Vascular Access-Related Complications in Women: Temporal Trends, Emerging Data, and the Current State of Interventional Cardiology Practice
AbstractPurpose of ReviewWomen undergoing cardiac catheterization, percutaneous coronary intervention, transcatheter aortic valve replacement, and other structural heart interventions have a significantly higher risk of vascular complications and bleeding than men, leading to significant morbidity and mortality. This review highlights the importance of recognizing female sex as a specific and independent risk factor, and focuses on mechanisms of increased risk and strategies to minimize that risk.Recent Findings and SummarySmaller caliber peripheral vessels, low body weight, variations in platelet reactivity, and inappropr...
Source: Current Atherosclerosis Reports - June 8, 2018 Category: Cardiology Source Type: research

Peripheral Arterial Disease in Women: an Overview of Risk Factor Profile, Clinical Features, and Outcomes
AbstractPurpose of ReviewPeripheral arterial disease (PAD) is the third most common manifestation of cardiovascular disease (CVD), following coronary artery disease (CAD) and stroke. PAD remains underdiagnosed and under-treated in women.Recent FindingsWomen with PAD experience more atypical symptoms and poorer overall health status. The prevalence of PAD in women increases with age, such that more women than men have PAD after the age of 40  years. There is under-representation of PAD patients in clinical trials in general and women in particular. In this article, we address the lack of women participants in PAD trial...
Source: Current Atherosclerosis Reports - June 2, 2018 Category: Cardiology Source Type: research

A Survey on Coronary Atherosclerotic Plaque Tissue Characterization in Intravascular Optical Coherence Tomography
AbstractPurpose of ReviewAtherosclerotic plaque deposition within the coronary vessel wall leads to arterial stenosis and severe catastrophic events over time. Identification of these atherosclerotic plaque components is essential to pre-estimate the risk of cardiovascular disease (CVD) and stratify them as a high or low risk. The characterization and quantification of coronary plaque components are not only vital but also a challenging task which can be possible using high-resolution imaging techniques.Recent FindingAtherosclerotic plaque components such as thin cap fibroatheroma (TCFA), fibrous cap, macrophage infiltrati...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

Mindset and Communication Barriers in the Diffusion of Bariatric Surgery
AbstractPurpose of ReviewCumulating evidence is available to demonstrate the efficacy of bariatric surgery (BS) in achieving weight loss and optimizing comorbidities. However, currently, only a minority of eligible patients approaches bariatric centers. The underuse of BS can no longer be explained by the lack of evidence supporting its beneficial outcomes along with its favorable safety-profile, rather, by the supporting infrastructure, insurance coverage, and mindset of society, including potential patients and allied healthcare professionals. As a framework to approach mindset barriers in the diffusion of BS, we used th...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

Prehospital Prediction of Large Vessel Occlusion in Suspected Stroke Patients
AbstractPurpose of ReviewRecent advances in endovascular thrombectomy have made acute ischemic stroke due to a large vessel occlusion more treatable than ever. Rapid access to treatment remains paramount and multiple large vessel occlusion prediction scales have been created to enhance prehospital identification and triage of these patients. This review summarizes the current state of large vessel occlusion prediction scales, proposes a set of ideal scale features, and discusses the future of these scales and prehospital neurological emergency response systems.Recent FindingsA meta-analysis of the available data concluded ...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

Antioxidants in the Fight Against Atherosclerosis: Is This a Dead End?
AbstractPurpose of ReviewThe purpose of this review is to focus on the outcome of recent antioxidant interventions using synthetic and naturally occurring molecules established as adjuvant strategies to lipid-lowering or anti-inflammatory therapies designed to reduce the risk of cardiovascular disease.Recent FindingsTo date, accumulated evidence regarding oxidation as a pro-atherogenic factor indicates that redox biochemical events involved in atherogenesis are indeed a very attractive target for the management of cardiovascular disease in the clinic. Nevertheless, although evidence indicates that redox reactions are impor...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

