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Ugovšek S, Zupan J, Rehberger Likozar A, Šebeštjen M. Influence of lipid-lowering drugs on inflammation: what is yet to be done? Arch Med Sci 2022; 18:855-869. [PMID: 35832698 PMCID: PMC9266870 DOI: 10.5114/aoms/133936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/04/2021] [Indexed: 12/17/2022] Open
Abstract
Atherosclerosis is a chronic inflammatory disease that is associated with risk of cardiovascular events. The best-characterised and well-standardised clinical indicator of inflammation is C-reactive protein. Current evidence-based drug therapies for prevention and treatment of cardiovascular diseases are mainly focused on reduction of low-density lipoprotein cholesterol. However, these drugs do not provide sufficient protection against recurrent cardiovascular events. One of the possible mechanisms behind this recurrence might be the persistence of residual inflammation. For the most commonly used lipid-lowering drugs, the statins, their reduction of cardiovascular events goes beyond lowering of low-density lipoprotein cholesterol. Here, we review the effects of these lipid-lowering drugs on inflammation, considering statins, ezetimibe, fibrates, niacin, proprotein convertase subtilisin/kexin type 9 inhibitors, bempedoic acid, ethyl eicosapentaenoic acid and antisense oligonucleotides. We focus in particular on C-reactive protein, and discuss how the effects of the statins might be related to reduced rates of cardiovascular events.
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Affiliation(s)
- Sabina Ugovšek
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Janja Zupan
- Department of Clinical Biochemistry, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | | | - Miran Šebeštjen
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre, Ljubljana, Slovenia
- University Medical Centre Ljubljana, Department of Cardiology, Slovenia
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2
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Zheng Z, Chen J, Chopp M. Mechanisms of Plasticity Remodeling and Recovery. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00011-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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3
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Lee JJ, Chi G, Fitzgerald C, Kazmi SHA, Kalayci A, Korjian S, Duffy D, Shaunik A, Kingwell B, Yeh RW, Bhatt DL, Gibson CM. Cholesterol Efflux Capacity and Its Association With Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2021; 8:774418. [PMID: 34966797 PMCID: PMC8710716 DOI: 10.3389/fcvm.2021.774418] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Serum high-density lipoprotein cholesterol (HDL-C) levels are inversely associated with cardiovascular disease events. Yet, emerging evidence suggests that it is the functional properties of HDL, in particular, reverse cholesterol transport, which is a key protective mechanism mediating cholesterol removal from macrophage cells and reducing plaque lipid content. Cholesterol efflux capacity (CEC) measures the capacity of HDL to perform this function. A systematic review and meta-analysis were conducted to explore the association of CEC and adverse cardiovascular events. Methods: A comprehensive literature review of Embase, PubMed, and Web of Science Core Collection from inception to September 2019 was performed for all studies that examined the association between CEC and cardiovascular outcomes. The primary outcome was adverse cardiovascular events, which were inclusive of atherosclerotic cardiovascular disease (ASCVD) or mortality. Results: A total of 20 trials were included. Compared with low CEC levels, high CEC levels were associated with a 37% lower risk of adverse cardiovascular events (crude RR = 0.63; 95% CI, 0.52–0.76; P < 0.00001). Every SD increase of CEC was associated with a 20% lower risk of adverse cardiovascular events (HR = 0.80; 95% CI, 0.66–0.97; P = 0.02). The association remained significant after adjusting for cardiovascular risk factors, medications, and HDL-C levels (HR = 0.76; 95% CI, 0.63–0.91; P = 0.004). A significant CEC-endpoint relationship was observed (P = 0.024) such that for every 0.1 unit increase in CEC, there was a 5% reduced risk for adverse cardiovascular events (RR = 0.95; 95% CI, 0.91–0.99). Conclusions: Higher CEC is associated with lower adverse cardiovascular outcomes. These findings warrant further research on whether CEC is merely a biomarker or a mechanism that could be targeted as a pharmacologic intervention for improving clinical outcomes. PROSPERO Registration Number: CRD42020146681; https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Jane J Lee
- Baim Institute for Clinical Research, Boston, MA, United States
| | - Gerald Chi
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Clara Fitzgerald
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Syed Hassan A Kazmi
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Arzu Kalayci
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Serge Korjian
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | | | | | | | - Robert W Yeh
- Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Deepak L Bhatt
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - C Michael Gibson
- Baim Institute for Clinical Research, Boston, MA, United States.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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4
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McGarrah RW. Refocusing the AIM on HDL in the metabolic syndrome. Atherosclerosis 2016; 251:531-533. [PMID: 27397735 DOI: 10.1016/j.atherosclerosis.2016.06.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 06/30/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Robert W McGarrah
- Duke Molecular Physiology Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, 300 N. Duke St, Room 49-208J, Durham, 27701, NC, United States.
