The Pandemic of Coronary Heart Disease in South Asia: What Clinicians Need to Know
AbstractPurpose of ReviewSouth Asia has around 1/6th of the current global population. Epidemiological studies suggest that South Asians living in South Asia and diaspora are at an increased risk of premature atherosclerotic cardiovascular diseases (ASCVDs). This is due to an interplay of genetic, acquired, and environmental risk factors. Due to its increasing share of the global population, clinicians need to know the reasons for this early predisposition, and strategies for early identification and mitigation.Recent FindingsSouth Asians have earlier onset of cardiometabolic risk factors such as insulin resistance, hypert...
Source: Current Atherosclerosis Reports - May 26, 2023 Category: Cardiology Source Type: research

Implementing Reporting Standards for Polygenic Risk Scores for Atherosclerotic Cardiovascular Disease
AbstractPurpose of ReviewThere is considerable interest in using polygenic risk scores (PRSs) for assessing risk of atherosclerotic cardiovascular disease (ASCVD). A barrier to the clinical use of PRSs is heterogeneity in how PRS studies are reported. In this review, we summarize approaches to establish a uniform reporting framework for PRSs for coronary heart disease (CHD), the most common form of ASCVD.Recent FindingsReporting standards for PRSs need to be contextualized for disease specific applications.SummaryIn addition to metrics of predictive performance, reporting standards for PRSs for CHD should include how cases...
Source: Current Atherosclerosis Reports - May 24, 2023 Category: Cardiology Source Type: research

In-Hospital Use of PCSK9 Inhibitors in the Post ACS Patient: What Does the Evidence Show?
AbstractPurpose of reviewThe purpose of this review is to analyze and discuss the most recent data on in hospital prescription of Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) inhibitors in patients with acute coronary syndrome (ACS).Recent findingsRecent randomized clinical trials (RTCs) have demonstrated a beneficial effect of monoclonal antibodies (mAb) PCSK9i prescription in patients with ACS on rapid reduction of low-density lipoprotein cholesterol (LDL-C) and on coronary atherosclerosis assessed by intracoronary imaging. Additionally, the safety profile of mAb PCSK9i was confirmed in all RTCs.SummaryAvailable RCTs...
Source: Current Atherosclerosis Reports - May 24, 2023 Category: Cardiology Source Type: research

Eggs and Cardiovascular Disease Risk: An Update of Recent Evidence
AbstractPurpose of ReviewThis review summarizes recent evidence published since a previous review in 2018 on the association between egg consumption and risk of cardiovascular disease (CVD) mortality, CVD incidence, and CVD risk factors.Recent FindingsNo recent randomized controlled trials were identified. Evidence from observational studies is mixed, with studies reporting either an increased risk or no association of highest egg consumption with CVD mortality, and a similar spread of increased risk, decreased risk, or no association between egg intake and total CVD incidence. Most studies reported a reduced risk or no as...
Source: Current Atherosclerosis Reports - May 23, 2023 Category: Cardiology Source Type: research

Coronary Artery Disease Risk Prediction in Young Adults: How Can We Overcome the Dominant Effect of Age?
AbstractPurpose of ReviewWe review the limitations of current approaches for predicting Coronary Artery Disease (CAD) in young adults and explore the alternative approaches identify high-risk individuals in this population.Recent FindingsAtherosclerosis begins in childhood, and young individuals with genetic predisposition and individuals with early exposure to traditional and non-traditional risk factors have an increased lifetime risk of CAD. However, most risk prediction models have been developed and validated in middle and older age groups and focus on short-term risk. Therefore, alternative approaches are needed in y...
Source: Current Atherosclerosis Reports - May 17, 2023 Category: Cardiology Source Type: research

What Is the Optimal Duration of Antiplatelet Therapy for Patients with Coronary Heart Disease?
AbstractPurpose of ReviewOptimal duration of antiplatelet therapy continues to attract extensive debates and has been progressively adjusted in the setting of advancements in stent design and assessment of patient clinical characteristics. Given the ever-changing landscape of antiplatelet therapy and the multitude of clinical trials that have examined this duration, there are varying scenarios for optimal duration based on patient presentation and risk profile. This review highlights the current concepts and recommendations regarding duration of antiplatelet therapy in coronary heart disease.Recent FindingsIn particular, w...
Source: Current Atherosclerosis Reports - May 13, 2023 Category: Cardiology Source Type: research

Revascularization Options for Left Main Disease: What Clinicians Need to Know
AbstractPurpose of ReviewLeft main disease represents the highest-risk lesion subset of coronary artery disease and is associated with adverse cardiovascular events. Accordingly, we aim to understand how the significance of left main disease is assessed by different modalities, followed by a review of management options in current era.Recent FindingsInvasive coronary angiogram remains the gold standard for assessment of left main disease, but intracoronary imaging or physiological testing is indicated for angiographically equivocal disease. Revascularization by either coronary artery bypass surgery or percutaneous coronary...
Source: Current Atherosclerosis Reports - May 13, 2023 Category: Cardiology Source Type: research

Medical Nutrition Therapy Provided by Dietitians is Effective and Saves Healthcare Costs in the Management of Adults with Dyslipidemia
AbstractPurpose of ReviewReferral to nutrition care providers in the USA such as registered dietitian nutritionists (RDNs) for medical nutrition therapy (MNT) remains low. We summarize research on the effectiveness of MNT provided by dietitians versus usual care in the management of adults with dyslipidemia. Improvements in lipids/lipoproteins were examined. If reported, blood pressure (BP), fasting blood glucose (FBG) glycated hemoglobin (A1c), body mass index (BMI), and cost outcomes were also examined.Recent FindingsThe synthesis of three systematic reviews included thirty randomized controlled trials. Multiple MNT visi...
Source: Current Atherosclerosis Reports - May 11, 2023 Category: Cardiology Source Type: research