Anticoagulation Resumption After Intracerebral Hemorrhage
AbstractPurpose of reviewDecision-making on resuming oral anticoagulant (OAC) after intracerebral hemorrhage (ICH) evokes significant debate among clinicians. Such patients have been excluded from randomized clinical trials. This review article provides a comprehensive summary of the evidence on anticoagulation resumption after ICH.Recent findingsOAC resumption does not increase the risk of recurrent ICH and can also reduce the risk of all-cause mortality. OAC cessation exposes patients to a significantly higher risk of thromboembolism, which could be reduced by resumption. The optimal timing of anticoagulation resumption ...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

Cerebral Autoregulation in Stroke
AbstractPurpose of ReviewCerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication.Recent FindingsExisting data suggest that CA is general...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

Cardiovascular Disease Prevention: Training Opportunities, the Challenges, and Future Directions
AbstractPurposeCardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide, necessitating major efforts in prevention. This review summarizes the currently available training opportunities in CVD prevention for fellows-in-training (FITs) and residents. We also highlight the challenges and future directions for CVD prevention as a field and propose a structure for an inclusive CVD prevention training program.Recent FindingsAt present, there is a lack of centralized training resources for FITs and residents interested in pursuing a career in CVD prevention. Training in CVD prevention is not an acc...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction
AbstractPurpose of ReviewIn this review, we examine one of the ironies of American health care —that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM.Recent FindingsThere is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, a...
Source: Current Atherosclerosis Reports - May 21, 2018 Category: Cardiology Source Type: research

The Present and the Future of Genetic Testing in Familial Hypercholesterolemia: Opportunities and Caveats
AbstractPurpose of ReviewWe summarize recent advances in the understanding of genetic testing in familial hypercholesterolemia (FH), the use of expanded FH next-generation sequencing panels, and directions for future research.Recent FindingsThe uptake of massively parallel sequencing in research and diagnostic laboratories has enabled expanded testing for FH and its phenocopies, with the added advantage that copy number variants can be detected. However, increasing the number of genes tested increases the number of variants detected, which may or may not be pathogenic. Guidelines for assessing variant pathogenicity will as...
Source: Current Atherosclerosis Reports - May 19, 2018 Category: Cardiology Source Type: research

Triad of the Ischemic Cardiovascular Disease in People Living with HIV? Association Between Risk Factors, HIV Infection, and Use of Antiretroviral Therapy
AbstractPurpose of ReviewThis review is focused on cardiovascular risk factors in HIV-infected people.Recent FindingsAntiretroviral therapy (ART) has significantly increased the life expectancy of HIV-infected people. Thus, this population has experienced non-HIV-related diseases, mainly cardiovascular diseases. Thus, in our review, we intend to understand the cardiovascular risk factors that trigger this situation.SummaryWe have demonstrated that both ART and traditional cardiovascular risk factors contribute to the development of cardiovascular disease in HIV-infected people. Thus, it becomes important to stratify the ri...
Source: Current Atherosclerosis Reports - May 18, 2018 Category: Cardiology Source Type: research

Recent Developments in the Role of Coenzyme Q10 for Coronary Heart Disease: a Systematic Review
AbstractPurpose of ReviewThis review examines recent randomized clinical trials evaluating the role of coenzyme Q10 (CoQ10) in the management of coronary heart disease.Recent FindingsCoQ10 is one of the most commonly used dietary supplements in the USA. Due to its antioxidant and anti-inflammatory effects, CoQ10 has been studied extensively for possible use in managing coronary heart disease. One of the most common applications of CoQ10 is to mitigate statin-associated muscle symptoms (SAMS) based on the theory that SAMS are caused by statin depletion of CoQ10 in the muscle. Although previous studies of CoQ10 for SAMS have...
Source: Current Atherosclerosis Reports - May 16, 2018 Category: Cardiology Source Type: research

Implementing a Mediterranean-Style Diet Outside the Mediterranean Region
AbstractPurpose of ReviewPopulations surrounding the Mediterranean basin have traditionally reaped health benefits from a Mediterranean diet (MedDiet), which may benefit Westernized countries plagued by chronic disease. But is it feasible to implement beyond the Mediterranean? To answer this question, we present evidence from randomized controlled trials that achieved high dietary compliance rates with subsequent physical and mental health benefits.Recent FindingsIn the 1960s, the Seven Countries Study identified dietary qualities of Mediterranean populations associated with healthy aging and longevity. The PREDIMED study ...
Source: Current Atherosclerosis Reports - May 4, 2018 Category: Cardiology Source Type: research

