1
|
Dimitriadis K, Theofilis P, Iliakis P, Pyrpyris N, Dri E, Sakalidis A, Soulaidopoulos S, Tsioufis P, Fragkoulis C, Chrysohoou C, Tsiachris D, Tsioufis K. Management of dyslipidemia in coronary artery disease: the present and the future. Coron Artery Dis 2024; 35:516-524. [PMID: 38682459 DOI: 10.1097/mca.0000000000001375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Coronary artery disease (CAD) remains a leading cause of global morbidity and mortality, necessitating continuous refinement in the management of dyslipidemia, one of its major risk factors, to mitigate cardiovascular risks. Previous studies have proven the critical role of immediate and robust low-density lipoprotein cholesterol (LDL-C) reduction in the aftermath of acute coronary syndrome (ACS). Emphasizing the evidence supporting this approach, we delve into the impact of early intervention on cardiovascular outcomes and propose optimal strategies for achieving rapid LDL-C lowering, while also providing the rationale for early proprotein convertase subtilisin/kexin 9 inhibitor use after an ACS. Given the importance of the residual lipidemic risk, we present an overview of emerging therapeutic avenues poised to reshape dyslipidemia management, such as bempedoic acid, lipoprotein(a) inhibition, ApoC3 modulation, and angiopoietin-like protein 3 targeting. This comprehensive review amalgamates current evidence with future prospects, offering a holistic perspective on the management of dyslipidemia in CAD. By exploring both the urgency for immediate post-ACS LDL-C reduction and the exciting advancements on the horizon, this article provides a roadmap for clinicians navigating the intricate landscape of lipid-lowering therapies in CAD.
Collapse
Affiliation(s)
- Kyriakos Dimitriadis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Han M, Huang K, Shen C, Hu H, Liu F, Li J, Yang X, Chen J, Liu X, Cao J, Chen S, Yu L, Zhao Y, Wu X, Zhao L, Li Y, Hu D, Huang J, Lu X, Gu D. Discordant High Remnant Cholesterol With LDL-C Increases the Risk of Stroke: A Chinese Prospective Cohort Study. Stroke 2024; 55:2066-2074. [PMID: 39038095 DOI: 10.1161/strokeaha.124.046811] [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: 02/06/2024] [Accepted: 06/06/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Previous studies focusing on assessing the effects of remnant cholesterol (RC) and low-density lipoprotein cholesterol (LDL-C) on stroke may not consider their mutual influence. We aimed to explore the associations of RC and discordant high RC with LDL-C with stroke, ischemic stroke (IS), and hemorrhagic stroke. METHODS This prospective cohort study was conducted based on 3 cohorts of the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) project. RC was calculated as non-high-density lipoprotein cholesterol minus LDL-C estimated by Martin/Hopkins equations. Concordant/discordant categories for RC versus LDL-C were determined based on cut-points of 130 mg/dL for LDL-C and equivalent percentile (32.50 mg/dL) for RC. Cox models were used to estimate adjusted hazard ratios and 95% CIs for incident stroke. RESULTS Among 113 448 participants recruited at baseline, a total of 98 967 participants were eligible for the final analysis (mean age of 51.44 years; 40.45% were men). During 728 776.87 person-years of follow-up, 2859 stroke cases, 1811 IS cases, and 849 hemorrhagic stroke cases were observed. RC was positively associated with stroke and IS, but not hemorrhagic stroke, with adjusted hazard ratios (95% CIs) of 1.06 (1.02-1.10), 1.09 (1.04-1.13), and 0.95 (0.88-1.03) for per SD increase in RC. Compared with low LDL-C/low RC group, low LDL-C/high RC group had higher risks of stroke (adjusted hazard ratio, 1.15 [95% CI, 1.02-1.30]) and IS (1.19, 1.03-1.38), while high LDL-C/low RC group had no increased risk of stroke (1.07 [0.95-1.20]) and IS (1.09 [0.94-1.25]). CONCLUSIONS Higher RC was associated with increased risks of stroke and IS but not hemorrhagic stroke. Discordantly high RC, not discordantly high LDL-C, conferred higher risks of stroke and IS. Our findings support further lowering RC by interventions to reduce residual IS risk.
