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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

Antiplatelet Therapy for Secondary Prevention of Vascular Disease Complications
AbstractPurpose of ReviewPlatelets are activated upon interaction with injured vascular endothelium to form a primary hemostatic plug. Pathogenic thrombosis driven by platelet aggregation can occur in the setting of vascular disease leading to ischemic events. The use of antiplatelet agents has become a mainstay for prevention of the secondary complications of vascular disease. This review summarizes seminal and recent literature related to this area.Recent FindingsAspirin is a cornerstone of antiplatelet therapy for coronary artery disease and cerebrovascular disease for prevention of myocardial infarction, stroke, and va...
Source: Current Atherosclerosis Reports - November 4, 2017 Category: Cardiology Source Type: research

Novel Approaches for HDL-Directed Therapies
AbstractPurpose of ReviewHigh-density lipoproteins (HDL) are thought to exert a protective role against atherosclerosis. The measurement of the cholesterol mass within HDL (HDL-C) represents a good biomarker of cardiovascular health, but HDL-C appears to be a poor therapeutic target. Here, we discuss new targets for the development of HDL-directed therapies.Recent FindingsAmong cardio-protective functions of HDL particles, the ability of HDL to remove cholesterol from cells involved in the early stages of atherosclerosis is considered one of the most important functions. This process, termed “HDL biogenesis,” i...
Source: Current Atherosclerosis Reports - November 4, 2017 Category: Cardiology Source Type: research

The Emergence of “Simpler” Surgical Options to Treat Obesity and Metabolic Syndrome
(Source: Current Atherosclerosis Reports)
Source: Current Atherosclerosis Reports - November 2, 2017 Category: Cardiology Source Type: research

Emerging Associations Between Neutrophils, Atherosclerosis, and Psoriasis
AbstractPurpose of ReviewAtherogenesis, once thought to be a passive process, is now recognized as a dynamic, immune-driven process. The critical innate immune cells, including neutrophils, normal-density granulocytes, and their newly identified subset low-density granulocytes, are moving to the forefront of interest in cardiovascular medicine due to their abundance in atherosclerotic plaques and chronic inflammatory diseases associating with early cardiovascular disease (CVD) such as psoriasis. In this review, we discuss the emerging roles of neutrophils in CVD and how they play a potential role in early CVD observed in p...
Source: Current Atherosclerosis Reports - October 30, 2017 Category: Cardiology Source Type: research

Is Mini-Gastric Bypass a Rational Approach for Type-2 Diabetes?
AbstractPurpose of ReviewMorbid obesity and type-2 diabetes mellitus (T2DM) are both major public health problems. Bariatric surgery is a proven and effective treatment for these conditions; laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the gold-standard treatment. One-anastomosis gastric bypass (OAGB) is described as a simpler, safer, and non-inferior alternative to RYGB to treat morbid obesity. Concerning T2DM, experts of the OAGB procedure report promising metabolic results with good long-term remission of T2DM; however, heterogeneity within the literature prompted us to analyze this issue.Recent FindingsOAG...
Source: Current Atherosclerosis Reports - October 24, 2017 Category: Cardiology Source Type: research

Improving Regional Stroke Systems of Care
AbstractPurpose of ReviewAcute ischemic stroke (AIS) care is rapidly evolving. This review discusses current diagnostic, therapeutic, and process models that can expedite stroke treatment to achieve best outcomes.Recent FindingsUse of stent retrievers after selection via advanced imaging is safe and effective, and is an important option for AIS patients with large vessel occlusion (LVO). Significant time delays occur before and during patient transfers, and upon comprehensive stroke center (CSC) arrival, and have deleterious effects on functional outcome. Removing obstacles, enhancing inter-facility communication, and crea...
Source: Current Atherosclerosis Reports - October 24, 2017 Category: Cardiology Source Type: research

Delayed Cerebral Ischemia after Subarachnoid Hemorrhage: Beyond Vasospasm and Towards a Multifactorial Pathophysiology
AbstractPurpose of ReviewDelayed cerebral ischemia (DCI) is common after subarachnoid hemorrhage (SAH) and represents a significant cause of poor functional outcome. DCI was mainly thought to be caused by cerebral vasospasm; however, recent clinical trials have been unable to confirm this hypothesis. Studies in humans and animal models have since supported the notion of a multifactorial pathophysiology of DCI. This review summarizes some of the main mechanisms under investigation including cerebral vascular dysregulation, microthrombosis, cortical spreading depolarizations, and neuroinflammation.Recent FindingsRecent guide...
Source: Current Atherosclerosis Reports - October 23, 2017 Category: Cardiology Source Type: research