Preserving Cardiovascular Health in Young Children: Beginning Healthier by Starting Earlier
AbstractPurpose of ReviewThe goals of this paper are to review current literature regarding maternal-fetal-pediatric diet and nutritional factors related to preserving cardiovascular health in the very young child and the emerging data implicating nutritional influences on neurodevelopmental factors. Questions related to maternal diet and influences of human milk on child ’s growth, neurodevelopment, and risk of developing obesity were addressed.Recent FindingsThe majority of US women in their reproductive years have overweight or obese status thereby increasing the risk of developing obesity in their children. Effor...
Source: Current Atherosclerosis Reports - April 25, 2018 Category: Cardiology Source Type: research

Effects of Different Weight Loss Approaches on CVD Risk
AbstractPurpose of ReviewIn this review, we aimed to answer the question as to whether deliberate weight loss can reduce cardiovascular events or improve cardiovascular risk factors and whether different methods of weight loss can have a differential effect on risk factor improvement.Recent FindingsIt would appear that deliberate weight loss reduces total mortality by 16% in obese people with risk factors including type 2 diabetes. People with type 2 diabetes who lose at least 10% of their initial body weight reduce CVD end points by 21% with dietary weight loss while the effect is greater with the greater weight loss indu...
Source: Current Atherosclerosis Reports - April 25, 2018 Category: Cardiology Source Type: research

Adoption and Design of Emerging Dietary Policies to Improve Cardiometabolic Health in the US
AbstractPurpose of ReviewSuboptimal diet is a leading cause of cardiometabolic disease and economic burdens. Evidence-based dietary policies within 5 domains —food prices, reformulation, marketing, labeling, and government food assistance programs—appear promising at improving cardiometabolic health. Yet, the extent of new dietary policy adoption in the US and key elements crucial to define in designing such policies are not well established. We crea ted an inventory of recent US dietary policy cases aiming to improve cardiometabolic health and assessed the extent of their proposal and adoption at federal, stat...
Source: Current Atherosclerosis Reports - April 14, 2018 Category: Cardiology Source Type: research

Dairy Products, Dairy Fatty Acids, and the Prevention of Cardiometabolic Disease: a Review of Recent Evidence
AbstractPurpose of ReviewTo examine recent literature on dairy products, dairy fatty acids, and cardiometabolic disease. Primary questions of interest include what unique challenges researchers face when investigating dairy products/biomarkers, whether one should consume dairy to reduce disease risk, whether dairy fatty acids may be beneficial for health, and whether one should prefer low- or high-fat dairy products.Recent FindingsDairy composes about 10% of the calories in a typical American diet, about half of that coming from fluid milk, half coming from cheese, and small amounts from yogurt. Most meta-analyses report n...
Source: Current Atherosclerosis Reports - March 21, 2018 Category: Cardiology Source Type: research

Assessing Cardiovascular Disease Risk and Responses to Preventive Therapies in Clinical Practice
AbstractPurpose of ReviewThe aims of this review are to provide perspective on evaluation of relative and absolute cardiovascular disease (CVD) risk reductions for assessing the efficacy of preventive therapies and to summarize methods for evaluation of CVD risk in clinical practice.Recent FindingsMajor CVD risk factors can be used to stratify patients into risk categories. Results from recent trials reinforce the view that benefits of preventive therapies will be greatest in those with the highest absolute risk and in those with the most severe disturbance in the risk factor targeted. In evaluating clinical utility, it is...
Source: Current Atherosclerosis Reports - March 20, 2018 Category: Cardiology Source Type: research

Blood Fatty Acid Profiles: New Biomarkers for Cardiometabolic Disease Risk
AbstractPurpose of ReviewFatty acid (FA) profiles in different blood compartments are reflections of both diet and metabolism, and some FA levels are related to disease risk.Recent FindingsPerhaps the most studied FA —disease relationship is between long-chain omega-3 polyunsaturated fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] and cardiovascular disease (CVD). Despite null results from recent large omega-3 FA supplementation trials, new research continues to support past studies sh owing that blood levels of EPA + DHA are inversely related to risk for total mortality and fat...
Source: Current Atherosclerosis Reports - March 20, 2018 Category: Cardiology Source Type: research