Collapse
Affiliation(s)
- Minghui Han
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, China (M.H., C.S., H.H., D.G.)
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Chong Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, China (M.H., C.S., H.H., D.G.)
- Research Units of Cohort Study on Cardiovascular Diseases and Cancers (C.S.), Chinese Academy of Medical Sciences, Beijing, China
| | - Hongyue Hu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, China (M.H., C.S., H.H., D.G.)
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, China (X.Y.)
| | - Jichun Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China (X. Liu)
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China (L.Y.)
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China (Y.Z.)
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, China (X.W.)
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, China (D.H.)
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, China (D.H.)
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
| | - Dongfeng Gu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, China (M.H., C.S., H.H., D.G.)
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.)
- Key Laboratory of Cardiovascular Epidemiology (M.H., K.H., H.H., F.L., J.L., J. Chen, J. Cao, S.C., L.Z., Y.L., J.H., X. Lu, D.G.), Chinese Academy of Medical Sciences, Beijing, China
- School of Medicine, Southern University of Science and Technology, Shenzhen, China (D.G.)
| |
Collapse
|
3
|
Kumar S, Singh A, Pandey P, Khopade A, Sawant KK. Application of sphingolipid-based nanocarriers in drug delivery: an overview. Ther Deliv 2024; 15:619-637. [PMID: 39072358 PMCID: PMC11412150 DOI: 10.1080/20415990.2024.2377066] [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: 12/01/2023] [Accepted: 07/03/2024] [Indexed: 07/30/2024] Open
Abstract
Sphingolipids (SL) are well recognized for their cell signaling through extracellular and intracellular pathways. Based on chemistry different types of SL are biosynthesized in mammalian cells and have specific function in cellular activity. SL has an ampiphilic structure with have hydrophobic body attached to the polar head enables their use as a drug delivery agent in the form of nanocarriers. SL-based liposomes can improve the solubility of lipophilic drugs through host and drug complexes and are more stable than conventional liposomal formulations. Preclinical studies of SL nanocarriers are reported on topical delivery, oral delivery, ocular delivery, chemotherapeutic delivery, cardiovascular delivery and Alzheimer's disease. The commercial challenges and patents related to SL nanoformulations are highlighted in this article.
Collapse
Affiliation(s)
- Samarth Kumar
- Formulation Research & Development-Non-Orals, Sun Pharmaceutical Industries Ltd, Vadodara, 390012, Gujarat, India
- Faculty of Pharmacy, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, 390001, India
| | - Ajit Singh
- Formulation Research & Development-Non-Orals, Sun Pharmaceutical Industries Ltd, Vadodara, 390012, Gujarat, India
| | - Prachi Pandey
- Krishna School of Pharmacy & Research, KPGU, Vadodara, Gujarat, 391243, India
| | - Ajay Khopade
- Formulation Research & Development-Non-Orals, Sun Pharmaceutical Industries Ltd, Vadodara, 390012, Gujarat, India
| | - Krutika K Sawant
- Faculty of Pharmacy, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, 390001, India
| |
Collapse
|
4
|
Deng K, Pan X, Voehler MW, Cai Q, Cai H, Shu X, Gupta DK, Lipworth L, Zheng W, Yu D. Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Racially Diverse Populations. J Am Heart Assoc 2024; 13:e034364. [PMID: 38726919 PMCID: PMC11179824 DOI: 10.1161/jaha.124.034364] [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: 01/08/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Comprehensive blood lipoprotein profiles and their association with incident coronary heart disease (CHD) among racially and geographically diverse populations remain understudied. METHODS AND RESULTS We conducted nested case-control studies of CHD among 3438 individuals (1719 pairs), including 1084 White Americans (542 pairs), 1244 Black Americans (622 pairs), and 1110 Chinese adults (555 pairs). We examined 36 plasma lipids, lipoproteins, and apolipoproteins, measured by nuclear magnetic resonance spectroscopy, with incident CHD among all participants and subgroups by demographics, lifestyle, and metabolic health