociedad Española de Nefrología (SEN), Unidad de Nefrología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, España
| | - María Mar Castellanos Rodrigo
- Sociedad Española de Neurología (SEN), Servicio de Neurología Complejo Hospitalario Universitario A Coruña/Instituto de Investigación Biomédica A Coruña, Coruña, España
| | - José María Mostaza Prieto
- Sociedad Española de Arteriosclerosis (SEA), Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
| | - Juan José Gómez Doblas
- Sociedad Española de Cardiología (SEC), Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Antonio Buño Soto
- Sociedad Española de Medicina de Laboratorio (SEQCML), Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, España
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Johansen AK, Bogsrud MP, Christensen JJ, Rundblad A, Narverud I, Ulven S, Langslet G, Retterstøl K, Holven KB. Young women with familial hypercholesterolemia have higher LDL-cholesterol burden than men: Novel data using repeated measurements during 12-years follow-up. ATHEROSCLEROSIS PLUS 2023; 51:28-34. [PMID: 36911286 PMCID: PMC9995918 DOI: 10.1016/j.athplu.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/14/2023] [Accepted: 01/31/2023] [Indexed: 03/06/2023]
Abstract
Background and aims The concentration and the duration of exposure to low-density lipoprotein cholesterol (LDL-C) (LDL-C burden) is an important determinant of risk for cardiovascular disease and thresholds has recently been estimated. Individuals with familial hypercholesterolemia (FH) have increased risk of premature cardiovascular disease. The overall aim of the present study was to describe differences in LDL-C level and LDL-C burden in females and males with FH visiting an outpatient lipid clinic from a young age, using multiple LDL-C measurements during a follow-up time of 12 years. First, we aimed to study if the LDL-C concentration and the LDL-C burden is different between females and males at ages 0-10, 10-20, 20-30 and >30 years. Second, we aimed to estimate the subject-specific LDL-C burden at age 19 and 30 years, and the proportion of female and male patients that reach suggested LDL-C thresholds indicating high risk of ASCVD. Methods Data was retrospectively collected from medical records of 438 subjects (207 girls and 231 boys) with FH, referred to the Lipid Clinic, Oslo University Hospital below the age of 19 years. The LDL-C burden was estimated based on repeated LDL-C measurements over time. Results Subjects were followed over a period of mean 12.0 (SD 7.0) years, with median 10 years (7-17; 25-75 percentiles, minimum 2), with median 6 (4-9; 25-75 percentiles, minimum 2) available LDL-C measurements, starting at mean age 11 (SD 3.9) years. There was a difference in both LDL-C and LDL-C burden between sexes at different ages. On average, males had lower LDL-C over time, although this difference was less pronounced with age and males also had lower estimated LDL-C burden over time, and this difference was further exacerbated with age. Conclusion Our study shows that young women with FH have a higher LDL-C burden than their male counterparts, potentially explaining the increased excess CVD risk seen among these. It underscores the importance of careful-follow up and early treatment initiation both prior to and after pregnancies in order to limit statin-free periods.
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Affiliation(s)
- Anja K Johansen
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Martin P Bogsrud
- Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Oslo, Norway
| | - Jacob J Christensen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Amanda Rundblad
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Ingunn Narverud
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Stine Ulven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | | | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,Lipid Clinic, Oslo University Hospital, Oslo, Norway
| | - Kirsten B Holven
- Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Cholesterol Remnants, Triglyceride-Rich Lipoproteins and Cardiovascular Risk. Int J Mol Sci 2023; 24:ijms24054268. [PMID: 36901696 PMCID: PMC10002331 DOI: 10.3390/ijms24054268] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/23/2023] Open
Abstract
Randomized clinical trials with statins and other lipid-lowering drugs have shown the presence of a "residual cardiovascular risk" in those treated to "target" for LDL-cholesterol. This risk is mainly associated to lipid components other than LDL and in particular to remnant cholesterol (RC) and to lipoproteins rich in triglycerides in fasting and non-fasting conditions. During fasting, RCs correspond to the cholesterol content of the VLDL and their partially depleted triglyceride remnant containing apoB-100. Conversely, in non-fasting conditions, RCs include also cholesterol present in chylomicrons containing apoB-48. Therefore, RCs refer to total plasma cholesterol minus HDL-cholesterol and LDL-cholesterol, that is, all the cholesterol present in the VLDL, chylomicrons and in their remnants. A large body of experimental and clinical data suggests a major role of RCs in the development of atherosclerosis. In fact, RCs easily pass the arterial wall and bind to the connective matrix stimulating the progression of smooth muscle cells and the proliferation of resident macrophages. RCs are a causal risk factor for cardiovascular events. Fasting and non-fasting RCs are equivalent for predicting vascular events. Further studies on drugs effect on RC levels and clinical trials to evaluate the efficacy of RC reduction on cardiovascular events are needed.