Functional Nitric Oxide Nutrition to Combat Cardiovascular Disease
AbstractPurpose of reviewTo reveal the mechanisms of nitric oxide (NO) production in humans and how lifestyle, drug therapy, and hygienic practices can decrease NO production. Furthermore, to show how functional nitric oxide nutrition can overcome these limitations to restore endogenous NO production and combat cardiovascular disease.Recent findingsResearch over the past decade has revealed that inorganic nitrate and nitrite found naturally in green leafy vegetables and other vegetables such as beets can provide the human body with a source of bioactive nitric oxide. NO is one of the most important molecules produced withi...
Source: Current Atherosclerosis Reports - March 17, 2018 Category: Cardiology Source Type: research

Pleiotropic Anti-atherosclerotic Effects of PCSK9 Inhibitors From Molecular Biology to Clinical Translation
AbstractPurpose of ReviewClinical trials with PCSK9 inhibitors have shown a robust decrease in plasma LDL levels and a significant reduction in the incidence of cardiovascular atherosclerotic events. However, the role of PCSK9 in atherosclerosis is not well investigated and it remains unclear whether PCSK9 inhibition has direct, LDL-independent, anti-atherosclerotic effects. This review outlines the molecular pathways and targets of PCSK9 in atherosclerosis and summarizes the experimental and clinical data supporting the anti-atherosclerotic (pleiotropic) actions of PCSK9 inhibitors.Recent FindingsPCSK9 is expressed by var...
Source: Current Atherosclerosis Reports - March 10, 2018 Category: Cardiology Source Type: research

A Clinical Guide to Combination Lipid-Lowering Therapy
AbstractPurpose of ReviewWe provide an overview of our current understanding of combination lipid-lowering therapies intended for dyslipidemia treatment and cardiovascular disease prevention. First, we analyze recent statin and non-statin combination therapy guidelines and clinical studies since the publication of 2013 American College of Cardiology Cholesterol Guidelines. Second, we examine the clinical utility of non-statin agents alone and in combination in terms of LDL-C lowering and ASCVD risk reduction.Recent FindingsMedical societies, including the American College of Cardiology (ACC), National Lipid Association (NL...
Source: Current Atherosclerosis Reports - March 7, 2018 Category: Cardiology Source Type: research

Evolocumab: Considerations for the Management of Hyperlipidemia
AbstractPurpose of ReviewTo review the efficacy, safety, pharmacology, and pharmacokinetics of evolocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor.Recent FindingsPCSK9 inhibitors are a class of lipid-lowering agents that significantly reduce low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease and hyperlipidemia. Evolocumab is a monoclonal antibody that inhibits PCSK9 and has been evaluated in phase II and III studies as monotherapy, in combination with statins and other lipid-lowering therapies, in patients who are statin intolerant, and in pa...
Source: Current Atherosclerosis Reports - March 6, 2018 Category: Cardiology Source Type: research

Cardiometabolic Effects of Anti-obesity Pharmacotherapy
AbstractPurpose of ReviewWe review recent studies discussing the impact of pharmacologic agents for weight loss on clinical cardiovascular events, as well as cardiometabolic risk factors.Recent FindingsPharmacotherapy with current FDA-approved medications for weight loss can significantly improve known risk factors for the development of cardiovascular disease such as hypertension, hyperlipidemia, insulin resistance, inflammatory biomarkers, and the quantity of visceral fat, as well as non-alcoholic fatty liver disease. However, data regarding the actual reduction in clinical cardiovascular events with the use of weight lo...
Source: Current Atherosclerosis Reports - March 6, 2018 Category: Cardiology Source Type: research

Imaging to Assess Ischemic Heart Disease in Women
AbstractPurpose of ReviewIschemic heart disease is a leading cause of morbidity and mortality for women and men around the world. However, traditional cardiovascular risk factors do not fully capture cardiac risk in women. This review summarizes sex-based differences in the clinical presentation, pathophysiology, and risk assessment of ischemic heart disease. We also examine the use of anatomic and functional imaging modalities in the diagnosis of ischemic heart disease in women.Recent FindingsRecent studies with women subjects have bolstered the predictive value of the coronary artery calcium (CAC) score in predicting ath...
Source: Current Atherosclerosis Reports - March 2, 2018 Category: Cardiology Source Type: research

