Genetics of Lipoprotein(a): Cardiovascular Disease and Future Therapy
AbstractPurpose of ReviewLipoprotein(a) levels are determined 80 –90% by genetics and differ by up to 1000-fold between individuals. This review discusses the most recent literature on lipoprotein(a) as a risk factor for cardiovascular disease, as well as future lipoprotein(a)lowering therapies.Recent FindingsOver the past few decades, numerous studies have observed that high lipoprotein(a) levels are associated observationally and causally through human genetics with increased risk of cardiovascular disease. Also, the development of safe and effective therapies to lower lipoprotein(a) is ongoing, most importantly using ...
Source: Current Atherosclerosis Reports - June 20, 2021 Category: Cardiology Source Type: research
Special Considerations for Lipid-Lowering Therapy in Women Reflecting Recent Randomized Trials
AbstractPurpose of ReviewAtherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in women across all racial and ethnic groups within the USA. Despite robust evidence from randomized controlled trials demonstrating that treatment of hypercholesterolemia in women reduces cardiovascular events, women who are eligible for lipid-lowering therapy are less likely than men to be prescribed guideline-recommended therapy or to have therapy prescribed at the appropriate intensity.Recent FindingsHistorically, women have been underrepresented in clinical trials. Recent randomized clinical trials have shown that...
Source: Current Atherosclerosis Reports - June 19, 2021 Category: Cardiology Source Type: research
Hypertension in Women Across the Lifespan
AbstractPurpose of ReviewWe will highlight the biological processes across a women ’s lifespan from young adulthood through menopause and beyond that impact blood pressure and summarize women’s representation in hypertension clinical trials.Recent FindingsThroughout their lifetime, women potentially undergo several unique sex-specific changes that may impact their risk of developing hypertension. Blood pressure diagnostic criteria for pregnant women remains 140/90 mmHg and has not been updated for concordance with the 2017 ACC/AHA guideline due to a lack of data. Although on a population level, women develop hypertensi...
Source: Current Atherosclerosis Reports - June 19, 2021 Category: Cardiology Source Type: research
The Genetic Basis of Hypertriglyceridemia
AbstractPurpose of ReviewHypertriglyceridemia is a common dyslipidemia associated with an increased risk of cardiovascular disease and pancreatitis. Severe hypertriglyceridemia may sometimes be a monogenic condition. However, in the vast majority of patients, hypertriglyceridemia is due to the cumulative effect of multiple genetic risk variants along with lifestyle factors, medications, and disease conditions that elevate triglyceride levels. In this review, we will summarize recent progress in the understanding of the genetic basis of hypertriglyceridemia.Recent FindingsMore than 300 genetic loci have been identified for ...
Source: Current Atherosclerosis Reports - June 19, 2021 Category: Cardiology Source Type: research
Is There a Role of Coronary CTA in Primary Prevention? Current State and Future Directions
AbstractPurpose of ReviewInformation on subclinical atherosclerosis burden provides prognostic information on atherosclerotic cardiovascular disease (ASCVD) risk beyond what can be achieved by traditional risk factors alone and may therefore improve allocation of preventive treatment in primary prevention. The purpose of this review is to discuss the potential role and value of assessing subclinical atherosclerosis using coronary artery calcium (CAC) versus computed tomography angiography (CTA) among asymptomatic patients in the context of current primary prevention cholesterol guidelines.Recent FindingsSince 2013, primary...
Source: Current Atherosclerosis Reports - June 19, 2021 Category: Cardiology Source Type: research
The Role of RNA-Targeted Therapeutics to Reduce ASCVD Risk: What Have We Learned Recently?
AbstractPurpose of ReviewTo discuss advances on the RNA-targeted therapies to treat dyslipidemia with the aim of reducing atherosclerotic cardiovascular disease (ASCVD).Recent FindingsGenetic studies have paved the way for therapies that reduce translation of proteins that play causal roles in dyslipidemia and atherosclerosis like proprotein convertase subtilisin/kexin type 9 (PCSK9), apolipoprotein B-100 (apoB), apolipoprotein(a) [apo(a)], apolipoprotein C3 (apoC3), and angiopoietin-like 3 (ANGPTL3). Either antisense oligonucleotide (ASO) therapies and small interfering RNA (siRNA) molecules inhibit protein synthesis and ...
Source: Current Atherosclerosis Reports - June 19, 2021 Category: Cardiology Source Type: research
Lipoprotein (a): Recent Updates on a Unique Lipoprotein
AbstractPurpose of ReviewGenetic, epidemiological, and translational data indicate that Lipoprotein (a) [Lp(a)] is likely in the causal pathway for atherosclerotic cardiovascular diseases as well as calcification of the aortic valves.Recent FindingsLp(a) is structurally similar to low-density lipoprotein, but in addition to apolipoprotein B-100, it has a glycoprotein apolipoprotein(a) [apo(a)], which is attached to the apolipoprotein B-100. Several distinctive properties of Lp(a) can be attributed to the presence of apo(a). This review discusses the current state of literature on pathophysiological and clinical aspects of ...
Source: Current Atherosclerosis Reports - June 19, 2021 Category: Cardiology Source Type: research
Novel RNAi-Based Therapies for Atherosclerosis
AbstractPurpose of ReviewAtherosclerosis, defined by inflammation and accumulation of cholesterol, extracellular matrix, and cell debris into the arteries is a common factor behind cardiovascular diseases (CVD), such as coronary artery disease, peripheral artery disease, and stroke. In this review, we discuss and describe novel RNA interference (RNAi)-based therapies in clinical trials and on the market.Recent FindingsThe first RNAi-based therapies have entered clinical use for the control of atherosclerosis risk factors, i.e., blood cholesterol levels. The most advanced treatment is silencing of proprotein convertase subt...
