Cardio-Obstetrics: the Next Frontier in Cardiovascular Disease Prevention
AbstractPurpose of ReviewInternationally, cardiovascular disease (CVD) is the leading cause of death in women. With risk factors for CVD continuing to rise, early identification and management of chronic diseases such as hypertension, diabetes, and obstructive sleep apnea is necessary for prevention. Pregnancy is a natural stress test for women with risk factors who may be predisposed to CVD and offers a unique opportunity to not only recognize disease but also implement effective and long-lasting strategies for prevention.Recent FindingsPrevention begins before pregnancy, as preconception screening, counseling, and optimi...
Source: Current Atherosclerosis Reports - May 7, 2022 Category: Cardiology Source Type: research

ApoA-I Infusion Therapies Following Acute Coronary Syndrome: Past, Present, and Future
AbstractPurpose of ReviewThe elevated adverse cardiovascular event rate among patients with low high-density lipoprotein cholesterol (HDL-C) formed the basis for the hypothesis that elevating HDL-C would reduce those events. Attempts to raise endogenous HDL-C levels, however, have consistently failed to show improvements in cardiovascular outcomes. However, steady-state HDL-C concentration does not reflect the function of this complex family of particles. Indeed, HDL functions correlate only weakly with serum HDL-C concentration. Thus, the field has pivoted from simply raising the quantity of HDL-C to a focus on improving ...
Source: Current Atherosclerosis Reports - May 7, 2022 Category: Cardiology Source Type: research

Management of Dyslipidemia in Patients with Non-Alcoholic Fatty Liver Disease
This article reviews the pathogenic interrelationship between NAFLD and dyslipidemia, elucidates underlying pathophysiological mechanisms and focuses on management approaches for dyslipidemic patients with NAFLD.Recent FindingsAtherogenic dyslipidemia in patients with NAFLD results from hepatic and peripheral insulin resistance along with associated alterations of hepatic glucose and lipoprotein metabolism, gut dysbiosis, and genetic factors.SummarySince atherogenic dyslipidemia and NAFLD share a bi-directional relationship and are both major driving forces of atherosclerotic cardiovascular disease (ASCVD) development, ear...
Source: Current Atherosclerosis Reports - May 4, 2022 Category: Cardiology Source Type: research

Long-Term Cardiovascular Effects of COVID-19: Emerging Data Relevant to the Cardiovascular Clinician
AbstractPurpose of ReviewCOVID-19 is now a global pandemic and the illness affects multiple organ systems, including the cardiovascular system. Long-term cardiovascular consequences of COVID-19 are not yet fully characterized. This review seeks to consolidate available data on long-term cardiovascular complications of COVID-19 infection.Recent FindingsAcute cardiovascular complications of COVID-19 infection include myocarditis, pericarditis, acute coronary syndrome, heart failure, pulmonary hypertension, right ventricular dysfunction, and arrhythmia. Long-term follow-up shows increased incidence of arrhythmia, heart failur...
Source: Current Atherosclerosis Reports - May 4, 2022 Category: Cardiology Source Type: research

Comprehensive Review and Updates on Holistic Approach Towards Non-Alcoholic Fatty Liver Disease Management with Cardiovascular Disease
AbstractPurpose of ReviewThe global prevalence of non-alcoholic fatty liver disease (NAFLD) presents an unmet need in treating these, often asymptomatic, individuals. In this review, we summarised NAFLD management and described recent developments in non-alcoholic steatohepatitis (NASH) therapeutics that can shape the future of NAFLD.Recent FindingsA multi-disciplinary effort in promoting sustainable lifestyle measures is paramount, with the goal of either limiting energy surplus alone or in combination with targeting downstream pathways of inflammation and fibrosis. Several antidiabetic medications like PPAR- γ agonist a...
Source: Current Atherosclerosis Reports - May 4, 2022 Category: Cardiology Source Type: research

Recent Advances in Coronary Computed Tomography Angiogram: The Ultimate Tool for Coronary Artery Disease
AbstractPurpose of ReviewThe emerging technologies in multidetector computed tomography scanners gave the ability to image coronary arteries in a single heartbeat, at a higher quality, and low radiation dose. Furthermore, incorporating artificial intelligence and machine learning into image processing and interpretation have extended the use for coronary computed tomography angiogram (CCTA) and its applications. In this review, we will explore the recent evidence and advances supporting CCTA to become the ultimate tool for coronary artery disease.Recent FindingsResults from the EVINCI, ISCHEMIA, SCOT-HEART, and PROMISE sho...
Source: Current Atherosclerosis Reports - May 4, 2022 Category: Cardiology Source Type: research

Dyslipidemia Management in Pregnancy: Why Is It not Covered in the Guidelines?
This article reviews the characteristics of lipid disorders and the possible management with dyslipidemia in pregnant women.Recent FindingsAmong many available groups of lipid-lowering drugs, only bile acid sequestrants are approved for the treatment of dyslipidemia during pregnancy. Ezetimibe and fenofibrate might be considered if benefits outweigh the potential risk. Statins are still contraindicated due to the results mainly from animal studies and series of human cases. However, recent systematic reviews and meta-analyses showed that their use may not be detrimental, and in some selected cases may be beneficial. Especi...
Source: Current Atherosclerosis Reports - April 30, 2022 Category: Cardiology Source Type: research