status using conditional or unconditional logistic regression adjusted for potential confounders. Conventionally measured blood lipids, that is, total cholesterol, triglycerides, low-density lipoprotein-cholesterol, and high-density lipoprotein-cholesterol, were each associated with incident CHD, with odds ratios (ORs) being 1.33, 1.32, 1.24, and 0.79 per 1-SD increase among all participants. Seventeen lipoprotein biomarkers showed numerically stronger associations than conventional lipids, with ORs per 1-SD among all participants ranging from 1.35 to 1.57 and a negative OR of 0.78 (all false discovery rate <0.05), including apolipoprotein B100 to apolipoprotein A1 ratio (OR, 1.57 [95% CI, 1.45-1.7]), low-density lipoprotein-triglycerides (OR, 1.55 [95% CI, 1.43-1.69]), and apolipoprotein B (OR, 1.49 [95% CI, 1.37-1.62]). All these associations were significant and consistent across racial groups and other subgroups defined by age, sex, smoking, obesity, and metabolic health status, including individuals with normal levels of conventionally measured lipids. CONCLUSIONS Our study highlighted several lipoprotein biomarkers, including apolipoprotein B/ apolipoprotein A1 ratio, apolipoprotein B, and low-density lipoprotein-triglycerides, strongly and consistently associated with incident CHD. Our results suggest that comprehensive lipoprotein measures may complement the standard lipid panel to inform CHD risk among diverse populations.
Collapse
Affiliation(s)
- Kui Deng
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Xiong‐Fei Pan
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
- Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University HospitalSichuan UniversityChengduSichuanChina
| | - Markus W. Voehler
- Department of Chemistry and Center for Structural BiologyVanderbilt UniversityNashvilleTNUSA
| | - Qiuyin Cai
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Hui Cai
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Xiao‐Ou Shu
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Deepak K. Gupta
- Vanderbilt Translational and Clinical Cardiovascular Research Center and Division of Cardiovascular Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Loren Lipworth
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Wei Zheng
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Danxia Yu
- Vanderbilt Epidemiology Center and Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| |
Collapse
|
5
|
WANG SS, YANG SS, PAN CJ, WANG JH, LI HW, CHEN SM, HAO JK, LI XH, LI RR, LI BY, YANG JH, SHI YT, LI HH, BAO YH, WANG WC, DU SY, HE Y, LI CL, LIU M. Cholesterol paradox in the community-living old adults: is higher better? J Geriatr Cardiol 2023; 20:837-844. [PMID: 38161338 PMCID: PMC10755211 DOI: 10.26599/1671-5411.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE To evaluate the associations of lipid indicators and mortality in Beijing Elderly Comprehensive Health Cohort Study. METHODS A prospective cohort was conducted based on Beijing Elderly Comprehensive Health Cohort Study with 4499 community older adults. After the baseline survey, the last follow-up was March 31, 2021 with an average 8.13 years of follow-up. Cox proportional hazard model was used to estimate the hazard ratios (HR) with 95% CI for cardiovascular disease (CVD) death and all-cause death in associations with baseline lipid indicators. RESULTS A total of 4499 participants were recruited, and the mean levels of uric acid, body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol (TC), triglyceride, and low-density lipoprotein cholesterol (LDL-C) showed an upward trend with the increasing remnant cholesterol (RC) quarters (Ptrend < 0.05), while the downward trend was found in high-density lipoprotein cholesterol (HDL-C). During the total 36,596 person-years follow-up, the CVD mortality and all-cause mortality during an average 8.13 years of follow-up was 3.87% (95% CI: 3.30%-4.43%) and 14.83% (95% CI: 13.79%-15.86%) with 174 CVD death participants and 667 all-cause death participants. After adjusting for confounders, the higher level of TC (HR = 0.854, 95% CI: 0.730-0.997), LDL-C (HR = 0.817, 95% CI: 0.680-0.982) and HDL-C (HR = 0.443, 95% CI: 0.271-0.724) were associated with lower risk of CVD death, and the higher level of HDL-C (HR = 0.637, 95% CI: 0.501-0.810) were associated with lower risk of all-cause death. The higher level of RC (HR = 1.276, 95% CI: 1.010-1.613) increase the risk of CVD death. Compared with the normal lipid group, TC ≥ 6.20 mmol/L group and LDL-C ≥ 4.10 mmol/L group were no longer associated with lower risk of CVD death, while RC ≥ 0.80 mmol/L group was still associated with higher risk of CVD death. In normal lipid group, the higher levels of TC, LDL-C and HDL-C were related with lower CVD death. CONCLUSIONS In community older adults, higher levels of TC and HDL-C were associated with lower CVD mortality in normal lipid reference range. Higher RC was associated with higher CVD mortality, which may be a better lipid indicator for estimating the CVD death risk in older adults.
