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Is Obesity the New Hypertension? Parallels in the Evolution of Obesity and Hypertension as Recognized Disease States
AbstractObesity and hypertension are recognized disease states that share many similarities including complex physiology, therapeutic response to both lifestyle modification and pharmacotherapy, and the need for long-term management. Both were initially believed to be disorders of lifestyle rather than true disease entities, and initial efforts at developing medical and surgical therapies were criticized. Ultimately, both have proven to be amenable to treatments that control their underlying physiology. Both hypertension and obesity have complex pathophysiology involving multiple regulatory pathways that may require combin...
Source: Current Atherosclerosis Reports - June 28, 2017 Category: Cardiology Source Type: research

The J-shaped Curve for Blood Pressure and Cardiovascular Disease Risk: Historical Context and Recent Updates
AbstractPurpose of ReviewThe definition and treatment of hypertension have both changed dramatically over the last century, with recent trials suggesting benefit for lower blood pressure (BP) targets than ever before considered. However, tempering the enthusiasm for more intensive BP targets are long-held concerns that BP reduction below a certain threshold may pose dangers, the so-called “J-curve.” In this review, we summarize the evidence for a J-curve in the treatment of hypertension.Recent FindingsThe Systolic Blood Pressure Intervention Trial (SPRINT) reported that achieving a systolic BP target of 120 &nb...
Source: Current Atherosclerosis Reports - June 13, 2017 Category: Cardiology Source Type: research

Endoplasmic Reticulum Stress, NRF2 Signalling and Cardiovascular Diseases in a Nutshell
AbstractPurpose of ReviewThis short review is intended primarily to summarize the understanding of the interrelated roles of endoplasmic reticulum (ER) stress, oxidative stress and inflammation in cardiovascular diseases.Recent FindingsInsults interfering with ER function lead to the accumulation of unfolded and misfolded proteins in the ER. An excess of proteins folding in the ER is known as ER stress. This condition initiates the unfolded protein response (UPR). When the UPR fails to control the level of unfolded and misfolded proteins, ER-initiated apoptotic signalling is induced. Moreover, the role of the protective nu...
Source: Current Atherosclerosis Reports - June 1, 2017 Category: Cardiology Source Type: research

Treatment of Dyslipidemia Using CRISPR/Cas9 Genome Editing
AbstractPurpose of ReviewClustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated 9 (Cas9) has recently emerged as a top genome editing technology and has afforded investigators the ability to more easily study a number of diseases. This review discusses CRISPR/Cas9 ’s advantages and limitations and highlights a few recent reports on genome editing applications for alleviating dyslipidemia through disruption of proprotein convertase subtilisin/kexin type 9 (PCSK9).Recent FindingsTargeting of mousePcsk9 using CRISPR/Cas9 technology has yielded promising results for lowering total cholesterol...
Source: Current Atherosclerosis Reports - May 26, 2017 Category: Cardiology Source Type: research

Genetics of Triglycerides and the Risk of Atherosclerosis
AbstractPurpose of ReviewPlasma triglycerides are routinely measured with a lipid profile, and elevated plasma triglycerides are commonly encountered in the clinic. The confounded nature of this trait, which is correlated with numerous other metabolic perturbations, including depressed high-density lipoprotein cholesterol (HDL-C), has thwarted efforts to directly implicate triglycerides as causal in atherogenesis. Human genetic approaches involving large-scale populations and high-throughput genomic assessment under a Mendelian randomization framework have undertaken to sort out questions of causality.Recent FindingsWe rev...
Source: Current Atherosclerosis Reports - May 23, 2017 Category: Cardiology Source Type: research

Role of Non-Statins, LDL-C Thresholds, and Special Population Considerations: A Look at the Updated 2016 ACC Consensus Committee Recommendations
AbstractPurpose of ReviewThe 2013 ACC/AHA Cholesterol guidelines was a major paradigm shift in the management and treatment of dyslipidemia. The new guidelines outlined “statin benefit groups,” highlighted weighing the benefit versus risks of statin therapy (“net benefit”), and discussed the importance of shared decision making between patients and providers in primary prevention. While there was widespread agreement on the main groups benefiting from stati n therapy, there was significant controversy regarding LDL-C goals and thresholds, the role of non-statin therapy, and the use of statins in spe...
Source: Current Atherosclerosis Reports - May 12, 2017 Category: Cardiology Source Type: research