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Arora S, Patra SK, Saini R. HDL—A molecule with a multi-faceted role in coronary artery disease. Clin Chim Acta 2016; 452:66-81. [DOI: 10.1016/j.cca.2015.10.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 10/13/2015] [Accepted: 10/22/2015] [Indexed: 01/18/2023]
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6
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Chai Kheng EY, Chee Fang S, Chang S, Kiat Mun SL, Su Chi L, Lee Ying Y, Xiao Wei N, Wern Ee T, Biing Ming SL, Tavintharan S. Low-density lipoprotein cholesterol levels in adults with type 2 diabetes: an alternative equation for accurate estimation and improved cardiovascular risk classification. Diab Vasc Dis Res 2014; 11:431-9. [PMID: 25205607 DOI: 10.1177/1479164114547703] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Low-density lipoprotein cholesterol (LDL-C) is a major risk factor for atherosclerotic disease. Despite its limitations, Friedewald-calculated LDL-C (F-LDL-C) remains widely used for LDL-C determination. In this observational study of 1999 adults with type 2 diabetes mellitus (T2DM), we compare the accuracy of F-LDL-C to directly measured LDL-C (M-LDL-C) and derived and validated a new [SMART2D (Singapore Study of MAcro-angiopathy and Micro-Vascular Reactivity in Type 2 Diabetes)] formula to estimate LDL-C. From 1000 randomly selected patients, M-LDL-C was compared to F-LDL-C. Using multiple linear regression to identify independent predictors for M-LDL-C, the SMART2D equation was derived and subsequently validated in the next 981 patients. F-LDL-C was 0.367 (0.216) mmol/L lower than M-LDL-C. This difference was -0.009 (0.189) for SMART2D-LDL-C. Using F-LDL-C, 27% with M-LDL-C ≥2.6 mmol/L were classified as LDL-C <2.6 mmol/L, reduced to 2.1% when using SMART2D-LDL-C. With F-LDL-C, misclassification was greater when triglycerides were ≥2.2 mmol/L, especially for the lower LDL-C cut-offs (1.8 and 2.6 mmol/L), and this was markedly improved with SMART2D-LDL-C. In conclusion, in T2DM, F-LDL-C underestimates M-LDL-C, with misclassifications that may potentially have an impact on therapeutic decisions in T2DM. The SMART2D equation improves accuracy of estimate, reducing misclassifications. Trials will be needed to ascertain the clinical significance of these findings.
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Affiliation(s)
- Ester Yeoh Chai Kheng
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore Division of Endocrinology, Medicine Unit 2, Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Sum Chee Fang
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore Division of Endocrinology, Medicine Unit 2, Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Su Chang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | - Lim Su Chi
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore Division of Endocrinology, Medicine Unit 2, Department of Medicine, Khoo Teck Puat Hospital, Singapore Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Yeoh Lee Ying
- Division of Nephrology, Medicine Unit 2, Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Ng Xiao Wei
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Tang Wern Ee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore
| | | | - S Tavintharan
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore Division of Endocrinology, Medicine Unit 2, Department of Medicine, Khoo Teck Puat Hospital, Singapore Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
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Cohen A, Myerscough MR, Thompson RS. Athero-protective effects of High Density Lipoproteins (HDL): An ODE model of the early stages of atherosclerosis. Bull Math Biol 2014; 76:1117-42. [PMID: 24722888 DOI: 10.1007/s11538-014-9948-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 03/07/2014] [Indexed: 10/25/2022]
Abstract
We present an ODE model which we use to investigate how High Density Lipoproteins (HDL) reduce the inflammatory response in atherosclerosis. HDL causes atherosclerotic plaque stabilisation and regression, and is an important potential marker and prevention target for cardiovascular disease. HDL enables cholesterol efflux from the arterial wall, macrophage and foam cell emigration, and has other athero-protective effects. Our basic inflammatory model is augmented to include several different ways that HDL can act in early atherosclerosis. In each case, the action of HDL is represented via a parameter in the model. The long-term model behaviour is investigated through phase plane analysis and simulations. Our results indicate that only HDL-enabled cholesterol efflux can stabilise the internalised lipid content in the lesion so that it does not continue to grow, but this does not reduce macrophage numbers which is required to stabilise the lesion or prevent rupture. HDL-enabled macrophage emigration guarantees lesion stabilisation by maintaining stable macrophage content.
