Reduction of serum cholesterol levels and regression of atherosclerosis

miRNA 206 and miRNA 574-5p are highly expression in coronary artery disease

Coronary artery disease (CAD) is the leading cause of human morbidity and mortality worldwide. Innovative diagnostic biomarkers are a pressing need for this disease. miRNAs profiling is an innovative method of identifying biomarkers for many diseases and could be proven as a powerful tool in the diagnosis and treatment of CAD. We performed miRNA microarray analysis from the plasma of three CAD patients and three healthy controls. Subsequently, we performed quantitative real-time PCR (qRT-PCR) analysis of miRNA expression in plasma of another 67 CAD patients and 67 healthy controls. We identified two miRNAs (miR-206 and miR-574-5p) that were significantly up-regulated in CAD patients as compared with healthy controls (P<0.05). The receiver operating characteristic (ROC) curves indicated these two miRNAs had great potential to provide sensitive and specific diagnostic value for CAD.

The cholesterol controversy

OBJECTIVE

To provide information about the controversy associated with lowering of cholesterol concentrations to prevent coronary heart disease (CHD).

DATA SOURCES

Studies, review articles, and editorials identified from MEDLINE searches (from 1966 to 1995) and bibliographies of identified articles.

STUDY SELECTION

Studies, review articles, and editorials addressing controversial issues related to cholesterol lowering.

DATA EXTRACTION

Pertinent information was selected and the data synthesized into a review format.

DATA SYNTHESIS

Hypercholesterolemia is a well-known CHD risk factor. Reduction of serum cholesterol concentrations has been shown to reduce the incidence of CHD. Unfortunately, cholesterol lowering also appears to increase the risk for cancer, accidental and violent death, stroke, and oddly enough, CHD when certain medications are used.

CONCLUSIONS

Significant reductions in serum cholesterol concentrations can be achieved with cholesterol-lowering interventions. However, the benefits associated with cholesterol reduction may not outweigh the risks in all patients with hypercholesterolemia. Cholesterol-lowering interventions should be recommended with caution in patients at increased risk of cancer, stroke, and depression. Caution should also be used when recommending fibric acid derivatives for patients with existing CHD.

The quality of epidemiological data in coronary heart disease and atherosclerosis

There are inherent difficulties in the use of indirect observations in the epidemiology of a chronic ubiquitous disease such as atherosclerosis. Such difficulties do not condone basic errors in epidemiological methodology, the use of low quality data, a lack of precision in measurements, invalid extrapolations and inappropriate use of terminology and coronary heart disease as a surrogate or synonym of coronary atherosclerosis and bias in the interpretation of data. These errors reveal a lack of rigorous and scientific standards in the epidemiology of coronary heart disease. Analysis cannot launder such data. Independent scientists must evaluate the data in respect of precision, logic and truth.

Science, atherosclerosis and the "age of unreason": a review

Research in atherosclerosis has been dominated by the lipid hypothesis. The pathology of both the cholesterol-fed animal and of familial hypercholesterolemia has been misrepresented. The vascular lesions of these disorders are not atherosclerotic but manifestations of fat storage. There has been undue faith in the epidemiology of coronary heart disease and atherosclerosis. Fundamental defects in the epidemiological approach to the cause of atherosclerosis include: (1) misuse of cause and risk factors; (2) misuse of coronary heart disease as an imprecise and inappropriate surrogate endpoint in clinical and mortality studies; (3) use of fallacious monocausal death certificates and mortality rates; (4) assumed causal role of risk factors; (5) use of fallacious dietary data; (6) ecological fallacies; (7) nonspecificity of statistical correlations and selection bias; (8) failure to take note of inconsistencies; (9) inappropriate use of the blood cholesterol level as a surrogate of atherosclerosis (substitution game) without demonstration of any such effect on arteries; and (10) misplaced faith in pathological and experimental corroborative evidence. The epidemiology of atherosclerosis is based on unscientific methodology and the lipid hypothesis as currently envisaged is invalid. There is need to review the cholesterol-lowering campaign especially for normolipidemic subjects.