Current Approach to the Diagnosis and Treatment of Heterozygote and Homozygous FH Children and Adolescents
AbstractPurpose of ReviewTo elucidate the current approach of care in pediatric patients with familial hypercholesterolemia (FH). We sought an answer to the question whether the advances and major changes in lipid management are relevant and apply to children and adolescents.Recent FindingsLatest research findings clearly demonstrate that lowering cholesterol levels at a young age prevents vascular atherosclerotic changes and decreases cardiovascular events in adulthood and emphasizes the importance of early detection and intervention in the pediatric FH patients group.SummaryFH is a common genetic disease caused by mutati...
Source: Current Atherosclerosis Reports - May 8, 2021 Category: Cardiology Source Type: research

Reverse Cholesterol Transport Dysfunction Is a Feature of Familial Hypercholesterolemia
AbstractPurpose of ReviewWe seek to establish whether high-density lipoprotein HDL metabolism and reverse cholesterol transport (RCT) impairment is an intrinsic feature of familial hypercholesterolemia (FH).Recent FindingsRCT from macrophages (m-RCT), a vascular cell type of major influence on atherosclerosis, is impaired in FH due to defective low-density lipoprotein receptor (LDLR) function via both the HDL- and LDL-mediated pathways. Potential mechanisms include impaired HDL metabolism, which is linked to increased LDL levels, as well as the increased transport of cellular unesterified cholesterol to LDL, which presents...
Source: Current Atherosclerosis Reports - April 29, 2021 Category: Cardiology Source Type: research

How Do We Incorporate Polygenic Risk Scores in Cardiovascular Disease Risk Assessment and Management?
AbstractPurpose of ReviewThe potential of polygenic risk scores (PRS) to improve atherosclerotic cardiovascular disease (ASCVD) risk assessment and management has stoked significant interest in their incorporation into clinical management. The goal of this review is to apprise the readers of the latest developments and evidence of PRS readiness for clinical integration. We also discuss current limitations that must be addressed before PRS can be implemented into routine clinical practice.Recent FindingsPRS have been shown to improve risk stratification for ASCVD and to identify patients who may derive increased benefit fro...
Source: Current Atherosclerosis Reports - April 1, 2021 Category: Cardiology Source Type: research

Cardiovascular Disease Risk Reduction in Mild-Moderate Hypertriglyceridemia: Integrating Prescription of Omega-3 with Standard Treatment
AbstractPurpose of ReviewThis reviews aims to evaluate the role of omega-3 for cardiovascular disease (CVD) risk reduction in mild-moderate hypertriglyceridemia.Recent FindingsEpidemiological and Mendelian randomization studies have demonstrated that hypertriglyceridemia is strongly correlated to CVD. Even in patients with optimal low-density lipoprotein cholesterol (LDL-C) levels, triglycerides remain an important predictor to lower residual cardiovascular risk. In addition to screening, lifestyle intervention, and LDL-C lowering with statins for hypercholesterolemia (and other agents if needed), additional pharmacologica...
Source: Current Atherosclerosis Reports - March 31, 2021 Category: Cardiology Source Type: research

Metabolomic Biomarkers of Healthy Dietary Patterns and Cardiovascular Outcomes
AbstractPurpose of ReviewHealthy dietary patterns are recommended for prevention of CVD. Recently, metabolomics has been used to identify biomarkers of healthy dietary patterns and elucidate mechanisms underlying diet-disease associations. This review provides an overview of approaches to define healthy dietary patterns, discusses important issues related to using metabolomics to describe healthy dietary patterns, and summarizes studies identifying blood metabolites associated with hypothesis-driven healthy dietary patterns and cardiovascular risk factors and incident CVD.Recent findingsWe identified 17 studies which repor...
Source: Current Atherosclerosis Reports - March 30, 2021 Category: Cardiology Source Type: research

Food Insecurity and Cardiovascular Disease Risk
AbstractPurpose of ReviewThis review examines the current epidemiological evidence for the relationship between levels of food insecurity and cardiovascular disease (CVD) outcomes among US adults> 17 years.Recent FindingsReview of recent literature revealed that reduced food security was associated with decreased likelihood of good self-reported cardiovascular health and higher odds of reporting CVD-related outcomes such as coronary heart disease, angina, heart attack, peripheral arterial disease, and hypertension.SummaryExisting evidence suggests a compelling association between each level of reduced food security and ...
Source: Current Atherosclerosis Reports - March 27, 2021 Category: Cardiology Source Type: research