Collapse
Affiliation(s)
- Sheng-Shu WANG
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shan-Shan YANG
- Department of Disease Prevention and Control, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Chun-Jiang PAN
- Department of Disease Control and Prevention, Chinese PLA Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Jian-Hua WANG
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hao-Wei LI
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shi-Min CHEN
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jun-Kai HAO
- Department of Health Service, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xue-Hang LI
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Rong-Rong LI
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo-Yan LI
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jun-Han YANG
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yue-Ting SHI
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Huai-Hao LI
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ying-Hui BAO
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wen-Chang WANG
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Sheng-Yan DU
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yao HE
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
- Department of Epidemiology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Chun-Lin LI
- Institute of Endocrinology, the Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Miao LIU
- Department of anti-NBC Medicine, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
6
|
Xu F, Shen L, Yang Y, Kong L, Zu W, Tian D, Cao X, Huang G. Association Between Plasma Levels of ANGPTL3, 4, 8 and the Most Common Additional Cardiovascular Risk Factors in Patients with Hypertension. Diabetes Metab Syndr Obes 2023; 16:1647-1655. [PMID: 37309506 PMCID: PMC10257919 DOI: 10.2147/dmso.s411483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023] Open
Abstract
Background ANGPTL3, 4 and 8 have been reported to be involved in the regulation of lipid and glucose metabolism. The aim of this study was to investigate the expression of ANGPTL3, 4, 8 in hypertensive patients with or without overweight/obesity, T2D, and hyperlipidemia, and the possible association between their expression and the status of the aforementioned comorbidities. Methods Plasma levels of ANGPTL3, 4, and 8 in 87 hospitalized patients with hypertension were measured using ELISA kits. Associations between circulating ANGPTLs levels and the most common additional cardiovascular risk factors were assessed using multivariate linear regression analyses. Pearson's correlation analysis was used to examine the association between ANGPTLs and clinical parameters. Results In the context of hypertension, (1) although not statistically significant, circulating ANGPTL3 levels were higher in the overweight/obese group than in the normal weight group; (2) circulating levels of ANGPTL3 and ANGPTL8 were significantly lower in patients with T2D than in non-diabetic patients; (3) circulating ANGPTL3 levels were significantly higher in the hyperlipidemic group than in the non-hyperlipidemic group. ANGPTL3 was associated with T2D and hyperlipidemia status, whereas ANGPTL8 was independently associated with T2D status. In addition, circulating ANGPTL3 levels were positively correlated with TC, TG, LDL-C, HCY, and ANGPTL8, and circulating ANGPTL4 levels were positively correlated with UACR and BNP. Conclusion Changes in circulating ANGPTL3 and ANGPTL8 levels have been observed in hypertensive patients with the most common additional cardiovascular risk factors, suggesting a role in the common comorbidities of hypertension and cardiovascular disease. Hypertensive patients with overweight/obesity or hyperlipidemia may benefit from therapies targeting ANGPTL3.