Update on APOA5 Genetics: Toward a Better Understanding of Its Physiological Impact
AbstractPurpose of ReviewThis review is intended to summarize the genetic studies published during the last 3  years that help us understand the physiology of apoAV and its clinical implications.Recent FindingsAPOA5 is probably the gene with the strongest effect on triglyceride (TG) metabolism.APOA5 is almost exclusively expressed in the liver, and its product apoAV has a very low circulating concentration. New physiological roles of apoAV have been recently elucidated, such as control of chylomicron production in the intestine and TG accumulation in adipose tissue.The key role ofAPOA5 in TG metabolism has been largel...
Source: Current Atherosclerosis Reports - May 12, 2017 Category: Cardiology Source Type: research

The Role of Emerging Risk Factors in Cardiovascular Outcomes
AbstractPurpose of ReviewThis review discusses the recent evidence for a selection of blood-based emerging risk factors, with particular reference to their relation with coronary heart disease and stroke.Recent FindingsFor lipid-related emerging risk factors, recent findings indicate that increasing high-density lipoprotein cholesterol is unlikely to reduce cardiovascular risk, whereas reducing triglyceride-rich lipoproteins and lipoprotein(a) may be beneficial. For inflammatory and hemostatic biomarkers, genetic studies suggest that IL-6 (a pro-inflammatory cytokine) and several coagulation factors are causal for cardiova...
Source: Current Atherosclerosis Reports - May 6, 2017 Category: Cardiology Source Type: research

What is the Current Knowledge About the Cardiovascular Risk for Users of Cannabis-Based Products? A Systematic Review
AbstractPurpose of ReviewThe purpose of the study was to examine the published evidence on the cardiovascular risk related to the use of cannabis-based products by performing a systematic review of recent literature.Recent FindingsThe World Health Organization (WHO) emphasizes that cannabis use represents a risky behavior as it may lead to many adverse effects, and in particular, cardiovascular effects.SummaryA systematic review of articles published between January 1, 2011 and May 31, 2016 was performed in agreement with the PRISMA statement. Articles presenting data on humans exposed to cannabis-based products and suffer...
Source: Current Atherosclerosis Reports - April 21, 2017 Category: Cardiology Source Type: research

Role of Inflammation in Heart Failure
AbstractPurpose of ReviewThis paper aims to discuss the interactions between inflammatory cytokines, immune cells, and heart failure (HF). The association of heart failure with inflammation has led to multiple studies on anti-inflammatory agents in acute and chronic heart failure.Recent FindingsRecent findings have implicated leukocytes subclasses and multiple inflammatory mediators in the progression of heart failure and cardiovascular disease. Studies have discovered further details on the interaction between immune cells —particularly macrophages and lymphocytes—and inflammation. There are both cell-mediated...
Source: Current Atherosclerosis Reports - April 21, 2017 Category: Cardiology Source Type: research

Overview of Coronary Heart Disease Risk Initiatives in South Asia
AbstractPurpose of ReviewCardiovascular disease (CVD) is now the leading cause of morbidity and mortality worldwide. Industrialization and economic growth have led to an unprecedented increment in the burden of CVD and their risk factors in less industrialized regions of the world. While there are abundant data on CVD and their risk factors from longitudinal cohort studies done in the West, good-quality data from South Asia are lacking.Recent FindingsSeveral multi-institutional, observational, prospective registries, and epidemiologic cohorts in South Asia have been established to systematically evaluate the burden of CVD ...
Source: Current Atherosclerosis Reports - April 17, 2017 Category: Cardiology Source Type: research

Coronary Heart Disease in the Middle East and North Africa: Current Status and Future Goals
AbstractPurpose of ReviewThe Middle East and North Africa has witnessed a dramatic transformation over the last 30  years caused by rapid urbanization and modernization and significant changes to diet and lifestyle. This review attempts to highlight recent data in regards to ischemic heart disease and its risk factors from the region.Recent FindingsIschemic heart disease is now the leading cause of death in the region. Age at presentation with myocardial infarction and acute coronary syndrome appears to be significantly younger than global averages. Increased rates of all major risk factors including diabetes, hyperte...
Source: Current Atherosclerosis Reports - April 4, 2017 Category: Cardiology Source Type: research