Understanding Immigration as a Social Determinant of Health: Cardiovascular Disease in Hispanics/Latinos and South Asians in the United States
AbstractPurpose of ReviewThe main purpose of this review is to summarize the epidemiology of cardiovascular disease and its risk factors among two of the largest and most diverse immigrant groups in the United States (Hispanics/Latinos and South Asians).Recent FindingsWhile the migration process generates unique challenges for individuals, there is a wide heterogeneity in the characteristics of immigrant populations, both between and within regions of origin. Hispanic/Latino immigrants to the United States have lower levels of cardiovascular risk factors, prevalence, and mortality, but this assessment is limited by issues ...
Source: Current Atherosclerosis Reports - March 27, 2021 Category: Cardiology Source Type: research

The Difference Between High Density Lipoprotein Subfractions and Subspecies: an Evolving Model in Cardiovascular Disease and Diabetes
AbstractPurpose of ReviewThe term high density lipoproteins (HDL) refers to an eclectic collection of subparticles that play diverse roles in physiology. Here, we define the term “HDL subspecies” and review recent work on their molecular characterization and relation to disease, focusing on cardiovascular disease and diabetes.Recent FindingsThe HDL family contains over 200 proteins and nearly 200 lipids that partition into different particles in plasma. Simple subfractionation of HDL based on a particular physicochemical property has not risen to the challenge of revealing the roles of specific particles in dis...
Source: Current Atherosclerosis Reports - March 27, 2021 Category: Cardiology Source Type: research

Time-Restricted Eating to Improve Cardiovascular Health
AbstractPurpose of ReviewTime-restricted eating (TRE) is a form of intermittent fasting that involves confining the eating window to 4 –10 h and fasting for the remaining hours of the day. The purpose of this review is to summarize the current literature pertaining to the effects of TRE on body weight and cardiovascular disease risk factors.Recent FindingsHuman trial findings show that TRE reduces body weight by 1 –4% after 1–16 weeks in individuals with obesity, relative to controls with no meal timing restrictions. This weight loss results from unintentional reductions in energy intake (~350–500 k...
Source: Current Atherosclerosis Reports - March 26, 2021 Category: Cardiology Source Type: research

Breast Arterial Calcification: A Potential Biomarker for Atherosclerotic Cardiovascular Disease Risk?
AbstractPurpose of ReviewWe aimed to summarize the current evidence regarding the association between breast arterial calcification (BAC) and atherosclerotic cardiovascular disease (ASCVD) in women and discuss the potential role of BAC in the risk stratification and preventive approaches for ASCVD.Recent FindingsBAC has emerged as a potential women-specific risk marker for ASCVD. Although BAC presents as a medial calcification of the arteries, notably different from the intimal atherosclerotic process, current evidence supports a correlation between BAC and ASCVD risk factors or subclinical and clinical ASCVD, such as coro...
Source: Current Atherosclerosis Reports - March 26, 2021 Category: Cardiology Source Type: research

ANGPTL3 and Apolipoprotein C-III as Novel Lipid-Lowering Targets
AbstractPurpose of ReviewDespite significant progress in plasma lipid lowering strategies, recent clinical trials highlight the existence of residual cardiovascular risk. Angiopoietin-like protein 3 (ANGPTL3) and apolipoprotein C-III (Apo C-III) have been identified as novel lipid-lowering targets.Recent FindingsApo C-III and ANGPTL3 have emerged as novel regulators of triglyceride (TG) and low-density lipoprotein-cholesterol (LDL-C) levels. ANGPTL3 is an inhibitor of lipoprotein lipase (LPL), reducing lipolysis of Apo B-containing lipoproteins. Loss-of-functionANGPLT3 mutations are associated with reduced plasma cholester...
Source: Current Atherosclerosis Reports - March 10, 2021 Category: Cardiology Source Type: research

Strengthening the Learning Health System in Cardiovascular Disease Prevention: Time to Leverage Big Data and Digital Solutions
AbstractPurpose of ReviewThe past few decades have seen significant technologic innovation for the treatment and diagnosis of cardiovascular diseases. The subsequent growing complexity of modern medicine, however, is causing fundamental challenges in our healthcare system primarily in the spheres of patient involvement, data generation, and timely clinical implementation. The Institute of Medicine advocated for a learning health system (LHS) in which knowledge generation and patient care are inherently symbiotic. The purpose of this paper is to review how the advances in technology and big data have been used to further pa...
Source: Current Atherosclerosis Reports - March 10, 2021 Category: Cardiology Source Type: research

