Correction: Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study

Consumption of Chokeberry Bio-Products Improves Specific Metabolic Parameters and Increases the Plasma Antioxidant Status

Because of its high antioxidant activity, chokeberry can be used both in the prevention and treatment of various metabolic disorders. In this study, for the first time, the synergistic effects of chokeberry juice and chokeberry fiber on selected metabolic and anthropometric parameters were assessed during a 90-day intervention including 102 people (67 women and 35 men). After 60 days of intervention with chokeberry juice, statistically significant increases in the muscle mass and antioxidant potential of the serum were observed. In turn, there were decreases in the waist circumference, systolic blood pressure, diastolic blood pressure, heart rate, glycated hemoglobin, glucose, LDL cholesterol, eGFR, and ALT level. The addition of chokeberry fiber for the next 30 days resulted in stabilizations of the diastolic blood pressure, glycated hemoglobin, glucose, and waist circumference, as well as reductions in the values of the heart rate, LDL cholesterol, insulin, and AST level. After 90 days, a significant increase in the FRAP value was also observed. This intervention indicates that chokeberry products may have a beneficial effect on metabolic health and serve as a foundation for developing functional foods.

[Predictive validity of the risk SCORE model in a Mediterranean population with arterial hypertension]

INTRODUCTION AND OBJECTIVES

Hypertension is the most prevalent risk factor globally. Calculation of cardiovascular risk in hypertensive patients before initiation of treatment is recommended. This study aimed to assess the predictive value and clinical utility of the SCORE scale in preventing cardiovascular events and all-cause mortality in patients with hypertension.

METHODS

Patients with hypertension from the ESCARVAL-RISK cohort were included. Cardiovascular risk was calculated using the SCORE scale. All deaths and cardiovascular events were recorded during a 5-year follow-up period. Sensitivity, specificity and predictive values were calculated for different cut-off points and the effect of different risk factors on the diagnostic accuracy of SCORE charts were assessed.

RESULTS

In a final cohort of 9834 patients, there were 555 cardiovascular events and 69 deaths. The recommended risk value for initiating drug treatment (5%) had a specificity of 92% for death and 91% for cardiovascular events, and a sensitivity of 20% for death and 22% for cardiovascular events. In addition, the scale classified 80.4% of patients who experienced a cardiovascular event and 78.3% of those who died as low risk. Age, body mass index, retinopathy and anticoagulant therapy were associated with reduced predictive ability of the SCORE scale, while being female was associated with better risk prediction.

CONCLUSIONS

The predictive ability of the SCORE scale for cardiovascular disease and total mortality in patients with hypertension is limited.

Remnant cholesterol in patients admitted for acute coronary syndromes

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.

Effect of PCSK9 inhibitors on remnant cholesterol and lipid residual risk: The LIPID-REAL registry

BACKGROUND

Monoclonal antibodies that inhibit the proprotein convertase subtilisin/kexin type 9 (PCSK9) reduce low-density lipoprotein cholesterol (LDLc) by 55%, regardless of baseline treatments. Nonetheless, the effect of other lipid parameters, such as cholesterol remnants or, the so-called lipid residual risk, is unknown.

METHODS

Multicenter and retrospective registry of patients treated with PCSK9 inhibitors from 14 different hospitals in Spain. Before and on-treatment lipid parameters were recorded. Residual lipid risk was estimated by (1) cholesterol remnants, (2) triglycerides/HDLc ratio (TG/HDL), (3) total cholesterol/HDLc (TC/HDL) and (4) the triglycerides-to-glucose index (TGGi).

RESULTS

Six hundred fifty-two patients were analysed, mean age of 60.2 (9.63) years, 24.69% women and mean LDLc before treatment 149.24 (49.86) mg/dl. Median time to second blood determination was 187.5 days. On-treatment LDLc was 67.46 (45.78) mg/dl, which represented a 55% reduction. Significant reductions were observed for TG/HDL ratio, cholesterol remnants, TC/HDL ratio and TGGi. As consequence, 34.61% patients had LDLc <55 mg/dl and cholesterol remnants <30 mg/dl; additionally, 31.95% had cholesterol remnants <30 mg/dl but LDLc >55 mg/dl. Patients who had levels of cholesterol remnants >30 mg/dl before initiating the treatment with PCSK9 had higher reductions in cholesterol remnants, TG/HDL ratio, TC/HDL and TGGi. By contrast, no reduction differences were observed according to baseline LDLc (< or > the mean), age, gender or obesity.

CONCLUSIONS

This multicenter and retrospective registry of real-world patients treated with PCSK9 inhibitors demonstrates a positive effect on cholesterol remnants and lipid residual risk beyond LDLc reductions.

Chokeberry (A. melanocarpa (Michx.) Elliott)—A Natural Product for Metabolic Disorders?

Abnormal metabolism of substances in the body can result in metabolic disorders which include obesity, cardiovascular diseases, diabetes, hypertension, chronic kidney disease, liver disease, or cancer. Foods rich in antioxidants can help to prevent and treat various types of disorders. Chokeberry fruits are rich in polyphenols, especially cyanidins, and therefore, can show a beneficial health effect. The aim of this study was to summarize and systematize reports about the effects of chokeberry on various metabolic parameters. Studies from 2000 to 2021, published in the PubMed and Google Scholar databases, were reviewed. The review of studies shows that chokeberry may have a positive effect in dyslipidemia and hypertension and may increase the body’s antioxidant defense mechanisms. The anti-inflammatory effect, in turn, may translate into a reduction in the risk of metabolic disorders over a longer period of use. Changes in glucose levels were reported by studies in which the intervention lasted more than 10 weeks in patients with carbohydrate metabolism disorders. The effects of protecting the liver, inhibiting platelet aggregation, lowering uric acid levels, and having a protective effect on the kidneys require additional confirmation in human clinical trials. Consumption of chokeberry fruit did not impact on anthropometric measurements; however, it seems that chokeberry fruit can be recommended in many metabolic disorders due to the richness of bioactive ingredients.

