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

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