Collapse
Affiliation(s)
- Fangfang Xu
- Key Laboratory of Geriatrics, Institute of Geriatrics, Department of Geriatric Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Lijun Shen
- Department of Clinical Medical Research Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yongguang Yang
- Department of Clinical Medical Research Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Limin Kong
- Department of General Medicine, Xinxiang Medical University, the Sixth People’s Hospital of Zhengzhou, Zhengzhou, People’s Republic of China
| | - Wufan Zu
- Department of Immunology, School of Basic Medical Science, Xinxiang Medical University, Xinxiang, People’s Republic of China
| | - Dandan Tian
- Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Xuanchao Cao
- Key Laboratory of Geriatrics, Institute of Geriatrics, Department of Geriatric Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Gairong Huang
- Key Laboratory of Geriatrics, Institute of Geriatrics, Department of Geriatric Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| |
Collapse
|
7
|
Lian Z, Perrard XYD, Antony AK, Peng X, Xu L, Ni J, Zhang B, O’Brien V, Saeed A, Jia X, Hussain A, Yu B, Simon SI, Sacks FM, Hoogeveen RC, Ballantyne CM, Wu H. Dietary Effects on Monocyte Phenotypes in Subjects With Hypertriglyceridemia and Metabolic Syndrome. JACC Basic Transl Sci 2023; 8:460-475. [PMID: 37325398 PMCID: PMC10264566 DOI: 10.1016/j.jacbts.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 06/17/2023]
Abstract
In patients with hypertriglyceridemia, a short-term low-saturated fat vs high-saturated fat diet induced lower plasma lipids and improved monocyte phenotypes. These findings highlight the role of diet fat content and composition for monocyte phenotypes and possibly cardiovascular disease risk in these patients. (Effects of Dietary Interventions on Monocytes in Metabolic Syndrome; NCT03591588).
Collapse
Affiliation(s)
- Zeqin Lian
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | | | | | - Xueying Peng
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Clinical Pharmacy, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Lu Xu
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Jing Ni
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Bingqian Zhang
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Veronica O’Brien
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Anum Saeed
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Xiaoming Jia
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, Texas, USA
| | - Aliza Hussain
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, Texas, USA
| | - Bing Yu
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Houston, Texas, USA
| | - Scott I. Simon
- Department of Biomedical Engineering, University of California, Davis, California, USA
| | - Frank M. Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, and Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Ron C. Hoogeveen
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Christie M. Ballantyne
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
- Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, Texas, USA
| | - Huaizhu Wu
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
8
|
Zivkovic S, Maric G, Cvetinovic N, Lepojevic-Stefanovic D, Bozic Cvijan B. Anti-Inflammatory Effects of Lipid-Lowering Drugs and Supplements-A Narrative Review. Nutrients 2023; 15:nu15061517. [PMID: 36986246 PMCID: PMC10053759 DOI: 10.3390/nu15061517] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide. Since the establishment of the "lipid hypothesis", according to which, cholesterol level is directly correlated to the risk of CVD, many different lipid-lowering agents have been introduced in clinical practice. A majority of these drugs, in addition to their lipid-lowering properties, may also exhibit some anti-inflammatory and immunomodulatory activities. This hypothesis was based on the observation that a decrease in lipid levels occurs along with a decrease in inflammation. Insufficient reduction in the inflammation during treatment with lipid-lowering drugs could be one of the explanations for treatment failure and recurrent CVD events. Thus, the aim of this narrative review was to evaluate the anti-inflammatory properties of currently available lipid-lowering medications including statins, ezetimibe, bile acid sequestrants (BAS), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, fibrates, omega-3 fatty acids, and niacin, as well as dietary supplements and novel drugs used in modern times.