Weighing the Anti-Ischemic Benefits and Bleeding Risks from Aspirin Therapy: a Rational Approach
AbstractPurpose of ReviewThe role of aspirin in secondary cardiovascular prevention is well understood; however, the role in primary prevention is less clear, and requires careful balancing of potential benefits with risks. Here, we summarize the evidence base on the benefits and risks of aspirin therapy, discuss clinical practice guidelines and decision support tools to assist in initiating aspirin therapy, and highlight ongoing trials that may clarify the role of aspirin in cardiovascular disease prevention.Recent FindingsIn 2016, the USPSTF released guidelines on the use of aspirin for primary prevention. Based on 11 tr...
Source: Current Atherosclerosis Reports - February 21, 2018 Category: Cardiology Source Type: research

Fasting or Non-fasting Lipids for Atherosclerotic Cardiovascular Disease Risk Assessment and Treatment?
AbstractPurpose of ReviewDyslipidemia is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD); however, lipid testing for risk assessment and treatment surveillance has been underutilized. Several factors likely account for this, including the common practice of measuring lipid levels in the fasting state, which often necessitates that patients return for an additional visit. In this review, we evaluate potential advantages and cautions associated with measuring lipids in the non-fasting state.Recent FindingsThere is similar performance with the use of either fasting or non-fasting total choles...
Source: Current Atherosclerosis Reports - February 17, 2018 Category: Cardiology Source Type: research

The Interplay of Lipids, Lipoproteins, and Immunity in Atherosclerosis
AbstractPurpose of ReviewAtherosclerosis is an inflammatory disorder of the arterial wall, in which several players contribute to the onset and progression of the disease. Besides the well-established role of lipids, specifically cholesterol, and immune cell activation, new insights on the molecular mechanisms underlying the atherogenic process have emerged.Recent FindingsMeta-inflammation, a condition of low-grade immune response caused by metabolic dysregulation, immunological memory of innate immune cells (referred to as “trained immunity”), cholesterol homeostasis in dendritic cells, and immunometabolism, i...
Source: Current Atherosclerosis Reports - February 14, 2018 Category: Cardiology Source Type: research

Gender Differences in Epidemiology, Pathophysiology, and Treatment of Hypertension
AbstractPurpose of ReviewThis review aims to examine gender differences in both the epidemiology and pathophysiology of hypertension and to explore gender peculiarities on the effects of antihypertensive agents in decreasing BP and CV events.Recent FindingsMen and women differ in prevalence, awareness, and control rate of hypertension in an age-dependent manner. Studies suggest that sex hormones changes play a pivotal role in the pathophysiology of hypertension in postmenopausal women. Estrogens influence the vascular system inducing vasodilatation, inhibiting vascular remodeling processes, and modulating the renin-angiote...
Source: Current Atherosclerosis Reports - February 14, 2018 Category: Cardiology Source Type: research

Diagnostic Error in Stroke —Reasons and Proposed Solutions
AbstractPurpose of ReviewWe discuss the frequency of stroke misdiagnosis and identify subgroups of stroke at high risk for specific diagnostic errors. In addition, we review common reasons for misdiagnosis and propose solutions to decrease error.Recent FindingsAccording to a recent report by the National Academy of Medicine, most people in the USA are likely to experience a diagnostic error during their lifetimes. Nearly half of such errors result in serious disability and death. Stroke misdiagnosis is a major health care concern, with initial misdiagnosis estimated to occur in 9% of all stroke patients in the emergency se...
Source: Current Atherosclerosis Reports - February 13, 2018 Category: Cardiology Source Type: research

Chemotherapeutic Agents and the Risk of Ischemia and Arterial Thrombosis
AbstractPurpose of ReviewNumerous chemotherapeutic agents have been associated with the development of ischemia and arterial thrombosis. As newer therapies have been developed to treat cancer, some of these chemotherapy drugs have been implicated in the development of vascular disease. In this review, we will summarize the most common chemotherapeutic drug classes that may play a role in the development of ischemic heart disease.Recent FindingsAngiogenesis inhibitors, alkylating agents, antimetabolites, antimicrotubules, and proteasome inhibitors have a number of cardiovascular toxicities. The possible mechanisms of action...
Source: Current Atherosclerosis Reports - February 8, 2018 Category: Cardiology Source Type: research