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Affiliation(s)
- Anna Cohen
- School of Mathematics and Statistics, University of Sydney, Sydney, NSW, 2006, Australia
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Hewing B, Parathath S, Barrett T, Chung WKK, Astudillo YM, Hamada T, Ramkhelawon B, Tallant TC, Yusufishaq MSS, Didonato JA, Huang Y, Buffa J, Berisha SZ, Smith JD, Hazen SL, Fisher EA. Effects of native and myeloperoxidase-modified apolipoprotein a-I on reverse cholesterol transport and atherosclerosis in mice. Arterioscler Thromb Vasc Biol 2014; 34:779-89. [PMID: 24407029 DOI: 10.1161/atvbaha.113.303044] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Preclinical and clinical studies have shown beneficial effects of infusions of apolipoprotein A-I (ApoA-I) on atherosclerosis. ApoA-I is also a target for myeloperoxidase-mediated oxidation, leading in vitro to a loss of its ability to promote ATP-binding cassette transporter A1-dependent macrophage cholesterol efflux. Therefore, we hypothesized that myeloperoxidase-mediated ApoA-I oxidation would impair its promotion of reverse cholesterol transport in vivo and the beneficial effects on atherosclerotic plaques. APPROACH AND RESULTS ApoA-I(-/-) or apolipoprotein E-deficient mice were subcutaneously injected with native human ApoA-I, oxidized human ApoA-I (myeloperoxidase/hydrogen peroxide/chloride treated), or carrier. Although early postinjection (8 hours) levels of total ApoA-I in plasma were similar for native versus oxidized human ApoA-I, native ApoA-I primarily resided within the high-density lipoprotein fraction, whereas the majority of oxidized human ApoA-I was highly cross-linked and not high-density lipoprotein particle associated, consistent with impaired ATP-binding cassette transporter A1 interaction. In ApoA-I(-/-) mice, ApoA-I oxidation significantly impaired reverse cholesterol transport in vivo. In advanced aortic root atherosclerotic plaques of apolipoprotein E-deficient mice, native ApoA-I injections led to significant decreases in lipid content, macrophage number, and an increase in collagen content; in contrast, oxidized human ApoA-I failed to mediate these changes. The decrease in plaque macrophages with native ApoA-I was accompanied by significant induction of their chemokine receptor CCR7. Furthermore, only native ApoA-I injections led to a significant reduction of inflammatory M1 and increase in anti-inflammatory M2 macrophage markers in the plaques. CONCLUSIONS Myeloperoxidase-mediated oxidation renders ApoA-I dysfunctional and unable to (1) promote reverse cholesterol transport, (2) mediate beneficial changes in the composition of atherosclerotic plaques, and (3) pacify the inflammatory status of plaque macrophages.
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Affiliation(s)
- Bernd Hewing
- From the Department of Medicine, Division of Cardiology and the Marc and Ruti Bell Program in Vascular Biology, New York University School of Medicine (B.H., S.P., T.B., W.K.K.C., Y.M.A., T.H., B.R., E.A.F.); Medizinische Klinik für Kardiologie und Angiologie, Charité-Universitaetsmedizin Berlin, Berlin, Germany (B.H.); and Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, OH (T.C.T., M.S.S.Y., J.A.D., Y.H., J.B., S.Z.B., J.D.S., S.L.H.)
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9
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Sibley CT, Vavere AL, Gottlieb I, Cox C, Matheson M, Spooner A, Godoy G, Fernandes V, Wasserman BA, Bluemke DA, Lima JAC. MRI-measured regression of carotid atherosclerosis induced by statins with and without niacin in a randomised controlled trial: the NIA plaque study. Heart 2013; 99:1675-80. [PMID: 23872591 PMCID: PMC5414579 DOI: 10.1136/heartjnl-2013-303926] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To evaluate the benefit of niacin in addition to statin therapy on plaque regression among older individuals with established atherosclerosis. DESIGN Randomised, controlled, double-blind clinical trial. SETTING University outpatient center. PATIENTS 145 patients older than 65 years, half of them older than 75 years of age, with established atherosclerosis were enrolled. INTERVENTIONS Participants received either extended release niacin (1500 mg daily) or placebo in addition to statin therapy to reach their National Cholesterol Education Program-defined low density lipoprotein (LDL) cholesterol target. MAIN OUTCOME MEASURES The primary endpoint was reduction in the wall volume of the internal carotid artery (ICA) measured by MRI. RESULTS After 18 months, high density lipoprotein cholesterol was higher with statins plus niacin compared with statins alone (1.6 ± 0.4 vs 1.4 ± 0.4 mmol/L p<0.001). Both groups had significant decreases in the main outcome measure of ICA wall volume, which regressed at 0.5%/month (SEM 0.2, p=0.004) in the statins plus placebo group and at 0.7%/month in the statins plus niacin group (SEM 0.2, p<0.001). There was no difference in the rate of regression between groups (p=0.49). CONCLUSIONS Treatment with statin therapy to presently recommended LDL levels, with or without niacin, resulted in significant atherosclerosis reduction.