The Role for Cardiovascular Remodeling in Cardiovascular Outcomes
AbstractPurpose of ReviewIschemic and non-ischemic injury to the heart causes deleterious changes in ventricular size, shape, and function. This adverse remodeling is mediated by neurohormonal and hemodynamic alterations and is reflected in non-invasive measures of left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and left ventricular end-diastolic volume (LVEDV). These measures are closely linked to cardiovascular outcomes and have become key surrogate endpoints for evaluating the therapeutic efficacy of contemporary treatments for heart failure with reduced ejection fraction (HFrEF)...
Source: Current Atherosclerosis Reports - March 29, 2017 Category: Cardiology Source Type: research

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease
AbstractPurpose of ReviewCardiovascular disease (CVD) increasingly afflicts people living with HIV (PLWH) in the contemporary era of antiretroviral therapy (ART). Coronary artery disease (CAD) is the most widely studied cardiovascular problem in PLWH; however, less is known about other clinically relevant subtypes of CVD such as heart failure (HF), cerebrovascular disease, sudden cardiac death, pericardial diseases, and pulmonary hypertension. This paper reviews evidence of other subtypes of CVD as emerging issues in the post-ART era.Recent FindingsRecent studies have shown that PLWH have higher risk of HF as well as subcl...
Source: Current Atherosclerosis Reports - March 17, 2017 Category: Cardiology Source Type: research

Radiation-Induced Cardiovascular Disease
AbstractPurpose of reviewThoracic radiation therapy is an effective treatment for several malignancies, such as Hodgkin ’s lymphoma and breast cancer. Over the years, however, the incidence of cardiovascular events has increased in these patients, notably in younger survivors who do not have traditional risk factors. This review summarizes the pathology, incidence, clinical presentation, and management of cardiac e vents after radiation therapy.Recent findingsMediastinal radiation therapy accelerates the atherosclerosis process, resulting in early onset coronary artery disease. Valvular disease due to radiation thera...
Source: Current Atherosclerosis Reports - March 17, 2017 Category: Cardiology Source Type: research

Erratum to: The Role of Adipocytokines in Coronary Atherosclerosis
(Source: Current Atherosclerosis Reports)
Source: Current Atherosclerosis Reports - March 17, 2017 Category: Cardiology Source Type: research

Update on the Management of Chronic Total Occlusions in Coronary Artery Disease
AbstractPurpose of the ReviewChronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence.Recent FindingsThe hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% ...
Source: Current Atherosclerosis Reports - March 16, 2017 Category: Cardiology Source Type: research

Coronary Artery Disease in HIV-Infected Patients: Downside of Living Longer
AbstractPurpose of ReviewIntroduction of combination antiretroviral therapy (ART) has increased the life expectancy of patients with HIV infection, allowing them to live longer with this chronic medical condition and consequently experiencing conditions such as cardiovascular diseases (CVDs). Several studies have investigated the increased risk of CVD in people living with HIV (PLWH). However, less is known about the exact mechanisms involved in this increased risk. Also, specific guidelines for management of CVD in PLWH have not been developed yet. In this article, we review the recent literature on the mechanisms involve...
Source: Current Atherosclerosis Reports - March 5, 2017 Category: Cardiology Source Type: research

Using Mobile Health (mHealth) Technology in the Management of Diabetes Mellitus, Physical Inactivity, and Smoking
AbstractPurpose of ReviewCardiovascular mortality remains high due to insufficient progress made in managing cardiovascular risk factors such as diabetes mellitus, physical inactivity, and smoking. Healthy lifestyle choices play an important role in the management of these modifiable risk factors. Mobile health or mHealth is defined as the use of mobile computing and communication technologies (i.e., mobile phones, wearable sensors) for the delivery of health services and health-related information. In this review, we examine some recent studies that utilized mHealth tools to improve management of these risk factors, with ...
Source: Current Atherosclerosis Reports - February 26, 2017 Category: Cardiology Source Type: research

Influence of Erythrocyte Membrane Stability in Atherosclerosis
AbstractPurpose of ReviewThe purpose of this study is to show how an excess of cholesterol in the erythrocyte membrane contributes stochastically to the progression of atherosclerosis, leading to damage in blood rheology and O2 transport, deposition of cholesterol (from trapped erythrocytes) in an area of intraplaque hemorrhage, and local exacerbation of oxidative stress.Recent FindingsCholesterol contained in the membrane of erythrocytes trapped in an intraplaque hemorrhage contributes to the growth of the necrotic nucleus. There is even a relationship between the amount of cholesterol in the erythrocyte membrane and the ...
Source: Current Atherosclerosis Reports - February 26, 2017 Category: Cardiology Source Type: research