Source: Current Atherosclerosis Reports - June 19, 2021 Category: Cardiology Source Type: research
HDL-small RNA Export, Transport, and Functional Delivery in Atherosclerosis
AbstractPurpose of ReviewThis review highlights recent advances on the mechanisms and impact of HDL-small non-coding RNAs (sRNA) on intercellular communication in atherosclerosis.Recent FindingsStudies demonstrate that HDL-microRNAs (miRNA) are significantly altered in atherosclerotic cardiovascular disease (ASCVD), and are responsive to diet, obesity, and diabetes. Immune cells, pancreatic beta cells, and neurons are shown to export miRNAs to HDL. In turn, HDL can deliver functional miRNAs to recipient hepatocytes and endothelial cells regulating adhesion molecule expression, cytokines, and angiogenesis. With high-through...
Source: Current Atherosclerosis Reports - May 13, 2021 Category: Cardiology Source Type: research
COVID and Cardiovascular Disease: What We Know in 2021
AbstractPurpose of ReviewCoronavirus disease 2019 (COVID-19) has been the cause of significant global morbidity and mortality. Here, we review the literature to date of the short-term and long-term consequences of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection on the heart.Recent FindingsEarly case reports described a spectrum of cardiovascular manifestations of COVID-19, including myocarditis, stress cardiomyopathy, myocardial infarction, and arrhythmia. However, in most cases, myocardial injury in COVID-19 appears to be predominantly mediated by the severity of critical illness rather than direct ...
Source: Current Atherosclerosis Reports - May 13, 2021 Category: Cardiology Source Type: research
mHealth Technology and CVD Risk Reduction
AbstractPurpose of ReviewTo review existing mHealth-based interventions and examine their efficacy in reducing cardiovascular disease (CVD) risk factors.Recent FindingsA total of 50 articles are included in this review. The majority of the mHealth interventions targeted a specific CVD risk factor, while 4 addressed 2 or more CVD risk factors. Of the 9 mHealth-supported weight loss intervention trials, 4 resulted in significant weight loss. Four out of 7 RCTs targeting improvement in physical activity reported significant improvement, while 4 of the 8 mHealth-supported smoking cessation intervention trials resulted in smoki...
Source: Current Atherosclerosis Reports - May 13, 2021 Category: Cardiology Source Type: research
Sodium and Health Outcomes: Ascertaining Valid Estimates in Research Studies
AbstractPurpose of ReviewThe dietary reference intake (DRI) for sodium has been highly debated with persuasive and elegant arguments made for both population sodium reduction and for maintenance of the status quo. After the 2015Dietary Guidelines Advisory Committee (DGAC) report was published, controversy ensued, and by Congressional mandate, the sodium DRIs were updated in 2019. The 2019 DRIs defined adequate intake (AI) levels by age –sex groups that are largely consistent with the DRIs for sodium that were published in 2005. Given the overall similarities between the 2005 and 2019 DRIs, one may wonder how the recently...
Source: Current Atherosclerosis Reports - May 11, 2021 Category: Cardiology Source Type: research
Apolipoprotein E and Atherosclerosis
AbstractPurpose of ReviewThe functions, genetic variations and impact of apolipoprotein E on lipoprotein metabolism in general are placed in the context of clinical practice dealing with moderate dyslipidaemia as well as dysbetalipoproteinemia, a highly atherogenic disorder and lipoprotein glomerulopathy.Recent FindingsAdditional variants of apolipoprotein E and participation of apolipoprotein E in inflammation are of interest. The mostly favourable effects of apolipoprotein E2 as well as the atherogenic nature of apolipoproteinE4, which has an association with cognitive impairment, are confirmed. The contribution of remna...
Source: Current Atherosclerosis Reports - May 10, 2021 Category: Cardiology Source Type: research
Colchicine and Cardiovascular Outcomes: a Critical Appraisal of Recent Studies
AbstractPurpose of ReviewRecent studies have demonstrated an important role for inflammation in the pathogenesis of atherosclerotic cardiovascular disease. Several studies have investigated the efficacy of colchicine (a widely used and safe anti-inflammatory drug) in patients with atherosclerosis. This review explains the rationale for the use of colchicine in this setting and critically appraises recent outcome trials.Recent FindingsTwo large randomised-controlled trials LoDoCo2 (included patients with chronic coronary syndromes) and COLCOT (acute coronary syndromes) have demonstrated reductions in atherosclerotic cardiov...
Source: Current Atherosclerosis Reports - May 10, 2021 Category: Cardiology Source Type: research
MicroRNAs and Circular RNAs in Lipoprotein Metabolism
AbstractPurpose of ReviewNon-coding RNAs (ncRNAs) including microRNAs (miRNAs) and circular RNAs (circRNAs) are pivotal regulators of mRNA and protein expression that critically contribute to cardiovascular pathophysiology. Although little is known about the origin and function of such ncRNAs, they have been suggested as promising biomarkers with powerful therapeutic value in cardiovascular disease (CVD). In this review, we summarize the most recent findings on ncRNAs biology and their implication on cholesterol homeostasis and lipoprotein metabolism that highlight novel therapeutic avenues for treating dyslipidemia and at...
Source: Current Atherosclerosis Reports - May 10, 2021 Category: Cardiology Source Type: research