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Affiliation(s)
- Christopher T Sibley
- Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Andrea L Vavere
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ilan Gottlieb
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Christopher Cox
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Matthew Matheson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amy Spooner
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Gustavo Godoy
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Veronica Fernandes
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Bruce A Wasserman
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - David A Bluemke
- Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - João A C Lima
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Tomé-Carneiro J, Gonzálvez M, Larrosa M, Yáñez-Gascón MJ, García-Almagro FJ, Ruiz-Ros JA, Tomás-Barberán FA, García-Conesa MT, Espín JC. Resveratrol in primary and secondary prevention of cardiovascular disease: a dietary and clinical perspective. Ann N Y Acad Sci 2013; 1290:37-51. [PMID: 23855464 DOI: 10.1111/nyas.12150] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Primary prevention of cardiovascular disease (CVD) aims to avoid a first event in subjects that are at risk but have not yet been diagnosed with heart disease. Secondary prevention of CVD aims to avoid new events in patients with established heart disease. Both approaches involve clinical intervention and implementation of healthy lifestyles. The grape and wine polyphenol resveratrol (3,5,4'-trihydroxy-trans-stilbene) has shown cardioprotective benefits in humans. Most of these approaches deal with rather high doses and short follow-ups, and do not address the issue of long-term resveratrol consumption safety, especially in medicated individuals. Here, we review the trials conducted with resveratrol in patients at risk for or with established CVD, focusing on the two longest human clinical trials reported so far (1-year follow-up). We also discuss the expectations for resveratrol from a dietary and clinical perspective in relation to CVD. However, statistically significant changes in CVD-risk markers do not necessarily equal clinical significance in the daily care of patients.
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Affiliation(s)
- João Tomé-Carneiro
- Research Group on Quality, Safety and Bioactivity of Plant Foods, CEBAS-CSIC, Murcia, Spain
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11
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Diabetic Dyslipidemia: From Evolving Pathophysiological Insight to Emerging Therapeutic Targets. Can J Diabetes 2013; 37:319-26. [DOI: 10.1016/j.jcjd.2013.07.062] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 07/22/2013] [Accepted: 07/22/2013] [Indexed: 12/12/2022]
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12
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Ambegaonkar BM, Bash LD, Chirovsky DR, Jameson K, Grant S, Nocea G, Pettersson B, Sazonov V. Attainment of normal lipid levels among high cardiovascular risk patients: pooled analysis of observational studies from the United Kingdom, Sweden, Spain and Canada. Eur J Intern Med 2013; 24:656-63. [PMID: 23953848 DOI: 10.1016/j.ejim.2013.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/22/2013] [Accepted: 07/05/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although low-density lipoprotein cholesterol (LDL-C) is the primary lipid target for cardiovascular disease (CVD) risk reduction, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) have also emerged as risk factors. This study evaluated attainment of goal/normal lipid levels in current clinical practice among high-risk patients following lipid-modifying therapy (LMT). METHODS Data for patients aged ≥35years and on LMT for ≥12months were identified from electronic medical records (United Kingdom and Sweden) and extracted from medical charts (Canada and Spain). High CVD risk was defined according to the Adult Treatment Panel III guidelines. An index period was defined, from January 1995-July 2008, during which patients received an initial LMT prescription. Prevalence of lipid abnormalities was assessed 12months before and after the index date. Multivariate logistic regressions evaluated predictors of attaining goal/normal lipid levels. RESULTS Among 12,768 high-risk patients, 75% had elevated LDL-C, 37% low HDL-C, and 30% elevated TG before LMT. Despite therapy (97% statins only), 23% had elevated LDL-C, 36% low HDL-C, 16% elevated TG, and 17% had ≥2 abnormal lipid levels. Framingham risk score >20% (Odds Ratio, 95% confidence interval: 0.37,0.31-0.43), diabetes (0.75,0.64-0.88), hypertension (1.26,1.09-1.46), current smoker (0.82,0.70-0.95) and increased body mass index (0.95,0.94-0.96) were associated with the likelihood of attaining ≥2 normal lipid levels (vs. LDL-C goal only). CONCLUSION Current approaches to lipid management improve LDL-C goal attainment; however, control of multiple lipid risk factors remains poor. Patients may benefit from more comprehensive approaches to lipid management, which treat multiple lipid abnormalities, as suggested in clinical guidelines.
