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Tsamoulis D, Siountri I, Rallidis LS. Lipoprotein(a): Its Association with Calcific Aortic Valve Stenosis, the Emerging RNA-Related Treatments and the Hope for a New Era in “Treating” Aortic Valve Calcification. J Cardiovasc Dev Dis 2023; 10:jcdd10030096. [PMID: 36975859 PMCID: PMC10056331 DOI: 10.3390/jcdd10030096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
The treatment of patients with aortic valve calcification (AVC) and calcific aortic valve stenosis (CAVS) remains challenging as, until today, all non-invasive interventions have proven fruitless in preventing the disease’s onset and progression. Despite the similarities in the pathogenesis of AVC and atherosclerosis, statins failed to show a favorable effect in preventing AVC progression. The recognition of lipoprotein(a) [Lp(a)] as a strong and potentially modifiable risk factor for the development and, perhaps, the progression of AVC and CAVS and the evolution of novel agents leading in a robust Lp(a) reduction, have rekindled hope for a promising future in the treatment of those patients. Lp(a) seems to promote AVC via a ‘three hit’ mechanism including lipid deposition, inflammation and autotaxin transportation. All of these lead to valve interstitial cells transition into osteoblast-like cells and, thus, to parenchymal calcification. Currently available lipid-lowering therapies have shown a neutral or mild effect on Lp(a), which was proven insufficient to contribute to clinical benefits. The short-term safety and the efficacy of the emerging agents in reducing Lp(a) have been proven; nevertheless, their effect on cardiovascular risk is currently under investigation in phase 3 clinical trials. A positive result of these trials will probably be the spark to test the hypothesis of the modification of AVC’s natural history with the novel Lp(a)-lowering agents.
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Affiliation(s)
- Donatos Tsamoulis
- 1st Department of Internal Medicine, Thriasio General Hospital of Eleusis, 192 00 Athens, Greece
- Society of Junior Doctors, 5 Menalou Str., 151 23 Athens, Greece
| | - Iliana Siountri
- 1st Department of Internal Medicine, General Hospital of Nikaia “Agios Panteleimon”, 184 54 Nikaia, Greece
| | - Loukianos S. Rallidis
- Second Department of Cardiology, National & Kapodistrian University of Athens, School of Medicine, University General Hospital ATTIKON, 124 62 Athens, Greece
- Correspondence:
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Roumeliotou S, Theohari A, Tsamoulis D, Vafeidou K, Siountri I, Siomou E. Persistent mild hypokalemia in an otherwise healthy 6-year-old girl: Questions. Pediatr Nephrol 2022; 37:1789-1790. [PMID: 35118534 DOI: 10.1007/s00467-022-05423-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Sofia Roumeliotou
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Anastasia Theohari
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Donatos Tsamoulis
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Kyriaki Vafeidou
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Iliana Siountri
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece.
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Roumeliotou S, Theohari A, Tsamoulis D, Vafeidou K, Siountri I, Siomou E. Persistent mild hypokalemia in an otherwise healthy 6-year-old girl: Answers. Pediatr Nephrol 2022; 37:1791-1794. [PMID: 35118535 DOI: 10.1007/s00467-022-05458-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Sofia Roumeliotou
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Anastasia Theohari
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Donatos Tsamoulis
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Kyriaki Vafeidou
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Iliana Siountri
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500, Ioannina, Greece.
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Tatsioni A, Siountri I, Tsamoulis D, Vafeidou K. Clinical trials during pandemic in primary care: Low number and low validity after one-year experience. Eur J Gen Pract 2021; 27:274-276. [PMID: 34633269 PMCID: PMC8510587 DOI: 10.1080/13814788.2021.1986279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, Ioannina, Greece
| | - Iliana Siountri
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, Ioannina, Greece
| | - Donatos Tsamoulis
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, Ioannina, Greece
| | - Kyriaki Vafeidou
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, Ioannina, Greece
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