Lipid Lowering Drugs: Present Status and Future Developments
AbstractPurpose of reviewBased on the recent data of the DA VINCI study, it is clear that, besides utilization of statins, there is a need to increase non-statin lipid lowering approaches to reduce the cardiovascular burden in patients at highest risk.Recent findingsFor hypercholesterolemia, the small synthetic molecule bempedoic acid has the added benefit of selective liver activation, whereas inclisiran, a hepatic inhibitor of the PCSK9 synthesis, has comparable effects with PCSK9 monoclonal antibodies. For hypertriglyceridemia, cardiovascular benefit has been achieved by the use of icosapent ethyl, whereas results with ...
Source: Current Atherosclerosis Reports - March 10, 2021 Category: Cardiology Source Type: research

Polypills in Cardiovascular Disease Prevention: Mass-Strategy Approach, Precision Medicine, or an Essential Intertwine Between Them?
AbstractPurpose of ReviewThis review considers the framework of high-risk vs. population approaches as proposed in the Rose ’s axiom within the context of cardiovascular diseases, including its benefits and limitations. We also contextualize the use of precision medicine in primary prevention therapy and contrast that with population approach.Recent FindingsAlthough the high-risk strategy aims at individualized care, the complexity of pharmacologic regimens and other limitations reduces its real-life impact. On the other hand, broad population strategies include treatment of a substantial number of low-risk individua...
Source: Current Atherosclerosis Reports - March 10, 2021 Category: Cardiology Source Type: research

Preventing Diabetes and Atherosclerosis in the Cardiometabolic Syndrome
AbstractPurpose of ReviewCardiometabolic syndrome is characterized by abdominal adiposity, insulin resistance, hypertension, and dyslipidemia. There is a growing burden of cardiometabolic disease in many parts of the world. This review highlights the critical preventive and therapeutic measures that need to be implemented to reduce the impact of cardiometabolic syndrome on cardiovascular health.Recent FindingsRecent cardiovascular outcome trials demonstrated that newer glucose-lowering medications reduce cardiovascular and renal events in patients with type 2 diabetes mellitus (T2DM). These medications should be considered...
Source: Current Atherosclerosis Reports - March 9, 2021 Category: Cardiology Source Type: research

LDL Apheresis and Lp (a) Apheresis: A Clinician ’s Perspective
AbstractPurpose of ReviewLipoprotein apheresis is the most effective means of lipid-lowering therapy. However, it ’s a semi-invasive, time consuming, and chronic therapy with variable adherence. There are still no specific guideline recommendations for the management of patients on lipid apheresis. The purpose of this review is to discuss the clinical indications and major drawbacks of lipid apheresis in the light of recent evidence.Recent FindingsLipoprotein apheresis should be initiated at early ages and performed frequently to receive the expected cardiovascular benefits. However, in clinical practice, most patien...
Source: Current Atherosclerosis Reports - February 17, 2021 Category: Cardiology Source Type: research

Trimethylamine N-Oxide (TMAO), Diet and Cardiovascular Disease
AbstractPurpose of ReviewThe association between plasma Trimethylamine N-Oxide (TMAO), diet and risk for cardiovascular disease (CVD) is still not fully understood. While epidemiologic research shows a causal relationship between plasma TMAO concentrations and CVD risk, the role of dietary precursors in determining plasma concentrations of TMAO and biomarkers for CVD is inconclusive.Recent FindingsStudies in diverse populations show that plasma TMAO concentrations are positively associated with inflammation, endothelial dysfunction, type-2 diabetes, central adiposity and hypertension. Most recent studies utilizing challeng...
Source: Current Atherosclerosis Reports - February 17, 2021 Category: Cardiology Source Type: research

Nutrition as Treatment Modality in Heart Failure
AbstractPurpose of ReviewThis review aims to discuss recent evidence and controversies regarding nutrition as a treatment modality for heart failure (HF) patients.Recent FindingsAdequate nutrition is known to promote health-related quality of life by addressing malnutrition and promoting optimal functioning among older adults and has an established role in the prevention of HF; however, evidence is limited on the effects of nutrition as a treatment modality in HF. While guidance of sodium restriction to address fluid overload is an ongoing debate among experts, evidence from case studies and small clinical trials suggest a...
Source: Current Atherosclerosis Reports - February 17, 2021 Category: Cardiology Source Type: research

Contributions of Food Environments to Dietary Quality and Cardiovascular Disease Risk
AbstractPurpose of ReviewTo evaluate the multidimensional influence of food environments on food choice, dietary quality, and diet-related health and identify critical gaps necessary to develop effective population interventions that influence food choice.Recent FindingsMulticomponent interventions that interact with multiple layers of the food environment show limited but consistent effects on dietary behaviors and may have wider and substantive population-level reach with greater incorporation of validated, holistic measurement tools. Opportunities to use smartphone technology to measure multiple components of the food e...
Source: Current Atherosclerosis Reports - February 17, 2021 Category: Cardiology Source Type: research