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Arrobas T, Guijarro C, Campuzano R, Rodríguez Piñero M, Valderrama Marcos JF, Botana López AM, Morais López A, García Donaire JA, Obaya JC, Castilla Guerra L, Pallarés Carratalà V, Egocheaga Cabello I, Salgueira Lazo M, Castellanos Rodrigo MM, Mostaza Prieto JM, Gómez Doblas JJ, Buño Soto A. Documento de consenso para la determinación e informe del perfil lipídico en laboratorios clínicos españoles. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2023. [DOI: 10.55783/rcmf.160106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Las enfermedades cardiovasculares (ECV) siguen siendo la principal causa de muerte en nuestro país. El control adecuado de las alteraciones del metabolismo lipídico es un reto clave en prevención cardiovascular que está lejos de alcanzarse en la práctica clínica real. Existe una gran heterogeneidad en los informes del metabolismo lipídico de los laboratorios clínicos españoles, lo que puede contribuir al mal control del mismo. Por ello, un grupo de trabajo de las principales sociedades científicas implicadas en la atención de los pacientes de riesgo vascular, hemos elaborado este documento con una propuesta básica de consenso sobre la determinación del perfil lipídico básico en prevención cardiovascular, recomendaciones para su realización y unificación de criterios para incorporar los objetivos de control lipídico adecuados al riesgo vascular de los pacientes en los informes de laboratorio.
Palabras clave: consenso, panel de lípidos, enfermedades cardiovasculares, bioquímica, colesterol, lípidos, triglicéridos, lipoproteína (a).
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Affiliation(s)
- Teresa Arrobas
- Miembro de la Sociedad Española de Medicina de Laboratorio (SEQCML). Laboratorio de Bioquímica Clínica. Hospital Universitario Virgen Macarena. Sevilla (España). Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Carlos Guijarro
- Miembro de la Sociedad Española de Arteriosclerosis (SEA). Unidad de Medicina Interna. Hospital Universitario Fundación de Alcorcón. Universidad Rey Juan Carlos. Madrid (España).Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Raquel Campuzano
- Miembro de la Sociedad Española de Cardiología (SEC). Unidad de Cardiología. Hospital Universitario Fundación de Alcorcón. Madrid (España). Los tres autores han contribuido de manera equivalente en la redacción del documento
| | - Manuel Rodríguez Piñero
- Miembro de la Sociedad Española de Angiología y Cirugía Vascular (SEACV). Unidad Intercentros Cádiz - Jerez de Angiología y Cirugía Vascular. Hospital Universitario Puerta del Mar. Cádiz (España)
| | - José Francisco Valderrama Marcos
- Miembro de la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE). Hospital Regional Universitario de Málaga. Málaga (España)
| | - Antonio M. Botana López
- Miembro de la Sociedad Española de Endocrinología y Nutrición (SEEN). Sección de Endocrinología. Hospital Universitario Lucus Augusti de Lugo. Lugo (España)
| | - Ana Morais López
- Miembro de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP). Unidad de Nutrición Infantil y Enfermedades Metabólicas. Hospital Universitario La Paz. Madrid (España)
| | - José Antonio García Donaire
- Miembro de la Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA). Unidad de Hipertensión Arterial. Hospital Clínico Universitario San Carlos. Madrid (España)
| | - Juan Carlos Obaya
- Sociedad Española de Medicina de Familia y Comunitaria (semFYC). Especialista en Medicina Familiar y Comunitaria. CS La Chopera. Alcobendas. Madrid (España)
| | - Luis Castilla Guerra
- Miembro de la Sociedad Española de Medicina Interna (SEMI). Unidad de Hipertensión, Lípidos y Riesgo Vascular. Servicio de Medicina Interna. Hospital Virgen Macarena. PCDV Departamento de Medicina. Universidad de Sevilla. Sevilla (España)
| | - Vicente Pallarés Carratalà
- Miembro de la Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Unidad de Vigilancia de la Salud. Unión de Mutuas. Universitat Jaume I. Castellón (España)
| | - Isabel Egocheaga Cabello
- Miembro de la Sociedad Española de Médicos Generales y de Familia (SEMG). Especialista en Medicina Familiar y Comunitaria. CS Isla de Oza. Madrid (España)
| | - Mercedes Salgueira Lazo
- Miembro de la Sociedad Española de Nefrología (SEN). Unidad de Nefrología. Hospital Universitario Virgen Macarena. Sevilla (España)
| | - María Mar Castellanos Rodrigo
- Miembro de la Sociedad Española de Neurología (SEN). Servicio de Neurología. Complejo Hospitalario Universitario A Coruña - Instituto de Investigación Biomédica A Coruña. A Coruña (España). Coordinadora del Grupo de Estudio de Enfermedades Cerebrovasculares de la SEN
| | - José María Mostaza Prieto
- Miembro de la Sociedad Española de Arterioesclerosis (SEA). Unidad de Medicina Interna. Hospital Carlos III de Madrid. Madrid (España)
| | - Juan José Gómez Doblas
- Miembro de la Sociedad Española de Cardiología (SEC). Unidad de Cardiología del Hospital Universitario Virgen de la Victoria. Málaga (España)
| | - Antonio Buño Soto
- Miembro de la Sociedad Española de Medicina de Laboratorio. Servicio de Análisis Clínicos. Hospital Universitario la Paz. Madrid (España)