Hypertensive Disorders of Pregnancy
AbstractPurpose of ReviewAlthough pregnancy-related deaths are rare in the USA, they are on the rise and have more than doubled in the last 20  years. A substantial portion of these deaths are related to cardiovascular disease, specifically hypertensive disorders of pregnancy (HDP). In this review, we will discuss the definitions and proposed pathophysiology of HDP as well as its potential role in cardiovascular morbidity and mortality.Recent FindingsPlacental hypoperfusion may lead to an imbalance in proangiogenic and antiangiogenic factors, notably an increase in soluble fms-like tyrosine kinsase-1 (sFlt-1), thereby...
Source: Current Atherosclerosis Reports - February 21, 2017 Category: Cardiology Source Type: research

New-Generation Coronary Stents: Current Data and Future Directions
AbstractPurpose of ReviewDrug-eluting stents are the mainstay in the treatment of coronary artery disease using percutaneous coronary intervention. Innovations developed to overcome the limitations of prior generations of stents include biodegradable polymer stents, drug-eluting stents without a polymer, and bioabsorbable scaffolds. Our review briefly discusses the clinical profiles of first- and second-generation coronary stents, and provides an up-to-date overview of design, technology, and clinical safety and efficacy profiles of newer generation coronary stents discussing the relevant clinical trials in this rapidly ev...
Source: Current Atherosclerosis Reports - February 19, 2017 Category: Cardiology Source Type: research

Alcohol and Cardiovascular Disease: How Much is Too Much?
AbstractPurpose of ReviewPrevious research suggests that low-moderate alcohol consumption may have cardioprotective effects, while heavy or binge-pattern drinking is harmful. New evidence and research methodology may inform safe thresholds of alcohol use. This review examines recent evidence regarding alcohol ’s effect on cardiovascular disease, with a special consideration of pattern, drink type, and total quantity.Recent FindingsNew epidemiologic research confirms the potential harmful cardiovascular effects of heavy episodic alcohol use and does not support the previous observation that low-moderate alcohol use pr...
Source: Current Atherosclerosis Reports - February 15, 2017 Category: Cardiology Source Type: research

The Role of Inflammation in Cardiovascular Outcome
AbstractPurpose of ReviewThe aim of this review is to update the pathophysiological role of innate immune response in the cardiovascular (CV) disease outcomes, particularly focusing on coronary atherosclerosis and heart failure.Recent FindingsInflammatory processes comprised with the innate immunity reaction are believed to actively trigger CV disease development and final clinical events. For instance, by releasing proteases and neutrophil extracellular traps, neutrophil recruitment and activation might strongly influence atherosclerotic plaque stability. Similarly, neutrophils drive the early inflammatory response follow...
Source: Current Atherosclerosis Reports - February 12, 2017 Category: Cardiology Source Type: research

Mobile Health (mHealth) Technology for the Management of Hypertension and Hyperlipidemia: Slow Start but Loads of Potential
AbstractPurpose of ReviewHypertension and hyperlipidemia represent two major risk factors for atherosclerotic cardiovascular disease. Mobile health or mHealth is defined as the use of mobile phone and wireless technologies to support the achievement of health objectives. Management of hypertension, and to some extent hyperlipidemia, has often employed mHealth interventions given lower cost and greater patient engagement compared to traditional methods. These interventions include the use of text messaging, wireless devices, and mobile phone applications. This review considers recent studies evaluating the effectiveness of ...
Source: Current Atherosclerosis Reports - February 12, 2017 Category: Cardiology Source Type: research

Role of the Gut on Glucose Homeostasis: Lesson Learned from Metabolic Surgery
AbstractPurpose of ReviewBariatric surgery was initially intended to reduce weight, and only subsequently was the remission of type two diabetes (T2D) observed as a collateral event. At the moment, the term “metabolic surgery” is used to underline the fact that this type of surgery is performed specifically to treat diabetes and its metabolic complications, such as hyperlipidemia.Recent FindingsRandomized, controlled studies have recently supported the use of bariatric surgery, and in particular of Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) as an effective treatment for decompensated T2...
Source: Current Atherosclerosis Reports - February 8, 2017 Category: Cardiology Source Type: research