APOA1: a Protein with Multiple Therapeutic Functions
AbstractPurpose of the ReviewApolipoprotein (APO) A1, the main apolipoprotein of plasma high-density lipoproteins (HDLs), has several well documented cardioprotective functions. A number of additional potentially beneficial functions of APOA1 have recently been identified. This review is concerned with the therapeutic potential of all of these functions in multiple disease states.Recent FindingsKnowledge of the beneficial functions of APOA1 in atherosclerosis, thrombosis, diabetes, cancer, and neurological disorders is increasing exponentially. These insights have led to the development of clinically relevant peptides and ...
Source: Current Atherosclerosis Reports - February 16, 2021 Category: Cardiology Source Type: research

The Truth About Fish (Oil) in the Treatment of Dyslipidemia
AbstractPurpose of ReviewTo discuss the effect of fish oils on dyslipidemias and associated disorders.Recent FindingsThe most important lipid effect of fish oils is reducing plasma triglycerides and the main potential protection against cardiovascular events is very probably mediated also through other mechanisms including anti-inflammatory ones. The best results are available for omega-3 fatty acids, namely, eicosapentaenoic acid. Less evidence is available for the impact of ω-3 fatty acids on liver steatosis/steatohepatitis and acute pancreatitis. In addition, particular fish oils have variable content of saturated...
Source: Current Atherosclerosis Reports - February 4, 2021 Category: Cardiology Source Type: research

The Role of Phospholipid Transfer Protein in the Development of Atherosclerosis
This article reviews recent PLTP research progresses, involving lipoprotein metabolism and atherogenesis.Recent FindingsPLTP activity influences atherogenic and anti-atherogenic lipoprotein levels. Human serum PLTP activity is a risk factor for human cardiovascular disease and is an independent predictor of all-cause mortality. PLTP deficiency reduces VLDL and LDL levels and attenuates atherosclerosis in mouse models, while PLTP overexpression exerts an opposite effect. Both PLTP deficiency and overexpression result in reduction of HDL which has different size, inflammatory index, and lipid composition. Moreover, although ...
Source: Current Atherosclerosis Reports - January 26, 2021 Category: Cardiology Source Type: research

Diabetes, Lipids, and CV Risk
AbstractPurpose of ReviewDiabetes is often associated with diabetic dyslipidemia. Both hyperglycemia and disorders of lipid metabolism strongly contribute to development of atherosclerosis, the crucial factor of cardiovascular disease. The aim of the manuscript is to summarize possible treatment to reduce cardiovascular risk.Recent FindingsMaximal cardiovascular risk reduction is maintained by targeting more pathologic disturbances together. While antihypertensive treatment has not changed much recently, novel PCSK9 inhibitors have significantly improved management of dyslipidemia. Similarly, modern antihyperglycemic agent...
Source: Current Atherosclerosis Reports - January 19, 2021 Category: Cardiology Source Type: research

High-Density Lipoproteins and Serum Amyloid A (SAA)
AbstractPurpose of ReviewSerum amyloid A (SAA) is a highly sensitive acute phase reactant that has been linked to a number of chronic inflammatory diseases. During a systemic inflammatory response, liver-derived SAA is primarily found on high-density lipoprotein (HDL). The purpose of this review is to discuss recent literature addressing the pathophysiological functions of SAA and the significance of its association with HDL.Recent FindingsStudies in gene-targeted mice establish that SAA contributes to atherosclerosis and some metastatic cancers. Accumulating evidence indicates that the lipidation state of SAA profoundly a...
Source: Current Atherosclerosis Reports - January 15, 2021 Category: Cardiology Source Type: research

Novel Functions of Endothelial Scavenger Receptor Class B Type I
AbstractPurpose of ReviewScavenger receptor class B type I (SR-BI) serves a key role in the reverse cholesterol transport in the liver as the high-affinity receptor for HDL. SR-BI is abundantly expressed in endothelium, and earlier works indicate that the receptor mediates anti-atherogenic actions of HDL. However, more recent studies uncovered novel functions of endothelial SR-BI as a lipoprotein transporter, which regulates transcellular transport process of both LDL and HDL. This brief review focuses on the unique functions of endothelial SR-BI and how they influence atherogenesis.Recent FindingsEarlier studies indicate ...
Source: Current Atherosclerosis Reports - January 9, 2021 Category: Cardiology Source Type: research