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Zhao L, Zhao X, Tian P, Liang L, Huang B, Huang L, Feng J, Zhang Y, Zhang J. Predictive value of remnant cholesterol level for all-cause mortality in heart failure patients. Front Cardiovasc Med 2023; 10:1063562. [PMID: 36873397 PMCID: PMC9975541 DOI: 10.3389/fcvm.2023.1063562] [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: 10/07/2022] [Accepted: 01/25/2023] [Indexed: 02/17/2023] Open
Abstract
Background Lower cholesterol levels are associated with increased mortality in heart failure (HF) patients. Remnant cholesterol corresponds to all cholesterol not found in high-density lipoprotein (HDL) and low-density lipoprotein (LDL). The prognostic role of remnant cholesterol in HF remains unknown. Objective To reveal the relationship between the baseline remnant cholesterol level and all-cause mortality in HF patients. Methods This study enrolled 2,823 patients hospitalized for HF. Kaplan-Meier analysis, Cox regression, C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the prognostic value of remnant cholesterol for all-cause mortality in HF. Results The mortality rate was lowest in the fourth quartile of remnant cholesterol, which had an adjusted hazard ratio (HR) for death of 0.56 [HR: 0.39, 95% confidence interval (CI): 0.46-0.68, p < 0.001] relative to the first quartile. After adjustment, a one-unit increase in the level of remnant cholesterol was associated with a 41% decrease in the risk of all-cause mortality (HR: 0.59, 95% CI: 0.47-0.73, p < 0.001). A refinement in risk prediction was observed after adding remnant cholesterol quartile to the original model (ΔC-statistic = 0.010, 95% CI: 0.003-0.017; NRI = 0.036, 95% CI: 0.003-0.070; IDI = 0.025, 95% CI: 0.018-0.033; all p < 0.05). Conclusion Low remnant cholesterol levels are associated with increased all-cause mortality in HF patients. The addition of the remnant cholesterol quartile improved the predictive value over traditional risk factors. Clinical Trial Registration ClinicalTrials.gov, Unique Identifier: NCT02664818.
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Affiliation(s)
- Lang Zhao
- Department of Emergency, China-Japan Friendship Hospital, Beijing, China.,State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuemei Zhao
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pengchao Tian
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Liang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Boping Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liyan Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiayu Feng
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuhui Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Hou Y, An Z, Hou X, Guan Y, Song G. A bibliometric analysis and visualization of literature on non-fasting lipid research from 2012 to 2022. Front Endocrinol (Lausanne) 2023; 14:1136048. [PMID: 37152935 PMCID: PMC10154597 DOI: 10.3389/fendo.2023.1136048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/06/2023] [Indexed: 05/09/2023] Open
Abstract
Background Non-fasting lipid assessment can help predict cardiovascular disease risks and is linked to multiple diseases, particularly diabetes. The significance of non-fasting lipid levels in routine screening and postprandial lipid tests for potential dyslipidemia has not been conclusively determined. Various new lipid-lowering strategies have been developed to improve non-fasting dyslipidemia. Therefore, analysis of scientific outputs over the past decade is essential to reveal trends, hotspots, and frontier areas for future research in this field. Methods The Science Citation Index Expanded in the Web of Science Core Collection database was searched for publications related to non-fasting lipid research from 2012 to 2022. The regional distributions, authors, disciplines, journals, references, and keywords of the studies were analyzed using the bibliometric software VOSviewer and CiteSpace. Results A total of 4160 articles and reviews that met the inclusion criteria were included in this study. The output trend was established to be stable and the number of citation indices has been persistently increasing. A total of 104 countries/regions, 4668 organizations, and 20782 authors were involved in this research area. In terms of country, the United States had the largest number of publications (979). The University of Copenhagen was the most productive institution, publishing 148 papers. Professor Børge G Nordestgaard has made the most significant contribution to this field. Nutrients was the most productive journal while the American Journal of Clinical Nutrition was the highest co-cited journal. Analysis of co-cited references indicated that lipid-lowering strategies, statin therapy, high-fat meals, insulin resistance, physical exercise, and fructose were hotspots. Analysis of co-cited keywords revealed that apolipoprotein B, especially apolipoprotein B48, is becoming a key research focus. The keywords "gut microbiota" and "meal timing" were the most extensively studied. Conclusion The causal relationship between non-fasting dyslipidemia and diseases is currently being explored and the standards for non-fasting or postprandial lipid assessment are continuously being updated. Among the hotspots, lipid-lowering strategies are a potential research direction. Apolipoprotein B48, gut microbiota, and chrononutrition are the research frontiers. This initial bibliometric analysis of non-fasting lipids will enable researchers to monitor swift transformations and recognize novel concepts for upcoming research.