Collapse
Affiliation(s)
- Stefan Zivkovic
- Department of Cardiovascular Disease, Zvezdara University Medical Center, 11000 Belgrade, Serbia
| | - Gorica Maric
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Dr. Subotica 8, 11000 Belgrade, Serbia
| | - Natasa Cvetinovic
- Department of Cardiovascular Disease, University Medical Center "Dr Dragisa Misovic-Dedinje", 11000 Belgrade, Serbia
| | | | - Bojana Bozic Cvijan
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| |
Collapse
|
9
|
Cordero A, Alvarez-Alvarez B, Escribano D, García-Acuña JM, Cid-Alvarez B, Rodríguez-Mañero M, Quintanilla MA, Agra-Bermejo R, Zuazola P, González-Juanatey JR. Remnant cholesterol in patients admitted for acute coronary syndromes. Eur J Prev Cardiol 2023; 30:340-348. [PMID: 36560864 DOI: 10.1093/eurjpc/zwac286] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/25/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Remnant cholesterol has been identified as one of leading lipid values associated with the incidence of coronary heart disease. There is scarce evidence on its distribution and prognostic value in acute coronary syndrome (ACS) patients. METHODS AND RESULTS We included all consecutive patients admitted for ACS in two different centres. Remnant cholesterol was calculated by the equation: total cholesterol minus LDL cholesterol minus HDL cholesterol, and values ≥30 were considered high. Among the 7479 patients, median remnant cholesterol level was 28 mg/dL (21-39), and 3429 (45.85%) patients had levels ≥30 mg/dL. Age (r: -0.29) and body mass index (r: 0.44) were the variables more strongly correlated. At any given age, patients with overweigh or obesity had higher levels. In-hospital mortality was 3.75% (280 patients). Remnant cholesterol was not associated to higher in-hospital mortality risk (odds ratio: 0.89; P = 0.21). After discharge (median follow-up of 57 months), an independent and linear risk of all-cause mortality and heart failure (HF) associated to cholesterol remnant levels was observed. Remnant cholesterol levels >60 mg/dL were associated to higher risk of mortality [hazard ratio (HR): 1.49 95% CI 1.08-2.06; P = 0.016], cardiovascular mortality (HR: 1.49 95% CI 1.08-2.06; P = 0.016), and HF re-admission (sub-HR: 1.55 95% CI 1.14-2.11; P = 0.005). CONCLUSIONS Elevated remnant cholesterol is highly prevalent in patients admitted for ACS and is inversely correlated with age and positively with body mass index. Remnant cholesterol levels were not associated to higher in-hospital mortality risk, but they were associated with higher long-term risk of mortality and HF.
Collapse
Affiliation(s)
- Alberto Cordero
- Cardiology Department, Hospital Universitario de San Juan, Carretera Valencia-Alicante sn. San Juan de Alicante, Spain
- Unidad de Investigación de Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Belén Alvarez-Alvarez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Rúa Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain
| | - David Escribano
- Cardiology Department, Hospital Universitario de San Juan, Carretera Valencia-Alicante sn. San Juan de Alicante, Spain
- Unidad de Investigación de Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - José Mª García-Acuña
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Rúa Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain
| | - Belén Cid-Alvarez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Rúa Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain
| | - Moisés Rodríguez-Mañero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Rúa Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain
| | - Mª Amparo Quintanilla
- Cardiology Department, Hospital Universitario de San Juan, Carretera Valencia-Alicante sn. San Juan de Alicante, Spain
- Unidad de Investigación de Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Rosa Agra-Bermejo