High HDL-Cholesterol Paradox: SCARB1 - LAG3 -HDL Axis
AbstractPurpose of the ReviewTo evaluate recent studies related to the paradox of high HDL-C with mortality and atherosclerotic cardiovascular disease (ASCVD) risk.Recent FindingsTwo observational studies (Cardiovascular Health in Ambulatory Care Research Team [CANHEART] and Copenhagen City Heart Study and the Copenhagen General Population Study [Copenhagen Heart Studies]) of adults without pre-existing ASCVD have shown a significant U-shaped association of HDL-C with all-cause and cause-specific mortality. Both studies showed that low HDL-C levels consistently increased hazard risk (HR) for all-cause and cause-specific mo...
Source: Current Atherosclerosis Reports - January 5, 2021 Category: Cardiology Source Type: research

Selective Peroxisome Proliferator-Activated Receptor Alpha Modulators (SPPARM α) in the Metabolic Syndrome: Is Pemafibrate Light at the End of the Tunnel?
AbstractPurpose of ReviewAdoption of poor lifestyles (inactivity and energy-dense diets) has driven the worldwide increase in the metabolic syndrome, type 2 diabetes mellitus and non-alcoholic steatohepatitis (NASH). Of the defining features of the metabolic syndrome, an atherogenic dyslipidaemia characterised by elevated triglycerides (TG) and low plasma concentration of high-density lipoprotein cholesterol is a major driver of risk for atherosclerotic cardiovascular disease. Beyond lifestyle intervention and statins, targeting the nuclear receptor peroxisome proliferator-activated receptor alpha (PPAR α) is a thera...
Source: Current Atherosclerosis Reports - January 3, 2021 Category: Cardiology Source Type: research

Highlights from Studies Presented at the American Heart Association Scientific Session 2020: Navigating New Roads in Prevention
AbstractPurpose of the ReviewThis review highlights late-breaking science presented at the American Heart Association Scientific Session 2020 that demonstrated advancements in preventative cardiology and introduced novel treatment approaches for the management of chronic kidney disease, type 2 diabetes, and/or heart failure.Recent FindingsThe studies reviewed include clinical trials that assessed the use of omecamtiv in the treatment of heart failure with reduced heart failure (GALACTIC-HF); effects of sotagliflozin in patients with diabetes and recent heart failure exacerbation; cardiovascular outcomes with the use of ome...
Source: Current Atherosclerosis Reports - January 3, 2021 Category: Cardiology Source Type: research

Should We Target Global Risk or Risk Factors?
AbstractPurpose of ReviewRecent evidence has shaped the new guidelines for the management of dyslipidemia. The importance of accurate risk estimation, subclinical disease detection, and contemporary dyslipidemia management approaches are discussed in this review.Recent FindingsRisk prediction helps determine the intensity of management strategies and identify high-risk patients. To overcome the pitfalls of the current risk prediction systems, incorporating genetic scores, biomarkers, and imaging is being explored. Key initiating event in atherogenesis is low-density lipoprotein cholesterol (LDL-C) retention in the arterial...
Source: Current Atherosclerosis Reports - January 3, 2021 Category: Cardiology Source Type: research

AIBP, Angiogenesis, Hematopoiesis, and Atherogenesis
AbstractPurpose of ReviewThe goal of this manuscript is to summarize the current understanding of the secreted APOA1 binding protein (AIBP), encoded byNAXE, in angiogenesis, hematopoiesis, and inflammation. The studies on AIBP illustrate a critical connection between lipid metabolism and the aforementioned endothelial and immune cell biology.Recent FindingsAIBP dictates both developmental processes such as angiogenesis and hematopoiesis, and pathological events such as inflammation, tumorigenesis, and atherosclerosis.SummaryAlthough cholesterol efflux dictates AIBP-mediated lipid raft disruption in many of the cell types, ...
Source: Current Atherosclerosis Reports - November 24, 2020 Category: Cardiology Source Type: research

The Role of the Gut Microbiota in Coronary Heart Disease
AbstractPurpose of ReviewThis review focuses on recent evidence examining the role gut microbiota play in coronary heart disease. It also provides a succinct overview of current and future therapies targeting the gut microbiota for coronary heart disease risk reduction.Recent FindingsA consensus has been reached that differences exist in the gut microbiotas of patients with coronary heart disease. Studies have shown that the gut microbiota is associated with obesity, diabetes, dyslipidemia, and hypertension, which are risk factors for coronary heart disease. The gut microbiota is involved in mediating basic metabolic proce...
Source: Current Atherosclerosis Reports - October 16, 2020 Category: Cardiology Source Type: research