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Affiliation(s)
- Yilin Hou
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Zehua An
- Department of Rehabilitation, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xiaoyu Hou
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yunpeng Guan
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Guangyao Song
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
- *Correspondence: Guangyao Song,
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Ryan A, Simpson WG, Twomey P. Hypertriglyceridaemia: a commentary. J Clin Pathol 2023; 76:2-4. [PMID: 36167730 DOI: 10.1136/jcp-2022-208513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/02/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Aidan Ryan
- Chemical Pathology, Cork University Hospital, Cork, Ireland.,Pathology, School of Medicine, University College Cork, Cork, Ireland
| | - William G Simpson
- Clinical Biochemistry, Aberdeen Royal Infirmary and the University of Aberdeen, Aberdeen, UK
| | - Patrick Twomey
- St Vincent's University Hospital Department of Pathology and Laboratory Medicine Clinical Biochemistry, Dublin, Ireland .,School of Medicine, University College Dublin, Dublin, Ireland
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Dietary Patterns and Non-Communicable Disease Biomarkers: A Network Meta-Analysis and Nutritional Geometry Approach. Nutrients 2022; 15:nu15010076. [PMID: 36615733 PMCID: PMC9824098 DOI: 10.3390/nu15010076] [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: 11/08/2022] [Revised: 12/17/2022] [Accepted: 12/18/2022] [Indexed: 12/28/2022] Open
Abstract
Quantitative rankings of multiple dietary patterns for their effects on non-communicable disease (NCD) biomarkers is lacking and would inform primary prevention strategies. Accordingly, a network meta-analysis (NMA) was conducted to compare and rank the effects of different dietary patterns on NCD biomarkers, and associations of dietary patterns’ underlying macronutrient composition with NCD biomarkers were determined by a nutritional geometry approach. Randomised controlled trials (RCTs) were eligible for inclusion if they enrolled healthy participants, employed food-based dietary pattern interventions without energy restriction, and reported NCD biomarker outcomes. NCD biomarkers were included as an outcome if ≥10 trials were available. A systematic search of five electronic databases identified 4008 records. Sixty-eight articles from 59 RCTs reporting lipids, glycemic, and inflammatory biomarkers were included for quantitative syntheses. Risk-of-bias was predominantly categorized as low or having some concerns, and confidence-of-evidence low. Relative to western habitual diet, the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), dietary guidelines-based, plant-based, and low-fat diets reduced low-density lipoprotein cholesterol (mean difference range: −0.29 to −0.17 mmol/L), total cholesterol (−0.36 to −0.24 mmol/L), and apolipoprotein B (−0.11 to −0.07 g/L) (all p < 0.05); the Paleo, plant-based and dietary guidelines-based diets reduced homeostasis model assessment of insulin resistance (−0.95 to −0.35, all p < 0.05). No dietary pattern ranked consistently highest. The Paleo diet received the highest all-outcomes-combined average Surface Under the Cumulative Ranking Curve value (67%), followed by DASH (62%) and Mediterranean diets (57%), whereas western habitual diet was lowest (36%). Our findings were independent of macronutrient composition, highlighting the significance of dietary pattern-level analysis.
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Doerfler AM, Park SH, Assini JM, Youssef A, Saxena L, Yaseen AB, De Giorgi M, Chuecos M, Hurley AE, Li A, Marcovina SM, Bao G, Boffa MB, Koschinsky ML, Lagor WR. LPA disruption with AAV-CRISPR potently lowers plasma apo(a) in transgenic mouse model: A proof-of-concept study. Mol Ther Methods Clin Dev 2022; 27:337-351. [PMID: 36381302 PMCID: PMC9630778 DOI: 10.1016/j.omtm.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Lipoprotein(a) (Lp(a)) represents a unique subclass of circulating lipoprotein particles and consists of an apolipoprotein(a) (apo(a)) molecule covalently bound to apolipoprotein B-100. The metabolism of Lp(a) particles is distinct from that of low-density lipoprotein (LDL) cholesterol, and currently approved lipid-lowering drugs do not provide substantial reductions in Lp(a), a causal risk factor for cardiovascular disease. Somatic genome editing has the potential to be a one-time therapy for individuals with extremely high Lp(a). We generated an LPA transgenic mouse model expressing apo(a) of physiologically relevant size. Adeno-associated virus (AAV) vector delivery of CRISPR-Cas9 was used to disrupt the LPA transgene in the liver. AAV-CRISPR nearly completely eliminated apo(a) from the circulation within a week. We performed genome-wide off-target assays to determine the specificity of CRISPR-Cas9 editing within the context of the human genome. Interestingly, we identified intrachromosomal rearrangements within the LPA cDNA in the transgenic mice as well as in the LPA gene in HEK293T cells, due to the repetitive sequences within LPA itself and neighboring pseudogenes. This proof-of-concept study establishes the feasibility of using CRISPR-Cas9 to disrupt LPA in vivo, and highlights the importance of examining the diverse consequences of CRISPR cutting within repetitive loci and in the genome globally.