Human Immunodeficiency Virus Infection, Antiretroviral Therapy, and Statin: a Clinical Update
AbstractPurpose of ReviewThis clinical update is intended to focus in relationship between HIV infection and use of antiretroviral therapy (ART) and statin.Recent FindingsThough ART significantly changed the course of HIV infection, it is related to numerous side effects principally to the lipid profile. In this way, statins became one of the most used lipid-lowering therapies in this population. In our clinical update, we evaluated studies that demonstrate the relationship and molecular mechanisms that HIV infection and ART use trigger dyslipidemia and also the use of statin to reduce this condition.SummaryWe have demonst...
Source: Current Atherosclerosis Reports - February 8, 2018 Category: Cardiology Source Type: research

Nutrition and Cardiovascular Disease —an Update
AbstractPurpose of ReviewThis review summarizes recent developments in nutrition and cardiovascular disease (CVD) prevention.Recent FindingsContemporary dietary guidance recommends healthy dietary patterns with emphasis on food-based recommendations because the totality of the diet (i.e., the combinations and quantities of foods and nutrients consumed) is an important determinant of health. In many guidelines, recommendations are still made for saturated fat, added sugar, sodium, and dietary cholesterol because these are over-consumed by many people and are related to chronic disease development. Epidemiological research i...
Source: Current Atherosclerosis Reports - January 30, 2018 Category: Cardiology Source Type: research

Microvascular Coronary Dysfunction —an Overview
AbstractPurpose of ReviewWe will review the available data on the epidemiology, pathophysiology, diagnosis, and management of microvascular coronary dysfunction (MCD).Recent FindingsThe study of MCD was pioneered by the Women ’s Ischemia Syndrome Evaluation (WISE) cohort. New techniques in the diagnosis of this condition, using invasive and noninvasive means, are helping to increase awareness of this condition as well as ways in which to treat it.SummaryMicrovascular coronary disease without epicardial involvement has become an increasingly recognized cause of cardiac chest pain, particularly in women. Dysfunction of...
Source: Current Atherosclerosis Reports - January 30, 2018 Category: Cardiology Source Type: research

Premature Coronary Heart Disease in South Asians: Burden and Determinants
AbstractPurpose of ReviewWhile the burden of cardiovascular disease (CVD) is on the decline globally, it is on the rise among South Asians. South Asians are also believed to present early with coronary artery disease (CAD) compared with other ethnicities.Recent FindingsSouth Asians have demonstrated a higher burden of premature CAD (PCAD) compared with other ethnicities. These findings are not limited to non-immigrant South Asians but have also been found in immigrant South Asians settled around the world. In this article, we first discuss studies evaluating PCAD among South Asians residing in South Asia and among South As...
Source: Current Atherosclerosis Reports - January 27, 2018 Category: Cardiology Source Type: research

Recent Approaches to Improve Medication Adherence in Patients with Coronary Heart Disease: Progress Towards a Learning Healthcare System
AbstractPurpose of ReviewNon-adherence to medications for the secondary prevention of myocardial infarction (MI) is a major contributor to morbidity and mortality in these patients. This review describes recent advances in promoting adherence to therapies for coronary artery disease (CAD).Recent FindingsTwo large randomized controlled trials to “incentivize” adherence were somewhat disappointing; neither financial incentives nor “peer pressure” successfully increased rates of adherence in the post-MI population. Patient education and provider engagement appear to be critical aspects of improving adh...
Source: Current Atherosclerosis Reports - January 24, 2018 Category: Cardiology Source Type: research

Concomitant Use of Antiplatelets and Anticoagulants in Patients with Coronary Heart Disease and Atrial Fibrillation: What Do Recent Clinical Trials Teach Us?
AbstractPurpose of ReviewCoronary heart disease (CHD) and atrial fibrillation (AF) are among the most common cardiovascular diseases. A significant proportion of patients have both CHD and AF and are at increased risk for thrombotic complications. Current therapy for CHD and AF includes antiplatelet and anticoagulant medications, respectively. Patients with concurrent CHD and AF may be prescribed dual antiplatelet therapy (DAPT) in addition to anticoagulation, which increases their bleeding risk. Controversy remains on how to balance risks and benefits in patients with CHD and AF in which multiple antithrombotic therapies ...
Source: Current Atherosclerosis Reports - January 19, 2018 Category: Cardiology Source Type: research