The Role of Adipocytokines in Coronary Atherosclerosis
AbstractPurpose of ReviewThe aim of this review is to overview the pathophysiological role of adipocytokines in atherogenesis, focusing on their potential role as biomarkers of coronary disease.Recent FindingsSeveral lines of evidence indicated adipose tissue not only as depot but rather as an endocrine organ. In this context, the balance between pro- and anti-inflammatory adipocytokines has been shown to critically regulate vascular homeostasis in both physiological and pathophysiological conditions. Overweight and obesity are characterized by dysfunctional adipose tissue and then the prevalence of pro-inflammatory mediat...
Source: Current Atherosclerosis Reports - February 8, 2017 Category: Cardiology Source Type: research

What We Learned with Recent Network Meta-analyses on Atherosclerosis Prevention and Treatment
AbstractPurpose of ReviewThe management of atherosclerosis requires a complex integration of the knowledge on its pathophysiology, patient values, and the synthesis of the global scientific evidence informing on its prevention and treatment. Novel statistical methods such as umbrella reviews and network meta-analyses (NMAs) offer a unique opportunity for integrating different sources of evidence stemming from randomized controlled trials (RCTs) or internally valid observational studies. We aimed to provide an updated perspective on the most important contributions of recent network meta-analyses on atherosclerosis preventi...
Source: Current Atherosclerosis Reports - February 3, 2017 Category: Cardiology Source Type: research

The Genetic Architecture of Coronary Artery Disease: Current Knowledge and Future Opportunities
AbstractPurpose of ReviewWe provide an overview of our current understanding of the genetic architecture of coronary artery disease (CAD) and discuss areas of research that provide excellent opportunities for further exploration.Recent FindingsLarge-scale studies in human populations, coupled with rapid advances in genetic technologies over the last decade, have clearly established the association of common genetic variation with risk of CAD. However, the effect sizes of the susceptibility alleles are for the most part modest and collectively explain only a small fraction of the overall heritability. By comparison, evidenc...
Source: Current Atherosclerosis Reports - January 27, 2017 Category: Cardiology Source Type: research

Addressing Knowledge Gaps in the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: a Review of Recent Coronary Artery Calcium Literature
AbstractPurpose of ReviewCoronary artery calcium (CAC) has been proposed as an integrator of information from traditionally measured, non-traditionally measured, and unmeasured risk factors for coronary atherosclerosis. The 2013 American College of Cardiology/American Heart Association Guideline on the Assessment of Cardiovascular Risk identified several knowledge gaps regarding CAC, including radiation risks, cost-effectiveness, and improving discrimination and reclassification of estimated risk over the Pooled Cohort Equations in the ACC/AHA Atherosclerotic Cardiovascular Disease Estimator. In this review, we focus on re...
Source: Current Atherosclerosis Reports - January 27, 2017 Category: Cardiology Source Type: research

Vitamin D, Calcium, and Cardiovascular Disease: A “D”vantageous or “D”etrimental? An Era of Uncertainty
AbstractWhile the function of vitamin D in regulating calcium homeostasis is well established, there has been growing interest in its role in the prevention of numerous chronic diseases, including cardiovascular disease (CVD). There is mounting epidemiological evidence suggesting that vitamin D deficiency is linked to increased CVD risk. However, the results of previous vitamin D supplementation trials have yielded mixed results in regards to cardiovascular health, and the results of ongoing large-scale randomized controlled trials are not yet available. Further complicating the issue, calcium supplementation, which is oft...
Source: Current Atherosclerosis Reports - January 26, 2017 Category: Cardiology Source Type: research

Evaluating Periodontal Treatment to Prevent Cardiovascular Disease: Challenges and Possible Solutions
AbstractPurpose of ReviewPeriodontal disease is correlated with cardiovascular disease (CVD) in observational studies, but a causal connection has not been established. The empirical evidence linking periodontal disease and CVD consists of a large body of observational and mechanistic studies, but a limited number of clinical trials evaluating the effects of periodontal treatment on surrogate CVD endpoints.Recent FindingsNo randomized controlled trial has been conducted to evaluate the effect of periodontal treatment on CVD risk. In this review, we have summarized these data, described possible biological mechanisms linkin...
Source: Current Atherosclerosis Reports - January 23, 2017 Category: Cardiology Source Type: research