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Affiliation(s)
- Alexandria M. Doerfler
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - So Hyun Park
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | - Julia M. Assini
- Department of Biochemistry, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, ON N6A 5B7, Canada
| | - Amer Youssef
- Robarts Research Institute, Schulich School of Medicine and Dentistry, London, ON N6G 2V4, Canada
| | - Lavanya Saxena
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | - Adam B. Yaseen
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | - Marco De Giorgi
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Marcel Chuecos
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ayrea E. Hurley
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Ang Li
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | | | - Gang Bao
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | - Michael B. Boffa
- Department of Biochemistry, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, ON N6A 5B7, Canada
- Robarts Research Institute, Schulich School of Medicine and Dentistry, London, ON N6G 2V4, Canada
| | - Marlys L. Koschinsky
- Robarts Research Institute, Schulich School of Medicine and Dentistry, London, ON N6G 2V4, Canada
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, London, ON N6A 5B7, Canada
| | - William R. Lagor
- Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
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Effects of diets rich in ghee or olive oil on cardiometabolic risk factors in healthy adults: a two-period, crossover, randomised trial. Br J Nutr 2022; 128:1720-1729. [PMID: 34794522 DOI: 10.1017/s0007114521004645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This study aimed to evaluate the cardiovascular health-related effects of consuming ghee in the usual diet. Thirty healthy men and women were studied in a free-living outpatient regimen. The participants were instructed for the isoenergetic inclusion of ghee or olive oil in their diets for 4 weeks using a randomised crossover design. At the end of run-in (baseline), 2-week wash-out and interventions, fasting blood samples were drawn. In addition, 2-h postprandial blood samples were collected after ingestion of a meal containing olive oil or ghee at week 4 of each dietary intervention. Body weight was not different between the two interventions. Compared with the olive oil, the diet with ghee increased fasting plasma apo-B (apo B) (0·09, 95 % CI 0·02, 0·17 g/l, P = 0·018), non-HDL-cholesterol (non-HDL-cholesterol) (0·53, 95 % CI 0·01, 1·05 mmol/l, P = 0·046) and LDL-cholesterol did not differ significantly between diet groups (0·29, 95 % CI -0·05, 0·63 mmol/l, P = 0·092), but had no significant effect on total cholesterol:HDL-cholesterol ratio (0·75, 95 % CI - 0·24 to 1·74 mmol/l, P = 0·118). No significant difference was observed in fasting as well as 2-h postprandial plasma TAG, glucose, insulin and plasminogen activator inhibitor-1 concentrations. This study showed that ghee that is predominantly saturated fats had an increasing effect on plasma apo B and non-HDL-cholesterol compared with olive oil, adding further evidence to the existing recommendations to replace dietary fats high in SFA with dietary fats high in unsaturated fats to reduce CVD risk.
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43
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Hyperlipoproteinemia(a) and Severe Coronary Artery Lesion Types. Biomedicines 2022; 10:biomedicines10112848. [DOI: 10.3390/biomedicines10112848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022] Open
Abstract
Diffuse atherosclerosis and calcification of the coronary arteries (CA) create serious difficulties for coronary artery bypass grafting (CABG). The aim of this study was to compare demographic indicators, lipids, and clinical results one year after CABG in patients with different phenotypes of coronary artery (CA) disease. In total, 390 patients hospitalized for elective CABG were included in a single-center prospective study. Demographic data, lipids (total, low-density lipoprotein and high-density lipoprotein cholesterol, and triglycerides), and lipoprotein(a) (Lp(a)) concentrations were analyzed for all patients. Major adverse cardiovascular events (MACE) included myocardial infarction, stroke, percutaneous coronary intervention, and death from cardiac causes within one year after surgery. No significant outcome differences were found between the groups with diffuse vs. segmental lesions, nor the groups with and without calcinosis for all studied parameters except for Lp(a). Median Lp(a) concentrations were higher in the group of patients with diffuse compared to segmental lesions (28 vs. 16 mg/dL, p = 0.023) and in the group with calcinosis compared to the group without it (35 vs. 19 mg/dL, p = 0.046). Lp(a) ≥ 30 mg/dL was associated with the presence of diffuse lesions (OR = 2.18 (95% CI 1.34–3.54), p = 0.002), calcinosis (2.15 (1.15–4.02), p = 0.02), and its combination (4.30 (1.81–10.19), p = 0.0009), irrespective of other risk factors. The risk of MACE within one year after CABG was higher for patients with combined diffuse and calcified lesions vs. patients with a segmental lesion without calcinosis (relative risk = 2.38 (1.13–5.01), p = 0.02). Conclusion: Diffuse atherosclerosis and coronary calcinosis are associated with elevated Lp(a) levels, independent of other risk factors. The risk of MACE in the first year after surgery is significantly higher in patients with diffuse atherosclerosis and coronary calcinosis, which should be considered when prescribing postoperative treatment for such patients.