The Current State of Left Main Percutaneous Coronary Intervention
AbstractPurpose of ReviewWhile coronary artery bypass grafting (CABG) remains the standard of care, advances in stenting technology and procedural technique are changing the role of percutaneous coronary intervention (PCI) in the treatment of severe left main coronary artery (LMCA) disease. We review contemporary evidence comparing PCI and CABG for the treatment of severe LMCA disease, discuss optimal techniques during left main PCI, and provide guidance on studied revascularization strategies within specific patient subgroups.Recent FindingsResults from randomized control trials of patients treated with PCI or CABG for se...
Source: Current Atherosclerosis Reports - January 17, 2018 Category: Cardiology Source Type: research

What We Have Learned from the Recent Meta-analyses on Diagnostic Methods for Atherosclerotic Plaque Regression
AbstractPurpose of ReviewAtherosclerosis has major morbidity and mortality implications globally. While it has often been considered an irreversible degenerative process, recent evidence provides compelling proof that atherosclerosis can be reversed. Plaque regression is however difficult to appraise and quantify, with competing diagnostic methods available. Given the potential of evidence synthesis to provide clinical guidance, we aimed to review recent meta-analyses on diagnostic methods for atherosclerotic plaque regression.Recent FindingsWe identified 8 meta-analyses published between 2015 and 2017, including 79 studie...
Source: Current Atherosclerosis Reports - January 17, 2018 Category: Cardiology Source Type: research

Cardiorespiratory Fitness and Cardiovascular Disease Prevention: an Update
AbstractPurpose of ReviewCardiovascular diseases account for nearly one third of all deaths globally. Improving exercise capacity and cardiorespiratory fitness (CRF) has been an important target to reduce cardiovascular events. In addition, the American Heart Association defined decreased physical activity as the fourth risk factor for coronary artery disease. Multiple large cohort studies have evaluated the impact of CRF on outcomes. In this review, we will discuss the role of CRF in reducing cardiovascular morbidity and mortality.Recent FindingsRecent data suggest that CRF has an important role in reducing not only cardi...
Source: Current Atherosclerosis Reports - January 16, 2018 Category: Cardiology Source Type: research

Organic Ion Transporters and Statin Drug Interactions
AbstractPurpose of ReviewStatin drug-drug interactions (DDIs) are both troublesome to patients as well as costly to medical resources. The ability to predict and avoid these events could lead to improved outcomes as well as patient satisfaction. This review will explore efforts to better understand and predict these interactions specifically related to one drug transport system, the organic anion-transporting polypeptides (OATPs) specifically OATP1B1 and OATP1B3.Recent FindingsSince the publication of the discovery of OATPs, there have been various pharmacokinetic models that have been proposed to explain the variation in ...
Source: Current Atherosclerosis Reports - November 25, 2017 Category: Cardiology Source Type: research

Community Interventions to Increase Stroke Preparedness and Acute Stroke Treatment Rates
AbstractPurpose of ReviewAcute stroke treatments reduce the risk of post-stroke disability. These treatments, tissue plasminogen activator (tPA) and intra-arterial treatment, are highly time-dependent; thus, one of the main barriers to treatment is pre-hospital delay. Stroke preparedness is defined as the ability to recognize stroke symptoms and the intent to activate emergency medical services (EMS). This review describes types of acute stroke treatment and preparedness interventions, including recent mass media interventions to increase acute stroke treatment rates, and adult and youth community interventions to increase...
Source: Current Atherosclerosis Reports - November 16, 2017 Category: Cardiology Source Type: research

Glycocalyx in Atherosclerosis-Relevant Endothelium Function and as a Therapeutic Target
AbstractPurpose of ReviewThe cell surface-attached extracellular glycocalyx (GCX) layer is a major contributor to endothelial cell (EC) function and EC-dependent vascular health and is a first line of defense against vascular diseases including atherosclerosis. Here, we highlight our findings regarding three GCX-dependent EC functions, which are altered when GCX is shed and in atherosclerosis. We discuss why the GCX is a viable option for the prevention and treatment of atherosclerosis.Recent FindingsGCX regulated EC activities such as barrier and filtration function, active cell-to-cell communication, and vascular tone me...
Source: Current Atherosclerosis Reports - November 10, 2017 Category: Cardiology Source Type: research