Early Cardioversion in Atrial Fibrillation: Earlier Is Better, but Not Always and (Maybe) Not Immediately
AbstractAtrial fibrillation (AF) is the most common cardiac arrhythmia in humans. One of its important features is the tendency to become more persistent over time, even in the absence of underlying progressive heart disease. Conversion and maintenance of sinus rhythm by pharmacological or electrical methods become increasingly difficult the longer the arrhythmia persists. Electrical, mechanical, structural, and autonomic remodeling processes have been implicated in the mechanisms of AF initiation, perpetuation, and progression. Prevention or reversal of these remodeling processes can halt the progression of the disease. C...
Source: Current Atherosclerosis Reports - January 19, 2017 Category: Cardiology Source Type: research

Influence of Inflammation and Atherosclerosis in Atrial Fibrillation
AbstractBackgroundInflammation markers have been associated with cardiovascular diseases including atrial fibrillation. This arrhythmia is the most frequent, with an incidence of 38/1000 person-years.Purpose of ReviewThe aims of this study are to discuss the association between inflammation, atherosclerosis and atrial fibrillation and its clinical implications.Recent Findings and SummaryAtherosclerosis is a chronic inflammatory disease and inflammation is a triggering factor of atherosclerotic plaque rupture. In addition to coronary artery disease, clinical conditions identified as risk factors for atrial fibrillation (AF)...
Source: Current Atherosclerosis Reports - January 18, 2017 Category: Cardiology Source Type: research

Strenuous Exercise and Cardiovascular Disease Outcomes
AbstractPurpose of ReviewThis review summarizes several issues at the forefront of recent controversies involving the appropriate exercise dose including epidemiologic data describing mortality trends in those who engage in high levels of physical activity and recent observational data suggesting adverse cardiovascular outcomes among long-term endurance athletes.Recent FindingsThe benefits of habitual and moderate levels of exercise on cardiovascular disease outcomes in the general population have been well established. However, recent data have questioned whether higher doses of physical and athletic activity are associat...
Source: Current Atherosclerosis Reports - January 16, 2017 Category: Cardiology Source Type: research

A Review on Atherosclerotic Biology, Wall Stiffness, Physics of Elasticity, and Its Ultrasound-Based Measurement
AbstractFunctional and structural changes in the common carotid artery are biomarkers for cardiovascular risk. Current methods for measuring functional changes include pulse wave velocity, compliance, distensibility, strain, stress, stiffness, and elasticity derived from arterial waveforms. The review is focused on the ultrasound-based carotid artery elasticity and stiffness measurements covering the physics of elasticity and linking it to biological evolution of arterial stiffness. The paper also presents evolution of plaque with a focus on the pathophysiologic cascade leading to arterial hardening. Using the concept of s...
Source: Current Atherosclerosis Reports - November 8, 2016 Category: Cardiology Source Type: research

Heterogeneity of Coronary Plaque Morphology and Natural History: Current Understanding and Clinical Significance
AbstractPurpose of ReviewDespite the important progress in identifying high-risk atherosclerotic plaques, many key elements are elusive. Advanced imaging modalities provide valuable information about the anatomic and functional plaque characteristics and underscore the presence of multiple plaque morphologies. However, how the heterogeneity of atherosclerotic plaque can alter our current understanding of coronary artery disease is not fully understood.Recent FindingsAlong the length of an individual plaque, the morphology patterns display marked heterogeneity. Contrary to previous beliefs, plaque morphology is also highly ...
Source: Current Atherosclerosis Reports - November 6, 2016 Category: Cardiology Source Type: research

The Different Facets of Dyslipidemia and Hypertension in Atherosclerosis
AbstractAtherosclerosis is the narrowing of arteries due to the accumulation of macrophages overloaded with lipids resulting in foam cell formation, and these events occur preferentially at the branching points of arteries which are particularly susceptible to hyperlipidemic stress-induced inflammation and oxidative stress. The different stages of atherogenesis rely on oxidative stress, endothelial dysfunction, and inflammation, and hypertension or dyslipidemia can independently trigger these stages. Dyslipidemia and hypertension are pathological conditions that damage the endothelium, triggering cell proliferation, vascul...
Source: Current Atherosclerosis Reports - November 6, 2016 Category: Cardiology Source Type: research