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Navarro A, Cabezas-Agrícola JM, Hermida FJ. Effect of lipoprotein (a) on the analytical determination of low-density lipoprotein cholesterol (LDLc) and its influence on pharmacological treatment with atorvastatin. Scand J Clin Lab Invest 2022; 82:513-517. [PMID: 36200772 DOI: 10.1080/00365513.2022.2128862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Lipoprotein(a) (Lp(a)) and Low-density lipoprotein cholesterol (LDLc) is an important risk factor for atherosclerotic cardiovascular disease. The objective of this study was to determine the impact of Lp(a) concentration both on the indirect analytical measurement of LDLc and on the efficacy of dyslipidaemia treatment using the atorvastatin statin. Two retrospective studies were conducted, one with 340 patients and another with 107 patients treated with atorvastatin. Lp(a) concentrations were measured by turbidimetry with an assay independent of the size of the apo(a) isoform. LDLc was calculated using the Friedewald equation and the corrected LDLc was calculated using the Dahlén equation. A strong positive correlation was observed between the serum Lp(a) concentration and the LDLc-overestimation percentage (r = 0.960, p < .001). It was also observed that as the Lp(a) concentration rose there was no significant variation in the percentage decrease in corrected LDLc during atorvastatin treatment (r = 0.186, p > .05). The concentration of LDLc obtained by using the Friedewald equation included Lp(a) cholesterol. The lowering of LDLc in patients treated with atorvastatin depended solely on accessible LDL cholesterol and not on Lp(a) cholesterol.
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Affiliation(s)
- Aida Navarro
- Servicio de Análisis Clínicos, Hospital Clínico Universitario de Santiago de Compostela, C/Choupana s/n, A Coruña, Spain
| | - José Manuel Cabezas-Agrícola
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Santiago de Compostela, C/Choupana s/n, A Coruña, Spain
| | - Fernando Jesús Hermida
- Servicio de Análisis Clínicos, Hospital Clínico Universitario de Santiago de Compostela, C/Choupana s/n, A Coruña, Spain
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45
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Yang PT, Li Y, Wang JG, Zhang LJ, Yang SQ, Tang L, Chen Q, Shi QL. The Association of Remnant Cholesterol with Endothelial Dysfunction and Subclinical Atherosclerosis in a Check-Up Population in China. J Atheroscler Thromb 2022. [PMID: 36104205 DOI: 10.5551/jat.63695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Vascular endothelial function and atherosclerosis are known to be important risk factors for cardiovascular disease. However, it remains unknown whether remnant cholesterol (RC) correlates with vascular endothelial function and atherosclerosis as represented by flow-mediated vasodilation (FMD) and brachial-ankle pulse wave velocity (baPWV). Therefore, in this study, we aimed to investigate this in the general population. METHODS In this study, we examined 13,237 subjects who have undergone blood lipid, FMD, and baPWV measurements. Participants were divided into four groups based on RC quartiles. Multivariable linear regression models were used to calculate odds ratios for FMD and baPWV according to the RC levels. RESULTS A significant negative relationship was found between RC and FMD (β=-0.14, p=0.014), whereas RC was positively associated with baPWV (β=21.42, p<0.001), especially in the male and without chronic disease medication populations. The population was divided into three groups according to their lipids: dyslipidemia group, nondyslipidemia but RC increased group (RC >0.78 mmol/L), and nondyslipidemia and RC normal group (RC ≤ 0.78 mmol/L). The FMD of the three groups was 7.09%±3.36%, 7.39%±3.38%, and 7.57%±3.54%, respectively. The baPWV of the three groups was 1445.26±261.56 cm/s, 1425.04±265.24 cm/s, and 1382.73±267.75 cm/s. Significant differences were noted between the groups. CONCLUSIONS The findings indicated that a higher RC was an independent predictive factor for participants with endothelial function and atherosclerosis. It is important to use RC as a risk management indicator of vascular function, especially for those with normal conventional lipid parameters but increased RC.
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Affiliation(s)
- Ping-Ting Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University.,Chongqing Haifu Medical Technology Co. Ltd.,Department of Health Management, The Third Xiangya Hospital, Central South University
| | - Ying Li
- Department of Health Management, The Third Xiangya Hospital, Central South University
| | - Jian-Gang Wang
- Department of Health Management, The Third Xiangya Hospital, Central South University
| | - Li-Jun Zhang
- School of Public Health and Management, Chongqing Medical University
| | - Sai-Qi Yang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University.,Department of Health Management, The Third Xiangya Hospital, Central South University
| | - Li Tang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University
| | - Qian Chen
- Department of Health Management, The Third Xiangya Hospital, Central South University
| | - Qiu-Ling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University
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46
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Reiss AB, De Leon J. Special Issue on "Advances in Cholesterol and Lipid Metabolism". Metabolites 2022; 12:metabo12080765. [PMID: 36005636 PMCID: PMC9413280 DOI: 10.3390/metabo12080765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Cholesterol and lipid metabolism is a broad topic that encompasses multiple aspects of cellular function in every organ [...].