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13
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New Treatment Approaches for Dyslipidemia and its Management. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0333-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Abstract
GPR109A has generated expanding interest since its discovery as the receptor for niacin a decade ago, along with deorphanisation as the receptor for endogenous ligand 3-hydroxy-butyrate shortly after. This interest is generated especially because of the continuing exploration of niacin's "pleiotropic" mechanisms of action and its potential in the "cross-talk" between metabolic and inflammatory pathways. As GPR109A's primary pharmacological ligand in clinical use, niacin has been used for over 50 years in the treatment of cardiovascular disease, mainly due to its favourable effects on plasma lipoproteins. However, it has become apparent that niacin also possesses lipoprotein-independent effects that influence inflammatory pathways mediated through GPR109A. In addition to its G-protein-mediated effects, recent evidence has emerged to support alternative GPR109A signalling via adaptive protein β-arrestins. In this article, we consider the role of GPR109A and its downstream effects in the context of atherosclerosis and vascular inflammation, along with insights into strategy for future drug development.
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Affiliation(s)
- Joshua T Chai
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
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15
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Lipid targets in clinical practice: successes, failures and lessons to be learned. Ir J Med Sci 2013; 182:673-8. [DOI: 10.1007/s11845-013-0954-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 04/11/2013] [Indexed: 10/26/2022]
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16
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Hsu TY, Chirovsky D, Moy FM, Ambegaonkar BM. Attainment of Goal and Normalized Lipid Levels With Lipid-Modifying Therapy in Malaysia. Clin Ther 2013; 35:450-60. [DOI: 10.1016/j.clinthera.2013.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/23/2013] [Accepted: 02/06/2013] [Indexed: 12/15/2022]
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17
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Marsche G, Saemann MD, Heinemann A, Holzer M. Inflammation alters HDL composition and function: Implications for HDL-raising therapies. Pharmacol Ther 2013; 137:341-51. [DOI: 10.1016/j.pharmthera.2012.12.001] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Kothapalli D, Liu SL, Bae YH, Monslow J, Xu T, Hawthorne EA, Byfield FJ, Castagnino P, Rao S, Rader DJ, Puré E, Phillips MC, Lund-Katz S, Janmey PA, Assoian RK. Cardiovascular protection by ApoE and ApoE-HDL linked to suppression of ECM gene expression and arterial stiffening. Cell Rep 2012; 2:1259-71. [PMID: 23103162 PMCID: PMC3535179 DOI: 10.1016/j.celrep.2012.09.018] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 07/23/2012] [Accepted: 09/12/2012] [Indexed: 12/20/2022] Open
Abstract
Arterial stiffening is a risk factor for cardiovascular disease, but how arteries stay supple is unknown. Here, we show that apolipoprotein E (apoE) and apoE-containing high-density lipoprotein (apoE-HDL) maintain arterial elasticity by suppressing the expression of extracellular matrix genes. ApoE interrupts a mechanically driven feed-forward loop that increases the expression of collagen-I, fibronectin, and lysyl oxidase in response to substratum stiffening. These effects are independent of the apoE lipid-binding domain and transduced by Cox2 and miR-145. Arterial stiffness is increased in apoE null mice. This stiffening can be reduced by administration of the lysyl oxidase inhibitor BAPN, and BAPN treatment attenuates atherosclerosis despite highly elevated cholesterol. Macrophage abundance in lesions is reduced by BAPN in vivo, and monocyte/macrophage adhesion is reduced by substratum softening in vitro. We conclude that apoE and apoE-containing HDL promote healthy arterial biomechanics and that this confers protection from cardiovascular disease independent of the established apoE-HDL effect on cholesterol.
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Affiliation(s)
- Devashish Kothapalli
- Institute for Translational Medicine and Therapeutics, Departments of Pharmacology, Medicine, and Physiology, and the Molecular Profiling Facility, University of Pennsylvania, Philadelphia, PA 19104, USA
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19
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Hanson J, Gille A, Offermanns S. Role of HCA2 (GPR109A) in nicotinic acid and fumaric acid ester-induced effects on the skin. Pharmacol Ther 2012; 136:1-7. [DOI: 10.1016/j.pharmthera.2012.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 06/08/2012] [Indexed: 11/16/2022]
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