Cardiovascular Prevention Among Young Adults with Congenital Heart Disease
AbstractPurpose of ReviewThere are over a million adults living with congenital heart disease (CHD) in the USA. There have been improvements in CHD management which have led to an expansion of the adult congenital heart disease (ACHD) population. There is a high prevalence of atherosclerotic cardiovascular disease (ASCVD) encountered in the aging ACHD population. This review focuses on the most recent literature regarding the primary prevention of ASCVD in young ACHD patients.Recent FindingsThere are unique considerations for ASCVD risk reduction in ACHD patients. ASCVD may be as prevalent in ACHD compared in the general p...
Source: Current Atherosclerosis Reports - April 30, 2022 Category: Cardiology Source Type: research

Controversies in the Use of Omega-3 Fatty Acids to Prevent Atherosclerosis
AbstractPurpose of ReviewWe discuss current controversies in the clinical use of omega-3 fatty acids (FA), primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and examine discrepancies between recent trials. Furthermore, we discuss potential side effects reported in these studies and the role of mixed omega-3 FA dietary supplements and concerns about their use.Recent FindingsREDUCE-IT showed that addition of icosapent ethyl, a highly purified form of EPA, can reduce risk of cardiovascular events among statin-treated individuals with high triglycerides. Additional supportive evidence for EPA has come from ...
Source: Current Atherosclerosis Reports - April 30, 2022 Category: Cardiology Source Type: research

Next Generation Risk Markers in Preventive Cardio-oncology
AbstractPurpose of ReviewCardiovascular disease (CVD) and cancer are the first and second most common causes of death within the USA. It is well established that a diagnosis of cancer increases risk and predisposes the patient to CVD, and vice versa. Despite these associations, cancer is not yet incorporated into current CVD risk calculators, necessitating additional CV risk markers for improved stratification in this at-risk population. In this review, we consider the utility of breast arterial calcification (BAC), coronary artery calcification (CAC), clonal hematopoiesis of indeterminate potential (CHIP), and cancer and ...
Source: Current Atherosclerosis Reports - April 19, 2022 Category: Cardiology Source Type: research

More than Just a Monolayer: the Multifaceted Role of Endothelial Cells in the Pathophysiology of Atherosclerosis
AbstractPurpose of the ReviewIn this review, we summarize current insights into the versatile roles of endothelial cells in atherogenesis.Recent FindingsThe vascular endothelium represents the first barrier that prevents the entry of lipoproteins and leukocytes into the vessel wall, thereby controlling two key events in the pathogenesis of atherosclerosis. Disturbance of endothelial homeostasis increases vascular permeability, inflammation, and cellular trans-differentiation, which not only promotes the build-up of atherosclerotic plaques but is also involved in life-threatening thromboembolic complications such as plaque ...
Source: Current Atherosclerosis Reports - April 11, 2022 Category: Cardiology Source Type: research

Are Clinicians Aggressive Enough in Treating Diabetes-Related Hyperlipidemia in Youth?
AbstractPurpose of ReviewCardiovascular disease is the leading cause of death in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D). Subclinical atherosclerotic changes are noted in youth with diabetes; therefore, timely identification and management of modifiable cardiovascular risk factors including hyperlipidemia is crucial. We review the current guidelines for hyperlipidemia screening and treatment in youth with T1D and T2D. We discuss the efficacy of non-pharmacological strategies including dietary modifications, exercise, and glycemic control and pharmacological therapy. We summarize reported rates of trea...
Source: Current Atherosclerosis Reports - April 11, 2022 Category: Cardiology Source Type: research

Familial Hypercholesterolemia and Lipoprotein(a): Two Partners in Crime?
AbstractPurpose of ReviewFamilial hypercholesterolemia is a high cardiovascular risk disorder. We will review the role of lipoprotein(a) in cardiovascular risk and in aortic valve stenosis in familial hypercholesterolemia, as well as its association with their phenotype, and strategies to identify this high-risk population.Recent FindingsPatients with familial hypercholesterolemia have higher lipoprotein(a) levels mainly due to an increased frequency of LPA variants, and the cardiovascular risk is increased twofolds when both conditions coexist. Also, an increased risk for aortic valve stenosis and valve replacement has be...
Source: Current Atherosclerosis Reports - April 7, 2022 Category: Cardiology Source Type: research

Monogenic Versus Polygenic Forms of Hypercholesterolemia and Cardiovascular Risk: Are There Any Differences?
AbstractPurpose of ReviewCommon DNA variants with small effects work together to create susceptibility to polygenic hypercholesterolemia. Some clinicians wonder whether patients with polygenic hypercholesterolemia have less severe clinical features compared to patients with monogenic familial hypercholesterolemia (FH) caused by rare deleterious variants.Recent FindingsStudies performed in cohorts of patients with both monogenic and polygenic hypercholesterolemia have assessed lipid levels, non-invasive markers of atherosclerosis, and clinical end points, including major adverse cardiovascular events. The totality of data s...
Source: Current Atherosclerosis Reports - April 7, 2022 Category: Cardiology Source Type: research

DOACs and Atherosclerotic Cardiovascular Disease Management: Can We Find the Right Balance Between Efficacy and Harm
AbstractPurpose of ReviewThe balance between efficacy and harm remains a challenge in the adoption of non-vitamin K antagonist direct oral anticoagulants (DOACs) for secondary atherosclerotic disease prevention. We provide a comprehensive review of the evidence for and against the addition of DOACs to the current management of atherosclerotic cardiovascular disease, including stable coronary artery disease (CAD), acute coronary syndrome (ACS), peripheral artery disease (PAD), and percutaneous coronary interventions (PCI).Recent FindingsThe DOAC class exerts pleiotropic effects on atherosclerotic progression through coagula...
Source: Current Atherosclerosis Reports - April 7, 2022 Category: Cardiology Source Type: research