Inflammatory Cytokines and Atherosclerotic Plaque Progression. Therapeutic Implications
AbstractPurpose of the ReviewInflammatory cytokines play a major role in atherosclerotic plaque progression. This review summarizes the rationale for personalized anti-inflammatory therapy.Recent FindingsSystemic inflammatory parameters may be used to follow the clinical outcome in primary and secondary prevention. Medical therapy, both in patients with stable cardiovascular disease, or with acute events, may be tailored taking into consideration the level and course of systemic inflammatory mediators. There is significant space for improvement in primary prevention and in the treatment of patients who have suffered from s...
Source: Current Atherosclerosis Reports - October 5, 2020 Category: Cardiology Source Type: research

Intra-coronary Imaging for the Evaluation of Plaque Modifications Induced by Drug Therapies for Secondary Prevention
This article aims to review potential application of intra-coronary imaging for the evaluation of plaque modifications, induced by medications for secondary prevention for CAD.Recent FindingsIntra-coronary imaging provides detailed information on the atherosclerotic plaque which is the primary pathological substrate for the recurrent ischemic cardiovascular events. These modalities can detect features associated with high risk and allow serial in vivo imaging of lesions. Therefore, intravascular imaging tools have been used in landmark studies and played a role in improving our understanding of the disease processes.Summar...
Source: Current Atherosclerosis Reports - October 5, 2020 Category: Cardiology Source Type: research

State of the Art in Noninvasive Imaging of Ischemic Heart Disease and Coronary Microvascular Dysfunction in Women: Indications, Performance, and Limitations
AbstractPurpose of ReviewEstablishing a diagnosis of ischemic heart disease (IHD) in women, including assessment for coronary microvascular dysfunction (CMD) when indicated, can be challenging. Access to performance of invasive testing when appropriate may be limited, and noninvasive imaging assessments have evolved. This review will summarize the various noninvasive imaging modalities available for the diagnosis of IHD and CMD in women, outlining indications, performance modalities, advantages, and limitations.Recent FindingsWhile stress echocardiography and single photon emission computed tomography (SPECT) myocardial pe...
Source: Current Atherosclerosis Reports - October 2, 2020 Category: Cardiology Source Type: research

Digital Health Innovations to Improve Cardiovascular Disease Care
AbstractPurpose of ReviewTo review the current evidence supporting the use of digital health technologies in cardiovascular disease (CVD) care.Recent FindingsStudies have evaluated the impact of the use of digital health technologies to improve CVD outcomes through several modalities: text-messaging programmes, smartphone applications (apps) and wearable devices. Text-messaging programmes are to date the most studied type of digital health interventions, and studies have demonstrated reduced CVD risk and improved medication adherence. Literature supporting the use of smartphone apps is also growing but remains limited, wit...
Source: Current Atherosclerosis Reports - October 2, 2020 Category: Cardiology Source Type: research

Omega n-3 Supplementation: Exploring the Cardiovascular Benefits Beyond Lipoprotein Reduction
AbstractPurpose of ReviewHypertriglyceridaemia is a highly prevalent disorder worldwide. Genetic and Mendelian randomization studies have suggested that triglyceride (TG)-rich lipoproteins are causal risk factors for coronary heart disease and contribute to the residual cardiovascular risk observed in patients optimally treated with statins. However, clinical trials failed to show cardiovascular benefits of TG-lowering; in this context, trials with omega-3 fatty acids provided contrasting results. Few trials have tested the supplementation of EPA alone rather than the combination of EPA + DHA. The JELIS study showed that E...
Source: Current Atherosclerosis Reports - October 2, 2020 Category: Cardiology Source Type: research

Highlights from Studies in Cardiovascular Disease Prevention Presented at the Digital 2020 European Society of Cardiology Congress: Prevention Is Alive and Well
AbstractPurpose of ReviewThe review highlights selected studies related to cardiovascular disease (CVD) prevention that were presented at the 2020 European Society of Cardiology (ESC) Congress —The Digital Experience.Recent FindingsThe studies reviewed include clinical trials on novel RNA interference-based lipid-lowering therapies AKCEA-APOCIII-LRx and vupanorsen (AKCEA-ANGPTL3-LRx); the EVAPORATE trial assessing the effects of icosapent ethyl on coronary plaque volume progression; the LoDoCo2 trial evaluating the efficacy of low-dose colchicine in cardiovascular disease risk reduction among patients with chronic co...
Source: Current Atherosclerosis Reports - October 2, 2020 Category: Cardiology Source Type: research