The Use of Primary Prevention Statin Therapy in Those Predisposed to Atherosclerosis
AbstractPurpose of ReviewMany guidelines exist for the use of statins in the primary prevention of atherosclerotic cardiovascular disease (ASCVD). Few have focused on disease specific states that predispose to ASCVD. This review is intended to focus on the recommendations and evidence in inflammatory diseases that predispose to an increased risk of ASCVD beyond what conventional cardiac risk scores would predict.Recent FindingsCertain autoimmune inflammatory diseases such as rheumatoid arthritis (RA), systemic lupus erythematous (SLE), and psoriasis/psoriatic arthritis have all been shown to increase the risk of ASCVD. Oth...
Source: Current Atherosclerosis Reports - October 17, 2017 Category: Cardiology Source Type: research

PCSK9 Mutations in Familial Hypercholesterolemia: from a Groundbreaking Discovery to Anti-PCSK9 Therapies
AbstractPurpose of ReviewIn 2003, Abifadel et al. (Nat. Genet. 34:154 –156, 2003) identifiedPCSK9, encoding proprotein convertase subtilisin/kexin type 9, as the third causal gene for autosomal dominant hypercholesterolemia. This review focuses on the main steps from this major breakthrough in familial hypercholesterolemia (FH) to the latest clinical trials with the anti-PCSK9 antibodies.Recent FindingsThe year 2015 was remarkable in cardiovascular disease through the field of cholesterol. Nearly 30  years after the discovery of statins, a new class of effective lipid-lowering drugs has emerged: the anti-PCSK9 a...
Source: Current Atherosclerosis Reports - October 17, 2017 Category: Cardiology Source Type: research

Statin Prescribing in the Elderly: Special Considerations
AbstractPurpose of ReviewOur aim was to examine the current evidence behind prescribing statins to individuals over 65  years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstr ate the benefit of statin therapy in both primary and secondary prevention patients, clinicians must more carefully consider adverse effects and drug–drug interactions before prescribing statin th...
Source: Current Atherosclerosis Reports - October 11, 2017 Category: Cardiology Source Type: research

Clinical Guidance for Managing Statin and Antimicrobial Drug-Drug Interactions
AbstractPurpose of ReviewThis review discusses potential drug-drug interactions between statins and antimicrobials and provides clinician ’s guidance on how to manage these interactions.Recent FindingsIn addition to statin utilization increasing in recent years, there is greater emphasis on using moderate to high-intensity statin doses. Statin-related adverse effects are often dose-dependent; therefore, patients may be at increased risk. Antimicrobial use has also increased in recent years, and various efforts have been implemented to ensure appropriate use of antimicrobials. Commonly used antimicrobials, such as mac...
Source: Current Atherosclerosis Reports - October 9, 2017 Category: Cardiology Source Type: research

The Role of Metabolic Surgery in Non-alcoholic Steatohepatitis Improvement
AbstractPurpose of reviewNon-alcoholic fatty liver disease (NAFLD) is frequently associated with obesity and overweight. It has a broad spectrum of clinical and histological presentations, such as steatosis, inflammation (known as non-alcoholic steatohepatitis or NASH), fibrosis, and cirrhosis. There is increasing evidence that marked weight loss following bariatric surgery is associated with NASH resolution; however, little is known about the mechanisms that may lead to this beneficial condition and if it is due to weight loss alone. In this review, the authors present the latest data regarding NASH resolution following m...
Source: Current Atherosclerosis Reports - October 7, 2017 Category: Cardiology Source Type: research

The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review
This article reviewed very recent papers (2016) discussing or bringing clinical evidences of the possible common pathways leading to diabetic foot syndrome (DFS) and increased mortality rates.Recent FindingsDiabetic patients with diabetic foot syndrome have a mortality rate greater than twofold when compared with non-ulcerated diabetics. In addition, the 5-year mortality rate following amputation is estimated at 39 –68%, a life expectancy comparable to aggressive types of cancer or advanced congestive heart failure. The majority of patients with diabetic foot ulcer also present insulin resistance, central obesity, dy...
Source: Current Atherosclerosis Reports - October 2, 2017 Category: Cardiology Source Type: research

Pharmacogenetics of Lipid-Lowering Agents: an Update Review on Genotype-Dependent Effects of HDL-Targetingand Statin Therapies
AbstractPurpose of ReviewHigh-density lipoproteins (HDL) are involved in reverse cholesterol transport. Results from randomized trials of HDL-targeting therapies, including cholesteryl ester transfer protein (CETP) inhibitors, have shown a lack of benefit in unsegmented populations. These observations could be explained by inter-individual variability of clinical responses to such agents depending on the patients ’ genotypes. In parallel, although lowering of LDL cholesterol (LDL-c) with statin therapy reduces the risk of vascular events in a wide range of individuals, inter-individual variability exists with regard ...
Source: Current Atherosclerosis Reports - September 25, 2017 Category: Cardiology Source Type: research