The Role of Cardiac PET in Diagnosis and Prognosis of Ischemic Heart Disease: Optimal Modality Across Different Patient Populations
AbstractPurpose of ReviewDespite single-photon emission computerized tomography (SPECT) being the most used nuclear imaging technique for diagnosis of coronary artery disease (CAD), many now consider positron emission tomography (PET) as a superior modality. This review will focus on the advances of cardiac PET in recent years and its advantages compared to SPECT in diagnosis and prognosis of CAD.Recent FindingsPET ’s higher resolution and enhanced diagnostic accuracy, as well as lower radiation exposure, all help explain the rationale for its wider spread and use. PET also allows for measurement of myocardial blood flow...
Source: Current Atherosclerosis Reports - May 10, 2023 Category: Cardiology Source Type: research

Lipoprotein (a): Does It Play a Role in Pediatric Ischemic Stroke and Thrombosis?
AbstractPurpose of ReviewThe goal of this paper is to describe the current understanding of lipoprotein (a) (Lp(a)), clinical practice guidelines, and the potential pathophysiological mechanisms that appear to increase the risk of cardiovascular and thromboembolic events, specifically within the pediatric population.Recent FindingsThe proatherogenic and pro-thrombotic properties of Lp(a) may increase the risk of atherothrombotic disease. In adults, atherosclerotic plaques increase thrombotic risk, but antifibrinolytic and proinflammatory properties appear to have an important role in children. Although it is not well estab...
Source: Current Atherosclerosis Reports - May 9, 2023 Category: Cardiology Source Type: research

Can Surrogate Markers Help Define Cardiovascular Disease in Youth?
AbstractPurpose of ReviewNon-invasive measurements such as arterial stiffness serve as proxy surrogates for detection of early atherosclerosis and ASCVD risk stratification. These surrogate measurements are influenced by age, gender, and ethnicity and affected by the physiological changes of puberty and somatic growth in children and adolescents.Recent FindingsThere is no consensus of the ideal method to measure surrogate markers in youth (<  18 years of age), nor standardized imaging protocols for youth. Currently, pediatric normative data are available but not generalizable.Summary of the ReviewIn this review, we p...
Source: Current Atherosclerosis Reports - May 6, 2023 Category: Cardiology Source Type: research

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American College of Cardiology Conference
AbstractPurpose of ReviewTo summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2023 American College of Cardiology (ACC) conference.Recent findingsThe CLEAR outcomes randomized control trial (RCT) compared bempedoic acid to placebo in patients at high-risk of cardiovascular disease (CVD) or prevalent CVD and statin intolerance for CV outcomes. The YELLOW III was a single-arm study that evaluated the effect of Evolocumab on coronary plaque characteristics in patients with stable coronary artery disease (CAD). A cohort evaluated the association between a self-reported low-carb...
Source: Current Atherosclerosis Reports - April 22, 2023 Category: Cardiology Source Type: research

Genetic Testing for Familial Hypercholesterolemia in Clinical Practice
AbstractPurpose of ReviewGenetic testing has proven utility in identifying and diagnosing individuals with FH. Here we outline the current landscape of genetic testing for FH, recommendations for testing practices and the efforts underway to improve access, availability, and uptake.Recent FindingsAlternatives to the traditional genetic testing and counseling paradigm for FH are being explored including expanding screening programs, testing in primary care and/or cardiology clinics, leveraging electronic communication tools like chatbots, and implementing direct contact approaches to facilitate genetic testing of both proba...
Source: Current Atherosclerosis Reports - April 15, 2023 Category: Cardiology Source Type: research

Combined Dyslipidemia in Children and Adolescents: a Proposed New Management Approach
AbstractPurpose of ReviewCombined dyslipidemia (CD), the predominant abnormal lipid pattern in children and adolescents, is characterized by moderate/severe triglyceride elevation with reduced high-density lipoprotein cholesterol. CD is prevalent, present in 30 –50% of obese adolescents. Epidemiologic and lipid sub-population findings demonstrate CD to be highly atherogenic. In the short term, CD responds well to lifestyle change; long-term results are lacking.Recent FindingsMajor longitudinal studies now confirm that CD in childhood predicts early cardiovascular disease events in adults. Targeted nutritional interventio...
Source: Current Atherosclerosis Reports - April 14, 2023 Category: Cardiology Source Type: research

Advances, Challenges, and Progress in Cardiac Rehabilitation in Chronic CVD Management
AbstractPurpose of ReviewTo review the benefits, challenges, and advances in cardiac rehabilitation (CR) in the management of cardiovascular disease (CVD).Recent FindingsNovel strategies of delivering CR are being studied that use remote technologies to link patients with CR professionals. These strategies used alone or in tandem with center-based, face-to-face strategies appear to have shorter-term effectiveness, but additional work is needed to assess the longer-term impact.SummaryCardiac rehabilitation improves patient outcomes, but only a minority of eligible individuals participate. Solutions exist to help bridge the ...
Source: Current Atherosclerosis Reports - April 11, 2023 Category: Cardiology Source Type: research