Biological Factors Linking ApoE ε4 Variant and Severe COVID-19
(Source: Current Atherosclerosis Reports)
Source: Current Atherosclerosis Reports - October 1, 2020 Category: Cardiology Source Type: research

Structural Basis for Vital Function and Malfunction of Serum Amyloid A: an Acute-Phase Protein that Wears Hydrophobicity on Its Sleeve
AbstractPurpose of ReviewThis review addresses normal and pathologic functions of serum amyloid A (SAA), an enigmatic biomarker of inflammation and protein precursor of AA amyloidosis, a life-threatening complication of chronic inflammation. SAA is a small, highly evolutionarily conserved acute-phase protein whose plasma levels increase up to one thousand-fold in inflammation, infection, or after trauma. The advantage of this dramatic but transient increase is unclear, and the complex role of SAA in immune response is intensely investigated. This review summarizes recent advances in our understanding of the structure-funct...
Source: Current Atherosclerosis Reports - September 23, 2020 Category: Cardiology Source Type: research

Therapeutic Apheresis for Management of Lp(a) Hyperlipoproteinemia
AbstractPurpose of ReviewHigh lipoprotein(a) (Lp(a)) level is an independent cardiovascular risk factor with higher prevalence among patients with atherosclerotic cardiovascular disease (ASCVD). The actual problem is that most currently available lipid-lowering drugs are unable to abolish Lp(a) pathogenicity. Lipoprotein apheresis (LA) is an effective method for elimination of atherogenic lipoproteins, but it is approved only in some countries for treatment of elevated Lp(a) level in the presence of progressive ASCVD. In recent years, new studies on LA were published and the purpose of this review is to present the informa...
Source: Current Atherosclerosis Reports - September 17, 2020 Category: Cardiology Source Type: research

The Role of Nutraceuticals in the Optimization of Lipid-Lowering Therapy in High-Risk Patients with Dyslipidaemia
AbstractPurpose of ReviewWe aimed to summarize recent guidelines, position papers, and high-quality clinical research relating the use of nutraceuticals in the management of individuals at high risk of atherosclerotic cardiovascular disease.Recent FindingsIt is essential that individuals at high risk of cardiovascular disease receive guideline-directed evidence-based therapies to reduce their risk of morbidity and mortality from cardiovascular events. Compared with conventional therapeutics, nutraceuticals have undergone relatively little investigation in randomized controlled trials. Thus, recommendations for nutraceutica...
Source: Current Atherosclerosis Reports - September 17, 2020 Category: Cardiology Source Type: research

Targeting Inflammation to Reduce Residual Cardiovascular Risk
AbstractPurpose of ReviewPatients with established cardiovascular disease are at high risk for recurrent myocardial infarction, stroke, and cardiovascular death. The termresidual risk refers to this risk that persists, even after optimal treatment. Considerable progress has been made to understand the biological basis of residual risk and to devise therapies that can safely and effectively reduce risk. The presence of ongoing subclinical vascular inflammation is known to be a marker of elevated residual risk, and reductions in measures of vascular inflammation predict improved outcome in these patients.Recent FindingsRecen...
Source: Current Atherosclerosis Reports - September 2, 2020 Category: Cardiology Source Type: research

Gender Differences in Residual Risk Factors for Major Adverse Cardiovascular Events Following ACS and How to Bridge the Gap
AbstractPurpose of ReviewThe review aims to describe the differences between men and women in those factors that can influence a worse prognosis in women after an acute cardiovascular event.Recent FindingsWomen adequately treated with current evidence-based medications for acute myocardial infarction and for conventional cardiovascular risk factors, such as hypertension, diabetes, smoking, and dyslipidemia, still have an extra risk of death compared with men. Additional factors that increase the risk of poor prognosis for the index event have been identified.SummaryThe residual risk can be due to factors affecting the prog...
Source: Current Atherosclerosis Reports - September 2, 2020 Category: Cardiology Source Type: research

The Knowns and Unknowns of Contemporary Statin Therapy for Familial Hypercholesterolemia
AbstractPurpose of ReviewStatins are first-line therapy for lowering low-density lipoprotein (LDL) cholesterol in familial hypercholesterolemia (FH), particularly in heterozygous patients. We review advances and new questions on the use of statins in FH.Recent FindingsCumulative evidence from registry data and sub-analyses of clinical trials mandates the value of statin therapy for prevention of atherosclerotic cardiovascular disease (ASCVD) in FH. Statins are safe in children and adolescents with FH, with longer term cardiovascular benefits. The potentially toxic effects of statins in pregnancy need to be considered, but ...
Source: Current Atherosclerosis Reports - August 31, 2020 Category: Cardiology Source Type: research