Chronic Toxic Metal Exposure and Cardiovascular Disease: Mechanisms of Risk and Emerging Role of Chelation Therapy
AbstractOver the last few decades, there has been a growing body of epidemiologic evidence linking chronic toxic metal exposure to cardiovascular disease-related morbidity and mortality. The recent and unexpectedly positive findings from a randomized, double-blind, multicenter trial of metal chelation for the secondary prevention of atherosclerotic cardiovascular disease (Trial to Assess Chelation Therapy (TACT)) have focused the discussion on the role of chronic exposure to toxic metals in the development and propagation of cardiovascular disease and the role of toxic metal chelation therapy in the secondary prevention of...
Source: Current Atherosclerosis Reports - November 6, 2016 Category: Cardiology Source Type: research

Novel Anti-glycemic Drugs and Reduction of Cardiovascular Risk in Diabetes: Expectations Realized, Promises Unmet
AbstractPurpose of ReviewThe purpose is to review evidence on cardiovascular risks and benefits of new treatments for type 2 diabetes mellitus.Recent FindingsIn response to guidance issued by the Food and Drug Administration, thousands of patients have been enrolled in large randomized trials evaluating the cardiovascular effects of the three newest diabetes drug classes: glucagon-like peptide-1 (GLP-1) receptor agonists, sodium glucose cotransporter 2 (SGLT-2) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors. Two studies of GLP-1 receptor agonists —one of liraglutide and one of semaglutide—have shown ...
Source: Current Atherosclerosis Reports - November 4, 2016 Category: Cardiology Source Type: research

Genetics —Current and Future Role in the Prevention and Management of Coronary Artery Disease
AbstractPurpose of ReviewThe purpose of this study is to review genetic risk variants for coronary artery disease (CAD) and how they will change the management and prevention of CAD currently and in the future.Recent FindingsThrough the efforts of international consortia, 58 genetic risk variants for CAD of genome-wide significance have been replicated in appropriate independent populations. Only one third of these variants mediate their risk through known conventional risk factors for CAD. Thus, unknown mechanisms contribute to CAD. Secondly, the genetic risk is proportional to the total number of risk variants rather tha...
Source: Current Atherosclerosis Reports - November 3, 2016 Category: Cardiology Source Type: research

Surgical Versus Endovascular Aortic Aneurysm Repair: Evidence to Guide the Optimal Approach for the Individual Patient
AbstractThe choice between an open surgical and an endovascular approach for abdominal aortic aneurysm (AAA) repair remains an individualized clinical decision. As the technology and applications of endovascular aortic aneurysm repair (EVAR) continue to evolve, so does the literature investigating its outcomes. Multiple high-quality, randomized controlled trials comparing EVAR to open surgical repair (OSR) have now been published with long-term follow-up. Experience with ruptured aneurysms and the use of complex endografts is growing as well. This review is an up-to-date compilation of pertinent clinical trials for practit...
Source: Current Atherosclerosis Reports - November 3, 2016 Category: Cardiology Source Type: research

Transcriptomic Signature of Atherosclerosis in the Peripheral Blood: Fact or Fiction?
AbstractThe notion that gene expression signatures in blood can serve as biomarkers of disease states is not new. In the case of atherosclerosis, and coronary artery disease in particular, whether changes in gene expression in peripheral blood mononuclear cells reflects disease processes occurring in the vessel wall remains controversial. When comparing 15 studies that identified 706 differentially expressed genes, only 23 genes were replicated in 2 to 3 studies, at most. This low level of replication may reflect sample sizes too small to overcome heterogeneity in the response to disease. Genetic differences affect how eac...
Source: Current Atherosclerosis Reports - November 3, 2016 Category: Cardiology Source Type: research

Lipid Lowering with Soluble Dietary Fiber
AbstractConsumption of dietary soluble fibers has been associated with health benefits such as reduced lipid levels, lower blood pressure, improved blood glucose control, weight loss, improved immune function, and reduced inflammation. Many of these health benefits relate to a reduced risk of developing cardiovascular disease. In this paper, we have reviewed recent studies on the hypocholesterolemic effects of dietary soluble fibers as well as fiber-rich foods. Findings include the following: (a) consumption of water-soluble, viscous-forming fibers can reduce total and low-density lipoprotein cholesterol levels by about 5 ...
Source: Current Atherosclerosis Reports - November 1, 2016 Category: Cardiology Source Type: research