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Rúa Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain
| | - Pilar Zuazola
- Cardiology Department, Hospital Universitario de San Juan, Carretera Valencia-Alicante sn. San Juan de Alicante, Spain
| | - José R González-Juanatey
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Rúa Choupana s/n, Santiago de Compostela, 15706, A Coruña, Spain
| |
Collapse
|
10
|
Tian Y, Wu W, Qin L, Yu X, Cai L, Wang H, Zhang Z. Prognostic value of remnant cholesterol in patients with coronary heart disease: A systematic review and meta-analysis of cohort studies. Front Cardiovasc Med 2023; 9:951523. [PMID: 36741830 PMCID: PMC9892060 DOI: 10.3389/fcvm.2022.951523] [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: 05/24/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
Background The relationship between abnormal lipid levels and atherosclerotic cardiovascular diseases is well established, but the association between remnant cholesterol (RC) and coronary heart disease (CHD) remains uncertain. The aim of this meta-analysis is to systematically evaluate the prognostic value of RC concentration in patients with CHD. Methods PubMed, EMBASE, Cochrane, and Web of Science databases were reviewed to identify relevant observational cohort studies published in English up to December 2021. Random-effects meta-analysis compared the highest and lowest RC concentration. The primary outcome was a composite of major adverse cardiovascular events (MACEs) and all-cause mortality in patients with CHD. Results A total of 10 studies recruiting 30,605 patients with CHD were selected to be included in this meta-analysis. Patients with CHD with elevated RC concentration had an increased risk of the composite endpoint events (RR = 1.54, 95% CI: 1.26-1.87) and MACEs (RR = 1.70, 95% CI: 1.54-1.88), but the risk of all-cause mortality was not statistically significant (RR = 1.16, 95% CI: 0.79-1.69, P = 0.44). Subgroup analysis showed consistent results. Conclusion Our results suggest that elevated concentration RC may independently predict MACEs in patients with CHD. Determination of RC concentration may improve risk stratification of prognosis in patients with CHD. However, more high-quality studies are necessary to confirm this association.
Collapse
|
11
|
Tietge UJF. Cholesterol in older age - it matters to mind. Curr Opin Lipidol 2022; 33:84-85. [PMID: 34939951 DOI: 10.1097/mol.0000000000000811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Uwe J F Tietge
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet
- Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
12
|
Rosenson RS, Shaik A, Song W. New Therapies for Lowering Triglyceride-Rich Lipoproteins: JACC Focus Seminar 3/4. J Am Coll Cardiol 2021; 78:1817-1830. [PMID: 34711341 DOI: 10.1016/j.jacc.2021.08.051] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 12/25/2022]
Abstract
Emerging evidence suggests that elevated concentrations of triglyceride-rich lipoprotein remnants (TRLs) derived from hepatic and intestinal sources contribute to the risk of atherosclerotic cardiovascular events. Natural selection studies support a causal role for elevated concentrations of remnant cholesterol and the pathways contributing to perturbations in metabolic pathways regulating TRLs with an increased risk of atherosclerotic cardiovascular disease events. New therapies targeting select catalytic pathways in TRL metabolism reduce atherosclerosis in experimental models, and concentrations of TRLs in patients with a vast range of triglyceride levels. Clinical trials with inhibitors of angiopoietin-like 3 protein and apolipoprotein C-III will be required to provide further guidance on the potential contribution of these emerging therapies in the paradigm of cardiovascular risk management in patients with elevated remnant cholesterol.