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47
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Zhang C, Ni J, Chen Z. Apolipoprotein B Displays Superior Predictive Value Than Other Lipids for Long-Term Prognosis in Coronary Atherosclerosis Patients and Particular Subpopulations: A Retrospective Study. Clin Ther 2022; 44:1071-1092. [PMID: 35902283 DOI: 10.1016/j.clinthera.2022.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/10/2022] [Accepted: 06/28/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Accumulating evidence that apolipoprotein B (apoB) plays a critical role in predicting coronary heart disease (CHD) and future outcomes. The 2019 European Society of Cardiology/European Atherosclerosis Society guidelines suggest that apoB can be an alternative to non-HDL-C or LDL-C in patients with high triglyceride levels, diabetes, obesity, metabolic syndrome, or very low LDL-C levels. This study explores whether apoB can also serve as predictive value for long-term major adverse cardiovascular events (MACEs) in normal people and specific coronary atherosclerosis patients. METHODS A total of 826 patients were followed up over 10 years, and the risk factors for MACEs were retrospectively analyzed in patients with CHD and particular subpopulations. All statistical analyses were performed in R software. Cox regressions were performed to assess independent risk factors of long-term MACEs in the atherosclerosis group and CHD subgroups. Kaplan-Meier survival curves were used to evaluate the survival rate for patients in different apoB quartiles, and receiver-operating characteristic curves were used to compare apoB and other lipids in predicting the presence of long-term MACE. FINDINGS apoB could be a "risk-enhancing factor" in patients with coronary atherosclerosis disease, whereas in the Normal population, LDL-C still acted as a major risk factor for predicting MACEs. apoB was a good risk predictor for long-term cardiovascular events in coronary atherosclerosis (AS) patients, including the AS group and CHD subpopulations (including CHD + triglyceride ≥2.3 mmol/L, CHD + diabetes mellitus, CHD + body mass index ≥25 kg/m2, or CHD + metabolic syndrome). In patients with CHD whose condition was complicated with diabetes, obesity, and metabolic syndrome, apoB performed better than other lipids in predicting the presence of myocardial infarction, hospitalization due to angina, and cardiac death. Despite achieving optimal LDL-C or non-HDL-C levels, patients with CHD are still at risk of worse survival if they are unable to reach a low apoB level (lower cut points such as 65 mg/dL). IMPLICATIONS More attention should be paid to special populations with residual elevations of atherogenic particle numbers, and greater focus should be placed on lowering baseline apoB to achieve long-term benefits. However, given that this was an observational study, the association of baseline apoB level and long-term MACEs only was evaluated; it is unclear whether the emergence of MACEs would be influenced by the dynamic changes of apoB. Because this was a retrospective and observational analysis, bias in data analysis was unavoidable; thus, the results cannot be used to generalize implications to broader patient populations, and more large-scale clinical trials are required to verify these findings. (Clin Ther. 2022;44:XXX-XXX) © 2022 Elsevier HS Journals, Inc.
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Affiliation(s)
- Chunyan Zhang
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingwei Ni
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenyue Chen
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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48
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Doi T, Langsted A, Nordestgaard BG. Elevated Remnant Cholesterol Reclassifies Risk of Ischemic Heart Disease and Myocardial Infarction. J Am Coll Cardiol 2022; 79:2383-2397. [PMID: 35710189 DOI: 10.1016/j.jacc.2022.03.384] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/18/2022] [Accepted: 03/29/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Elevated remnant cholesterol causes ischemic heart disease. OBJECTIVES We tested the hypothesis that the inclusion of elevated remnant cholesterol will lead to appropriate reclassification of individuals who later experience myocardial infarction and ischemic heart disease. METHODS For >10 years we followed up 41,928 white Danish individuals from the Copenhagen General Population Study without a history of ischemic cardiovascular disease, diabetes, and statin use. Using predefined cut points for elevated remnant cholesterol, we calculated net reclassification index (NRI) from below to above 5%, 7.5%, and/or 10% 10-year occurrence of myocardial infarction and ischemic heart disease defined as a composite of death from ischemic heart disease, myocardial infarction, and coronary revascularization. RESULTS For individuals with remnant cholesterol levels ≥95th percentile (≥1.6 mmol/L, 61 mg/dL), 23% (P < 0.001) of myocardial infarction and 21% (P < 0.001) of ischemic heart disease were reclassified correctly from below to above 5% for 10-year occurrence when remnant cholesterol levels were added to models based on conventional risk factors, whereas no events were reclassified incorrectly. Consequently, the addition of remnant cholesterol levels yielded NRI of 10% (95% CI: 1%-20%) for myocardial infarction and 5% (95% CI: -3% to 13%) for ischemic heart disease. Correspondingly, when reclassifications were combined from below to above 5%, 7.5%, and 10% risk of events, 42% (P < 0.001) of individuals with myocardial infarction and 41% (P < 0.001) with ischemic heart disease were reclassified appropriately, leading to NRI of respectively 20% (95% CI: 9%-31%) and 11% (95% CI: 2%-21%). CONCLUSIONS Elevated remnant cholesterol levels considerably improve myocardial infarction and ischemic heart disease risk prediction.