Acute Coronary Syndromes: Differences in Men and Women
AbstractPurpose of ReviewIncreased awareness of cardiovascular disease in women has prompted studies to investigate gender-related disparities in acute coronary syndromes (ACSs). In this review, we discuss findings from current literature on the clinical presentation, pathophysiology, diagnosis, and management of ACS in women as compared to men.Recent FindingsEmerging data show that cardiovascular disease (CVD) continues to be the leading cause of death in women and the annual mortality rate from CVD remains higher in women compared to men. Recent studies demonstrate sex-specific differences in patients presenting with ACS...
Source: Current Atherosclerosis Reports - November 1, 2016 Category: Cardiology Source Type: research

Aspirin Use in Women: Current Perspectives and Future Directions
AbstractPurpose of ReviewThis review examines the recent literature on the use of low-dose aspirin (LDA) for primary and secondary prevention of cardiovascular disease in women, use of LDA for pre-eclampsia prevention in pregnancy, and the underutilization of aspirin therapy in women as compared to men.Recent FindingsWhile men and women should not differ with respect to aspirin use for secondary prevention, its role in primary prevention remains unclear for both sexes, with particular uncertainty in women. Reflective of this are conflicting recommendations in current guidelines for primary prevention and thus investigation...
Source: Current Atherosclerosis Reports - November 1, 2016 Category: Cardiology Source Type: research

Protective Effects of Statins in Cancer: Should They Be Prescribed for High-Risk Patients?
AbstractPurpose of ReviewStatins are one of the most widely prescribed drug classes in the USA. This review aims to summarize recent research on the relationship between statin use and cancer outcomes, in the context of clinical guidelines for statin use in patients with cancer or who are at high risk for cancer.Recent FindingsA growing body of research has investigated the relationship between statins and cancer with mixed results. Cancer incidence has been more extensively studied than cancer survival, though results are inconsistent as some large meta-analyses have not found an association, while other studies have repo...
Source: Current Atherosclerosis Reports - October 27, 2016 Category: Cardiology Source Type: research

HDL as a Causal Factor in Atherosclerosis: Insights from Human Genetics
AbstractHigh-density lipoprotein cholesterol (HDL-C) levels are inversely related to risk of atherosclerotic cardiovascular disease (ASCVD). However, the simplistic assumption that HDL-C levels directly and causally impact atherogenesis has been challenged in recent years. The purpose of this article is to review the current state of knowledge regarding genetically determined HDL-C levels and ASCVD risk and determine what insight these studies provide into the causal relationship between HDL and atherosclerosis. (Source: Current Atherosclerosis Reports)
Source: Current Atherosclerosis Reports - October 25, 2016 Category: Cardiology Source Type: research

Threshold and Target for Blood Pressure Lowering in the Elderly
AbstractPurpose of ReviewDetection of elevated blood pressure values in elderly patients represents a common clinical condition associated with an increased cardiovascular risk. This has been shown to be the case in both systodiastolic and isolated systolic hypertension as well. However, despite the evidence of the benefits of the blood pressure lowering intervention in terms of reduction of cardiovascular morbidity and mortality, at least two issues related to antihypertensive drug treatment in aged individuals are still undefined: (1) the blood pressure threshold at which antihypertensive drug should be initiated and (2)...
Source: Current Atherosclerosis Reports - October 21, 2016 Category: Cardiology Source Type: research

Emerging Therapeutic Options for Lowering of Lipoprotein(a): Implications for Prevention of Cardiovascular Disease
AbstractPurpose of ReviewElevated plasma concentrations of lipoprotein(a) (Lp(a)) are an independent and causal risk factor for cardiovascular diseases including coronary artery disease, ischemic stroke, and calcific aortic valve stenosis. This review summarizes the rationale for Lp(a) lowering and surveys relevant clinical trial data using a variety of agents capable of lowering Lp(a).Recent FindingsContemporary guidelines and recommendations outline populations of patients who should be screened for elevated Lp(a) and who might benefit from Lp(a) lowering. Therapies including drugs and apheresis have been described that ...
Source: Current Atherosclerosis Reports - October 19, 2016 Category: Cardiology Source Type: research