Collapse
Affiliation(s)
- Robert S Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| | - Aleesha Shaik
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Wenliang Song
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
13
|
Ling P, Zheng X, Luo S, Ge J, Xu S, Weng J. Targeting angiopoietin-like 3 in atherosclerosis: From bench to bedside. Diabetes Obes Metab 2021; 23:2020-2034. [PMID: 34047441 DOI: 10.1111/dom.14450] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/10/2021] [Accepted: 05/23/2021] [Indexed: 12/13/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is the largest cause of morbidity and mortality worldwide. Lipid-lowering therapies are the current major cornerstone of ASCVD management. Statins, ezetimibe, fibrates and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors effectively reduce the plasma low-density lipoprotein cholesterol (LDL-C) level in most individuals at risk of atherosclerosis. Still, some patients (such as those with homozygous familial hypercholesterolaemia), who do not respond to standard therapies, and other patients who cannot take these agents, remain at a high risk of ASCVD. In recent years there has been tremendous progress in understanding the mechanism and efficacy of lipid-lowering strategies. Apart from the recently approved PCSK9 and ATP citrate lyase inhibitors, angiopoietin-like 3 (ANGPTL3) is another potential target for the treatment of dyslipidaemia and its clinical sequalae of atherosclerosis. ANGPTL3 is a pivotal modulator of plasma triglycerides (TG), LDL-C and high-density lipoprotein cholesterol (HDL-C) levels, achieved by inhibiting the activities of lipoprotein lipase and endothelial lipase. Familial combined hypolipidaemia is derived from the Angptl3 loss-of-function mutations, which leads to low levels of LDL-C, HDL-C and TG, and has a 34% decreased risk of ASCVD compared with non-carriers. To date, monoclonal antibodies (evinacumab) and antisense oligonucleotides against ANGPTL3 have been investigated in clinical trials for dyslipidaemia therapy. Herein, we review the biology and function of ANGPTL3, as well as the latest developments of ANGPTL3-targeted therapies. We also summarize evidence from basic research to clinical trials, with the aim of providing novel insights into the biological functions of ANGPTL3 and related targeted therapies.
Collapse
Affiliation(s)
- Ping Ling
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Sihui Luo
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Junbo Ge
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Department of Cardiology, Zhong Shan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Suowen Xu
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| |
Collapse
|
14
|
Affiliation(s)
- Jan Borén
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
15
|
Sascău R, Clement A, Radu R, Prisacariu C, Stătescu C. Triglyceride-Rich Lipoproteins and Their Remnants as Silent Promoters of Atherosclerotic Cardiovascular Disease and Other Metabolic Disorders: A Review. Nutrients 2021; 13:1774. [PMID: 34067469 PMCID: PMC8224751 DOI: 10.3390/nu13061774] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022] Open
Abstract
While targeting elevated serum levels of low-density lipoprotein cholesterol has been the mainstay of atherosclerosis prevention and treatment for decades, the evidence regarding the atherogenic role of hypertriglyceridemia is still controversial. Various epidemiological population-based studies on statin-treated subjects nominated triglycerides, triglyceride-rich lipoproteins (namely, chylomicrons and very-low-density lipoprotein particles), and their remnants as major determinants of the substantial residual cardiovascular risk. With the triglyceride-glucose index and triglyceride to high-density lipoprotein ratio emerging as surrogate indicators of peripheral artery disease and atherosclerotic cerebrovascular disease, one can conclude that further research addressing the intricate relationship between triglycerides and atherosclerosis is warranted. Therefore, this review aims to provide insight into the current clinical and epidemiological state of knowledge on the relationship between triglycerides and atherosclerotic cardiovascular disease. It also intends to highlight the connection between triglycerides and other metabolic disorders, including diabetes mellitus, and the potential benefits of triglyceride-lowering agents on cardiovascular outcomes and all-cause mortality.
Collapse
Affiliation(s)
- Radu Sascău
- Internal Medicine Department, ”Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (R.S.); (R.R.); (C.P.); (C.S.)
- Cardiology Department, Institute of Cardiovascular Diseases Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
| | - Alexandra Clement
- Cardiology Department, Institute of Cardiovascular Diseases Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
| | - Rodica Radu
- Internal Medicine Department, ”Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (R.S.); (R.R.); (C.P.); (C.S.)
- Cardiology Department, Institute of Cardiovascular Diseases Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
| | - Cristina Prisacariu
- Internal Medicine Department, ”Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (R.S.); (R.R.); (C.P.); (C.S.)
- Cardiology Department, Institute of Cardiovascular Diseases Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
| | - Cristian Stătescu
- Internal Medicine Department, ”Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (R.S.); (R.R.); (C.P.); (C.S.)
- Cardiology Department, Institute of Cardiovascular Diseases Prof. Dr. George I.M. Georgescu, 700503 Iași, Romania
| |
Collapse
|