Highlights of Cardiovascular Disease Studies Presented at the 2021 European Society of Cardiology Congress
AbstractPurpose of ReviewThis review highlights select studies presented at the virtual 2021 European Society of Cardiology (ESC) Congress.Recent FindingsReviewed studies assess single photon emission computed tomography, positron emission tomography, magnetic resonance imaging in coronary artery disease (PACIFIC-II); empagliflozin in heart failure with preserved ejection fraction (EMPEROR-Preserved); dapagliflozin in chronic heart failure (DAPA-HF); proprotein convertase subtilisin/kexin type 9 inhibitor and its lipid lowering effects (NATURE-PCSK9); fixed-dose combination therapies with or without aspirin in primary prev...
Source: Current Atherosclerosis Reports - October 14, 2021 Category: Cardiology Source Type: research
Gene-Environment Interactions for Cardiovascular Disease
AbstractPurpose of ReviewWe provide an overview of recent findings with respect to gene-environment (GxE) interactions for cardiovascular disease (CVD) risk and discuss future opportunities for advancing the field.Recent Findings.Over the last several years, GxE interactions for CVD have mostly been identified for smoking and coronary artery disease (CAD) or related risk factors. By comparison, there is more limited evidence for GxE interactions between CVD outcomes and other exposures, such as physical activity, air pollution, diet, and sex. The establishment of large consortia and population-based cohorts, in combination...
Source: Current Atherosclerosis Reports - October 14, 2021 Category: Cardiology Source Type: research
Oral Lipid-Lowering Treatments Beyond Statins: Too Old and Outdated or Still Useful?
AbstractPurpose of ReviewFor many years, the lipid-lowering armamentarium consisted of statins and/or ezetimibe and/or bile acid sequestrants and/or fibrates. Now, with the availability of new drugs mostly injectables, the field has changed and the role of oral non-statin drugs (including bempedoic acid) must be reevaluated.Recent FindingsEzetimibe remains a very important combination partner for statins with continuously increasing treatment numbers. Bempedoic acid is another interesting combination partner for statin/ezetimibe or ezetimibe alone but lacks in contrast to ezetimibe evidence from outcome trials. The role of...
Source: Current Atherosclerosis Reports - October 14, 2021 Category: Cardiology Source Type: research
The Role of Coronary Artery Calcium Testing for Value-Based Clinical Trials in Primary Prevention
AbstractPurpose of ReviewReview the role of coronary artery calcium (CAC) testing in designing future clinical trials in primary prevention.Recent FindingsWhile there are numerous new agents that have been found to lower cardiovascular event rates in clinical trials, these studies have required a large sample size, in part due to low event rates as well as improved baseline treatments. More precise risk assessment could allow for better identification of individuals who stand to derive the most benefit from various therapies. Coronary CAC testing offers a simple method for identifying high-risk primary prevention cohorts, ...
Source: Current Atherosclerosis Reports - September 15, 2021 Category: Cardiology Source Type: research
Clinical Management of Hypertriglyceridemia in the Prevention of Cardiovascular Disease and Pancreatitis
AbstractPurpose of ReviewHypertriglyceridemia (HTG) is common and is a significant contributor to atherosclerosis and pancreatitis risk. Specific HTG treatments have had variable success in reducing atherosclerosis risk. Novel therapies for severe HTG treatment and pancreatitis risk reduction are likely to be available soon. These novel therapies are expected to have broader applications for more moderate HTG and atherosclerosis risk reduction as well.Recent FindingsNHANES 2012 data has confirmed a reduction in average triglyceride (TG) levels in the US population. Dietary modification and weight reduction when needed rema...
Source: Current Atherosclerosis Reports - September 13, 2021 Category: Cardiology Source Type: research
Clonal Hematopoiesis of Indeterminate Potential: an Expanding Genetic Cause of Cardiovascular Disease
AbstractPurpose of ReviewClonal hematopoiesis of indeterminate potential (CHIP) is a novel cardiovascular risk factor that develops as aging hematopoietic stem cells (HSCs) acquire somatic mutations which confer a clonal survival advantage in their progeny. These cells confer increased leukemogenic risk but confer a greater absolute risk of cardiovascular disease —which appears to be mediated through altered inflammatory pathways. Here we review the evidence the risk of cardiovascular disease conferred by CHIP. We also review the evidence regarding risk factors associated with CHIP.Recent FindingsThe most recent evidence...
Source: Current Atherosclerosis Reports - September 1, 2021 Category: Cardiology Source Type: research
Implications of the Landmark ISCHEMIA Trial on the Initial Management of High-Risk Patients with Stable Ischemic Heart Disease
AbstractPurpose of the ReviewIn the decades following the advent of percutaneous coronary intervention, the optimal treatment strategy for managing stable ischemic heart disease has remained a topic of debate. The purpose of this review is to discuss current literature that provides insight into preferred treatment strategies for managing stable coronary artery disease.Recent FindingsThe COURAGE trial (2007) compared patients with stable coronary artery disease treated with percutaneous coronary intervention plus optimal medical therapy versus optimal medical therapy alone and found no difference in death from any cause an...
Source: Current Atherosclerosis Reports - September 1, 2021 Category: Cardiology Source Type: research
RNA Silencing in the Management of Dyslipidemias
AbstractPurpose of ReviewRemarkable reductions in cardiovascular morbidity and mortality have been achieved in recent decades through the widespread use of ‘small-molecule’ hypolipidaemic drugs such as statins and ezetimibe. An alternative approach is to perturb the production of proteins through ribonucleic acid (RNA) silencing, leading to long-lasting knock-down of specific biological molecules. This review describes the scientific basis of RNA s ilencing, and critically evaluates the evidence relating to inclisiran, a small interfering RNA against proprotein convertase subtilisin kexin 9 (PCSK9).Recent FindingsPoole...