Familial Chylomicronemia Syndrome (FCS): Recent Data on Diagnosis and Treatment
AbstractPurpose of ReviewFamilial chylomicronemia syndrome (FCS) is a rare recessive genetic disorder often underdiagnosed with potentially severe clinical consequences. In this review, we describe the clinical and biological characteristics of the disease together with its main complication, i.e., acute pancreatitis. We focused the paper on new diagnostic tools, progress in understanding the role of two key proteins (apolipoprotein CIII (apo CIII) and angiopoietin-like3 (ANGPTL-3)), and new therapeutic options.Recent FindingsRecently, a new diagnostic tool has been proposed by European experts to help identify these patie...
Source: Current Atherosclerosis Reports - August 26, 2020 Category: Cardiology Source Type: research

Is Any Cardiovascular Disease-Specific DNA Methylation Biomarker Within Reach?
AbstractPurpose of ReviewA detailed understanding of the epigenome of cardiovascular disease (CVD) should broaden current insights into mechanisms of atherogenesis and help identify suitable biomarkers for disease risk and progression. This review addresses the question whether a consensus has been reached on identifying the main aberrant DNA methylation profile in CVD. Additionally, it presents advances and setbacks in the search for specific CVD biomarkers.Recent FindingsAlthough the literature points to DNA hypermethylation as an epigenetic landmark of CVD, inconsistencies are significant. In particular, the DNA methylo...
Source: Current Atherosclerosis Reports - August 25, 2020 Category: Cardiology Source Type: research

Effect of Renin-Angiotensin-Aldosterone System Inhibitors in Patients with COVID-19: a Systematic Review and Meta-analysis of 28,872 Patients
AbstractPurpose of ReviewThe role of renin-angiotensin-aldosterone system (RAAS) inhibitors, notably angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs), in the COVID-19 pandemic has not been fully evaluated. With an increasing number of COVID-19 cases worldwide, it is imperative to better understand the impact of RAAS inhibitors in hypertensive COVID patients. PubMed, Embase and the pre-print database Medrxiv were searched, and studies with data on patients on ACEi/ARB with COVID-19 were included. Random effects models were used to estimate the pooled mean difference with 95% confidence...
Source: Current Atherosclerosis Reports - August 23, 2020 Category: Cardiology Source Type: research

Women Living with Familial Hypercholesterolemia: Challenges and Considerations Surrounding Their Care
AbstractPurpose of ReviewTo highlight the gender-based differences in presentation and disparities in care for women with familial hypercholesterolemia (FH).Recent FindingsWomen with FH experience specific barriers to care including underrepresentation in research, significant underappreciation of risk, and interrupted therapy during childbearing. National and international registry and clinical trial data show significant healthcare disparities for women with FH. Women with FH are less likely to be on guideline-recommended high-intensity statin medications and those placed on statins are more likely to discontinue them wi...
Source: Current Atherosclerosis Reports - August 19, 2020 Category: Cardiology Source Type: research

Exosomes: Multifaceted Messengers in Atherosclerosis
AbstractPurpose of ReviewAtherosclerosis (AS) is a chronic inflammatory disease that contributes to the development of coronary artery disease, which has become a leading health burden worldwide. Though several strategies such as pharmacological treatment, exercise intervention, and surgery have been used in clinical practice, there is still no effective strategy to cure AS. Exosomes are extensively studied both as diagnostic markers as well as for therapeutic purposes due to their role in pathological processes related to AS. To elucidate the role of exosomes in AS and thus provide a new insight into AS therapy, we review...
Source: Current Atherosclerosis Reports - August 8, 2020 Category: Cardiology Source Type: research

Preventive Cardiology and Risk Assessment: Beyond LDL
AbstractPurpose of ReviewRisk assessment is the foundational cornerstone for cardiovascular prevention. The goal of this review is to apprise the reader of the latest evidence and guideline-based stepwise method for clinical risk assessment for future atherosclerotic events. We also discuss caveats to the current approach and review future directions including the promise of precision medicine.Recent FindingsThe most recent cholesterol and prevention guidelines improve upon the widely used pooled cohort equations by incorporating risk-enhancing factors to further personalize risk assessment. For those in whom uncertainty r...
Source: Current Atherosclerosis Reports - August 8, 2020 Category: Cardiology Source Type: research