Assessment of Right Ventricular Function in Patients With Acute Myocardial Infarction

Introduction

We assessed the right ventricular function in patients with first acute anterior wall myocardial infarction (AWMI) and inferior wall myocardial infarction (IWMI) without associated right ventricular infarction and assessed the relation between right ventricular function and the in-hospital clinical outcomes.

Methods

The present study was an observational cross-sectional study, which enrolled a total of 200 patients with chest pain of <24 hours who were diagnosed with acute ST-segment elevation myocardial infarction (MI) for the first time. Echocardiography was performed with a special emphasis on the tricuspid annular plane systolic excursion (TAPSE) score. The in-hospital clinical outcomes include major adverse cardiac events (MACE), which refer to all-cause mortality, cardiovascular mortality, recurrent MI, heart failure, or stroke in patients with acute myocardial infarction (AMI).

Results

A total of 200 patients with AMI were enrolled in the study of which 66% were males. Of patients, 68% had AWMI and 32% had IWMI. Patients with AWMI had more right ventricular dysfunctional changes as compared to IWMI, as measured by TAPSE score (17.8 ± 4.64 mm vs. 19.87 ± 3.61; p = 0.01, respectively). The incidence of MACE was 27.9% in AWMI as compared to 12.5% in IWMI (41.9% vs. 18.75% had right ventricular dysfunction, respectively). The outcome of AWMI patients was poor as compared to IWMI patients, as measured by duration of hospital stay (9.5 ± 4.73 days and 6.6 ± 4.70 days, respectively) and mortality (17.64% in AWMI vs. 6.25% in IWMI). The patients of AMI with TAPSE score ≤18 mm, suggesting right ventricular dysfunction, had a higher rate of MACE compared to those with TAPSE score >18 mm, respectively, 36.23% vs. 12.2%.

Conclusion

From this study, it is concluded that AWMI results in a higher incidence of right ventricular dysfunction as compared to IWMI. Furthermore, patients with AMI with concomitant right ventricular dysfunction were found to have poorer outcomes in terms of longer duration of hospital stay, higher incidence of MACE, and higher mortality rate, as compared to patients of AMI without right ventricular dysfunction.

Jaboticaba berry: A comprehensive review on its polyphenol composition, health effects, metabolism, and the development of food products

Jaboticaba, a popular Brazilian berry, has been studied due to its relevant polyphenol composition, health benefits and potential use for the development of derived food products. Considering that around 200 articles have been published in recent years, this review aims to provide comprehensive and updated information, as well as a critical discussion on: (i) jaboticaba polyphenolic composition and extraction methods for their accurate determination; (ii) jaboticaba polyphenol's metabolism; (iii) biological effects of the fruit and the relationship with its polyphenols and their metabolites; (iv) challenges in the development of jaboticaba derived products. The determination of jaboticaba polyphenols should employ hydrolysis procedures during extraction, followed by liquid chromatographic analysis. Jaboticaba polyphenols, mainly anthocyanins and ellagitannins, are extensively metabolized, and their metabolites are probably the most important contributors to the relevant health effects associated with the fruit, such as antioxidant, anti-inflammatory, antidiabetic, hepatoprotective and hypolipidemic. Most of the technological processing of jaboticaba fruit and its residues is related to their application as a colorant, antioxidant, antimicrobial and source of polyphenols. The scientific literature still lacks studies on the metabolism and bioactivity of polyphenols from jaboticaba in humans, as well as the effect of technological processes on these issues.

Association of early life factors with dyslipidemia in children and adolescents: The CASPIAN-V study

Background: This study aimed to investigate the association between prenatal/infancy factors and lipid profile in children and adolescents.

Methods: This multicentric national study was conducted in 30 provinces in Iran. It comprised 4200 participants, aged 7-18 years, from the fifth survey of a national surveillance program. History regarding birth weight, as well as the type of consumed milk and food during infancy was obtained from parents. In addition to physical examinations, fasting blood samples were obtained to assess the lipid profile of these students.

Results: Data from 3844 participants were available (91.5% participation rate), 52.4 % of students were boys. Mean (SD) age of participants was 12.3(3.2) years. Consuming cow milk in the first two years significantly increased the risk of high triglycerides (TG) (odds ratio [OR]:2.77, 95% CI: 1.32-5.85, P: 0.01), elevated low-density lipoprotein (LDL) (P<0.05) and low high-density lipoprotein (HDL) (P <0.05). Students who had consumed commercially made food as complementary feeding were 93% more likely to have high LDL (OR: 1.93, 95% CI=1.19-3.13, P: 0.01) and 90% more likely to have high TG than students who had consumed homemade food (OR: 1.90, 95% CI: 1.15-3.12, P: 0.01). The aforementioned figures were not significantly associated with an elevated total cholesterol (TC) level.

Conclusion: Our findings revealed that the history of using human milk and home-made food as complementary feeding was associated with better lipid profile in childhood and early adolescence. Increasing public knowledge in this regard might be useful for encouragement of healthier life prevention of chronic diseases.