Source: Current Atherosclerosis Reports - September 1, 2021 Category: Cardiology Source Type: research
Psoriasis and Cardiovascular Disease: Novel Mechanisms and Evolving Therapeutics
AbstractPurpose of ReviewPsoriasis is a chronic inflammatory skin condition that is associated with increased cardiovascular risk compared to those without psoriasis. This review will cover emerging mechanisms of cardiovascular risk, key pathways targeted with biologic therapies, and the current evidence on therapies to modulate this risk in patients with psoriasis.Recent FindingsRecent scientific work has highlighted mechanisms that contribute to this enhanced risk, including the role of vascular endothelial dysfunction, platelet activation, dyslipidemia, and increased cardiometabolic comorbidities. Newer biologic and tar...
Source: Current Atherosclerosis Reports - September 1, 2021 Category: Cardiology Source Type: research
Lipid Phenotypes and DNA Methylation: a Review of the Literature
AbstractPurpose of ReviewEpigenetic modifications via DNA methylation have previously been linked to blood lipid levels, dyslipidemias, and atherosclerosis. The purpose of this review is to discuss current literature on the role of DNA methylation on lipid traits and their associated pathologies.Recent FindingsCandidate gene and epigenome-wide approaches have identified differential methylation of genes associated with lipid traits (particularlyCPT1A,ABCG1,SREBF1), and novel approaches are being implemented to further characterize these relationships. Moreover, studies on environmental factors have shown that methylation v...
Source: Current Atherosclerosis Reports - September 1, 2021 Category: Cardiology Source Type: research
Rare Treatments for Rare Dyslipidemias: New Perspectives in the Treatment of Homozygous Familial Hypercholesterolemia (HoFH) and Familial Chylomicronemia Syndrome (FCS)
AbstractPurpose of ReviewThis review aims to summarize the most recent published literature concerning lomitapide and volanesorsen that are approved for the use in HoFH and FCS patients, respectively. Moreover, it will briefly revise the published evidence on novel, non-approved treatments that are under evaluation for the management of these rare forms of dyslipidemiasRecent FindingsThe definition of rare dyslipidemias identifies a large number of severe disorders of lipid metabolism of genetic origin. Among them were homozygous familial hypercholesterolemia (HoFH) (OMIM #143890) and familial chylomicronemia syndrome (FCS...
Source: Current Atherosclerosis Reports - September 1, 2021 Category: Cardiology Source Type: research
Phytosterols and Cardiovascular Disease
AbstractPurpose of ReviewCoronary heart disease is the leading cause of mortality worldwide. Elevated blood cholesterol levels are not only the major but also the best modifiable cardiovascular risk factor. Lifestyle modifications which include a healthy diet are the cornerstone of lipid-lowering therapy. So-called functional foods supplemented with plant sterols lower blood cholesterol levels by about 10 –15%.Recent FindingsIn the recent revision of the ESC/EAS dyslipidemia guideline 2019, plant sterols are recommended for the first time as an adjunct to lifestyle modification to lower blood cholesterol levels. However,...
Source: Current Atherosclerosis Reports - September 1, 2021 Category: Cardiology Source Type: research
Prevention of Atherosclerotic Cardiovascular Disease in Children with Familial Hypercholesterolemia
AbstractPurpose of ReviewFamilial hypercholesterolemia (FH), a common inherited disorder of LDL-C metabolism that predisposes to premature cardiovascular disease, is underdiagnosed. Despite recommendations for screening all children and initiation of lipid-lowering medication beginning at 8 –10 years of age, adherence to guidelines is low. Most individuals with FH are inadequately treated, especially women and children. The purpose of this review is to discuss current literature and recommendations for the diagnosis and treatment of heterozygous FH (HeFH) in the pediatric population .Recent FindingsTwenty-year outcome d...
Source: Current Atherosclerosis Reports - August 27, 2021 Category: Cardiology Source Type: research
Ambient Air Pollution and Atherosclerosis: Recent Updates
AbstractPurpose of ReviewDuring the past century, exposure to particulate matter (PM) air pollution< 2.5 μm in diameter (PM2.5) has emerged as an all-pervading element of modern-day society. This increased exposure has come at the cost of heightened risk for cardiovascular (CV) morbidity and mortality. Not only can short-term PM2.5 exposure trigger acute CV events in susceptible individuals, but longer-term exposure over years augments CV risk to a greater extent in comparison with short-term exposure. The purpose of this review is to examine the available evidence for how ambient air pollution exposure may precipitate...
Source: Current Atherosclerosis Reports - August 21, 2021 Category: Cardiology Source Type: research
Dietary Influences on Atherosclerotic Cardiovascular Disease Risk
AbstractPurposeof ReviewProfessional organizations recommend various healthy dietary patterns for atherosclerotic vascular disease (ASCVD) prevention. The purpose of this review is to discuss the evidence for the recommended healthy dietary patterns and ASCVD risk reduction, as well as briefly review specific areas of controversy.Recent FindingsThe Mediterranean, Dietary Approach to Stop Hypertension, and plant-based dietary patterns have been associated with lower ASCVD risk in observational studies. The Mediterranean dietary pattern has been demonstrated to reduce ASCVD event risk in a large, randomized, controlled trial...
Source: Current Atherosclerosis Reports - August 18, 2021 Category: Cardiology Source Type: research