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Anne Langsted
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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49
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Abstract
Intravascular catabolism of chylomicrons and very low-density lipoproteins (VLDLs) gives rise to a spectrum of partially lipolyzed remnant particles. Their plasma levels and properties are influenced by lipases, lipid transfer proteins, and content of exchangeable lipoproteins. Particularly important among the latter are apoE, which mediates hepatic binding and uptake of remnants, and apoCIII, which can retard this process. In the course of their plasma transit, remnants can acquire pathologic properties that promote the development of atherosclerotic cardiovascular disease (ASCVD) including increased cholesterol content and transport of thrombogenic and inflammatory mediators. Levels of cholesterol-enriched remnant particles determined by various analytic techniques have been significantly linked to the incidence of ASCVD, most dramatically in dyslipidemic patients homozygous for the apoE2 genetic isoform. Further research is warranted for development of clinical assays that can better capture the pathologic impact of remnant lipoprotein subspecies, and for testing the impact on ASCVD of therapies that reduce their levels.
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Affiliation(s)
- Ronald M Krauss
- University of California, San Francisco, 5700 Martin Luther King, Jr. Way, Oakland CA 94608, USA.
| | - Sarah M King
- University of California, San Francisco, 5700 Martin Luther King, Jr. Way, Oakland CA 94608, USA.
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50
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Bays HE, Kulkarni A, German C, Satish P, Iluyomade A, Dudum R, Thakkar A, Rifai MA, Mehta A, Thobani A, Al-Saiegh Y, Nelson AJ, Sheth S, Toth PP. Ten things to know about ten cardiovascular disease risk factors - 2022. Am J Prev Cardiol 2022; 10:100342. [PMID: 35517870 PMCID: PMC9061634 DOI: 10.1016/j.ajpc.2022.100342] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/19/2022] [Accepted: 04/01/2022] [Indexed: 12/12/2022] Open
Abstract
The American Society for Preventive Cardiology (ASPC) "Ten things to know about ten cardiovascular disease risk factors - 2022" is a summary document regarding cardiovascular disease (CVD) risk factors. This 2022 update provides summary tables of ten things to know about 10 CVD risk factors and builds upon the foundation of prior annual versions of "Ten things to know about ten cardiovascular disease risk factors" published since 2020. This 2022 version provides the perspective of ASPC members and includes updated sentinel references (i.e., applicable guidelines and select reviews) for each CVD risk factor section. The ten CVD risk factors include unhealthful dietary intake, physical inactivity, dyslipidemia, pre-diabetes/diabetes, high blood pressure, obesity, considerations of select populations (older age, race/ethnicity, and sex differences), thrombosis (with smoking as a potential contributor to thrombosis), kidney dysfunction and genetics/familial hypercholesterolemia. Other CVD risk factors may be relevant, beyond the CVD risk factors discussed here. However, it is the intent of the ASPC "Ten things to know about ten cardiovascular disease risk factors - 2022" to provide a tabular overview of things to know about ten of the most common CVD risk factors applicable to preventive cardiology and provide ready access to applicable guidelines and sentinel reviews.
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Affiliation(s)
- Harold E Bays
- Louisville Metabolic and Atherosclerosis Research Center, Clinical Associate Professor, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville KY 40213
| | - Anandita Kulkarni
- Duke Clinical Research Institute, 200 Morris Street, Durham, NC, 27701
| | - Charles German
- University of Chicago, Section of Cardiology, 5841 South Maryland Ave, MC 6080, Chicago, IL 60637
| | - Priyanka Satish
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA 77030
| | - Adedapo Iluyomade
- Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, FL 33176
| | - Ramzi Dudum
- Department of Cardiovascular Medicine, Stanford University, Stanford, CA
| | - Aarti Thakkar
- Osler Medicine Program, Johns Hopkins Hospital, Baltimore MD
| | | | - Anurag Mehta
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Aneesha Thobani
- Emory University School of Medicine | Department of Cardiology, 101 Woodruff Circle, WMB 2125, Atlanta, GA 30322
| | - Yousif Al-Saiegh
- Lankenau Medical Center – Mainline Health, Department of Cardiovascular Disease, 100 E Lancaster Ave, Wynnewood, PA 19096
| | - Adam J Nelson
- Center for Cardiovascular Disease Prevention, Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX 75093
| | - Samip Sheth
- Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC 20007
| | - Peter P. Toth
- CGH Medical Cener, Sterling, IL 61081
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD
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