ApoCIII as a Cardiovascular Risk Factor and Modulation by the Novel Lipid-Lowering Agent Volanesorsen
AbstractPurpose of ReviewApolipoprotein CIII (ApoCIII) is now recognized as a key regulator in severe hypertriglyceridemia, chylomicronemia, and conditions of triglyceride-rich lipoprotein (TRL) remnant excess due to its inhibition of lipoprotein lipase (LPL) and hepatic lipase, leading to decreased hepatic reuptake of TRLs, as well as enhanced synthesis and secretion of VLDL from the liver. ApoCIII gain-of-function mutations are associated with atherosclerosis and coronary heart disease (CHD), and contribute to the development of cardiometabolic syndrome, hypertriglyceridemia, and type 2 diabetes mellitus. Conversely, los...
Source: Current Atherosclerosis Reports - November 9, 2017 Category: Cardiology Source Type: research

Implementing Evidence-Based Practices for Acute Stroke Care in Low- and Middle-Income Countries
AbstractPurpose of ReviewMost strokes occur in low- and middle-income countries where resources to manage patients are limited. We explore the resources required to providing optimal acute stroke care and review barriers to implementing evidence-based stroke care in settings with limited resources using the World Stroke Organization ’s Global Stroke Services Action Plan framework.Recent FindingsMajor advances have been made during the past few decades in stroke prevention, treatment, and rehabilitation. These advances have been translated into practice in many high-income countries, but their uptake remains suboptima...
Source: Current Atherosclerosis Reports - November 8, 2017 Category: Cardiology Source Type: research

Early Rehabilitation After Stroke: a Narrative Review
AbstractPurpose of ReviewDespite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain ’s dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits .Recent FindingsOverall, trials of rehabilitation in the first 2  weeks after stroke are scarce. In the re...
Source: Current Atherosclerosis Reports - November 7, 2017 Category: Cardiology Source Type: research

Review of Cardiometabolic Effects of Prescription Omega-3 Fatty Acids
AbstractPurpose of ReviewPopulations with significant dietary fish intake tend to have lower cardiovascular (CV) risk and demonstrable physiologic differences including lower lipid/lipoprotein levels and other direct and indirect effects on the arterial wall and inhibiting factors that promote atherosclerosis. Treatment with high doses of pharmacologic-grade omega-3 fatty acid (n-3FA) supplements achieves significant reductions in triglycerides (TG), non-high-density lipoprotein- (non-HDL-) and TG-rich lipoprotein- (TRL-) cholesterol levels.n-3FA supplements have significant effects on markers of atherosclerosis risk inclu...
Source: Current Atherosclerosis Reports - November 7, 2017 Category: Cardiology Source Type: research

Cardiovascular Risk Factors After Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S): a New Effective Therapeutic Approach?
AbstractObesity and its associated comorbidities entail a significantly increased cardiovascular mortality. Therefore, approaching obesity control must include among its aims the reduction of the associated comorbidities and the higher cardiovascular mortality risk and not only weight loss. Many observational studies indicate that bariatric surgery (BS) is associated with a better long-term survival than standard care. Furthermore, in general, these epidemiological studies included patients who underwent gastric bypass (GB), not biliopancreatic diversion/duodenal switch (BPD/DS), so the potential additional benefit of this...
Source: Current Atherosclerosis Reports - November 7, 2017 Category: Cardiology Source Type: research

Atherosclerosis, Periodontal Disease, and Treatment with Resolvins
AbstractPurpose of ReviewThis review aims to discuss the existing evidence on the link between atherosclerosis and periodontitis by particularly presenting new findings that link the pathology and therapy of these diseases. Acute vascular ischemic events that can lead to stroke or myocardial infarction are initiated by inflammatory processes leading to rupture or erosion of plaques susceptible to thrombosis ( “high risk” or “vulnerable”). These are highly inflamed plaques residing in the media and adventitia that may not be detected by angiography measurments of luminal narrowing. Statistically sign...
Source: Current Atherosclerosis Reports - November 6, 2017 Category: Cardiology Source Type: research