Oxidative Stress in Atherosclerosis
AbstractPurpose of ReviewAtherosclerosis is now considered a chronic inflammatory disease. Oxidative stress induced by generation of excess reactive oxygen species has emerged as a critical, final common mechanism in atherosclerosis. Reactive oxygen species (ROS) are a group of small reactive molecules that play critical roles in the regulation of various cell functions and biological processes. Although essential for vascular homeostasis, uncontrolled production of ROS is implicated in vascular injury. Endogenous anti-oxidants function as checkpoints to avoid these untoward consequences of ROS, and an imbalance in the oxi...
Source: Current Atherosclerosis Reports - September 18, 2017 Category: Cardiology Source Type: research

Internal Carotid Artery Occlusion: Pathophysiology, Diagnosis, and Management
AbstractPurpose of ReviewAcute internal carotid artery occlusion (ICAO) is associated with large infarcts and poor clinical outcomes and contributes to morbidity and mortality worldwide. In this review, we discuss various etiologies and pathophysiology of clinical presentations of ICAO, different radiographic patterns, and management of patients with ICAO.Recent FindingsRecanalization rates remain suboptimal with systemic thrombolysis amongst patients with acute ICAO. Recent success of endovascular therapy for vessel occlusion in anterior circulation has expanded the horizons; however, few patients with cervical dissection...
Source: Current Atherosclerosis Reports - August 31, 2017 Category: Cardiology Source Type: research

The Effect of Metabolic and Bariatric Surgery on DNA Methylation Patterns
AbstractPurpose of ReviewMetabolic and bariatric surgery (MBS) is considered to be the most effective treatment for obesity. Not only due to the significant weight reduction but also because of the many health benefits associated with it. In the last 5  years, several studies have suggested that epigenetic modifications could be involved in the mechanisms underlying the response to bariatric surgery. In this review, we will compile the different studies (2012–2017) concerning the effect of this surgical procedure on DNA methylation patterns (th e most studied epigenetic marker) and its association with metabolic...
Source: Current Atherosclerosis Reports - August 30, 2017 Category: Cardiology Source Type: research

Gut Microbiota and Atherosclerosis
AbstractPurpose of ReviewStudies in microbiota-mediated health risks have gained traction in recent years since the compilation of the Human Microbiome Project. No longer do we believe that our gut microbiota is an inert set of microorganisms that reside in the body without consequence. In this review, we discuss the recent findings which further our understanding of the connection between the gut microbiota and the atherosclerosis.Recent FindingsWe evaluate studies which illustrate the current understanding of the relationship between infection, immunity, altered metabolism, and bacterial products such as immune activator...
Source: Current Atherosclerosis Reports - August 25, 2017 Category: Cardiology Source Type: research

Coronary Artery Plaque Imaging
AbstractPurpose of ReviewThis short review summarizes the recent development in clinical and experimental imaging techniques for coronary atherosclerosis.Recent FindingsCoronary atherosclerosis is the underlying disease of myocardial infarction, the leading cause of death in the industrialized world. Conventional ways of risk assessment, including evaluation of traditional risk factors and interrogation of luminal stenosis, have proven imprecise for the prediction of major events. Rapid advances in noninvasive imaging techniques including MRI, CT, and PET, as well as catheter-based methods, have opened the doors to more in...
Source: Current Atherosclerosis Reports - August 4, 2017 Category: Cardiology Source Type: research

Do Food Preferences Change After Bariatric Surgery?
AbstractPurpose of ReviewInsights into physiological mechanisms responsible for weight loss after bariatric surgery (BS) have challenged the traditional view that mechanical restriction and caloric malabsorption are major drivers of weight loss and health benefits after BS. Altered diet selection with an increased postoperative preference for low-sugar and low-fat food has also been implicated as a potential mechanism beyond mere reduction of calorie intake. However, the empirical support for this phenomenon is not uniform and evidence is largely based on indirect measurements, such as self-reported food intake data, which...
Source: Current Atherosclerosis Reports - August 4, 2017 Category: Cardiology Source Type: research

Connecting the Dots Between Fatty Acids, Mitochondrial Function, and DNA Methylation in Atherosclerosis
AbstractPurpose of ReviewThe quest for factors and mechanisms responsible for aberrant DNA methylation in human disease —including atherosclerosis—is a promising area of research. This review focuses on the role of fatty acids (FAs) as modulators of DNA methylation—in particular the role of mitochondrial beta-oxidation in FA-induced changes in DNA methylation during the progression of atherosclerosis.Recent FindingsRecent publications have advanced the knowledge in all areas touched by this review: the causal role of lipids in shaping the DNA methylome, the associations between chronic degenerative diseas...
Source: Current Atherosclerosis Reports - July 22, 2017 Category: Cardiology Source Type: research

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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