Schlagen Frauenherzen anders? – Geschlechterunterschiede im Lipidmanagement DOI Creative Commons

Maximilian A. Muck,

Andrea Baessler

Deleted Journal, Journal Year: 2025, Volume and Issue: unknown

Published: March 10, 2025

Zusammenfassung Geschlechterspezifische Unterschiede im Lipidstoffwechsel sind vor allem hormonell bedingt. Frauen haben prämenopausal Vergleich zu Männern tendenziell günstigere Lipidwerte, wie höhere Konzentrationen an High-Density-Lipoprotein-Cholesterin (HDL-C) und niedrigere Low-Density-Lipoprotein-Cholesterin (LDL-C). Mit Beginn der Menopause verschlechtern sich diese Werte jedoch durch hormonelle Veränderungen, wodurch bei das Risiko für atherosklerotische Herz-Kreislauf-Erkrankungen erhöht. Trotz vergleichbarer Wirksamkeit lipidsenkender Therapien zeigen mehrere Studien einheitlich, dass seltener die empfohlenen LDL-C-Zielwerte erreichen. Besonders in klinischen Praxis bestehen große Diskrepanzen zwischen Leitlinienempfehlungen tatsächlicher Behandlung, Hochrisikopatientinnen. Verschiedene Barrieren tragen wesentlich dazu bei: Dazu gehören Unterschätzung des Risikos behandelnde Ärzte, ein zurückhaltenderes Verordnungsverhalten, eingeschränktes Bewusstsein Notwendigkeit einer Therapie Patientinnen sowie eine verminderte Medikamentenadhärenz. Letztere wird unter anderem stärkere Wahrnehmung von Nebenwirkungen Prävalenz Statinintoleranz beeinflusst. Die Betreuung spezialisierten Lipidzentren zeigt, viele schwer einstellbare Patienten, z. B. Patienten mit oder hohen LDL-C-Ausgangswerten, gezielter Nachsorge erfolgreich behandelt werden können. Neue pharmakologische Ansätze Kombinationstherapien ermöglichen es, Therapieziele Dennoch erreichen trotz solcher Maßnahmen ihre LDL-Zielwerte, was auf intensiverer geschlechtersensibler Strategien hinweist. Eine wirksame Lipidtherapie erfordert verstärkt den Einsatz Kombinationstherapien, regelmäßige Kontrollen enge Zusammenarbeit Patient Arzt. ist es entscheidend, Therapieadhärenz verbessern mögliche konsequent anzugehen, um kardiovaskuläre effektiv senken.

Particle Number and Characteristics of Lipoprotein(a), LDL, and apoB DOI Creative Commons
Sotirios Tsimikas, Vera Bittner

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(3), P. 396 - 400

Published: Jan. 1, 2024

Language: Английский

Citations

5
Lipid Toxicity in the Cardiovascular-Kidney-Metabolic Syndrome (CKMS) DOI Creative Commons
John A. D’Elia, Larry A. Weinrauch

Biomedicines, Journal Year: 2024, Volume and Issue: 12(5), P. 978 - 978

Published: April 29, 2024

Recent studies of Cardiovascular-Kidney-Metabolic Syndrome (CKMS) indicate that elevated concentrations derivatives phospholipids (ceramide, sphingosine), oxidized LDL, and lipoproteins (a, b) are toxic to kidney heart function. Energy production for renal proximal tubule resorption critical fuels electrolytes is required homeostasis. Cardiac energy ventricular contraction/relaxation preferentially supplied by long chain fatty acids. Metabolism acids accomplished within the cardiomyocyte cytoplasm mitochondria means glycolytic, tricarboxylic acid, electron transport cycles. Toxic lipids excessive lipid may inhibit cardiac contraction requires calcium movement from sarcoplasmic reticulum a high low concentration at relatively cost. relaxation involves return lower higher more consumption. Diastolic dysfunction occurs when conversion inadequate. diminished ATP availability in presence inadequate blood pressure, glycemia, or control lead failure. Similar disruption tubular fuels/electrolytes has been found be associated with phospholipid (sphingolipid) accumulation. Elevated tissue low-density lipoprotein cholesterols loss filtration efficiency level glomerular podocyte. Macroscopically deposits epicardial intra-nephric adipose vascular pathology, fibrosis, inhibition essential functions both kidney. Chronic triglyceride accumulation fibrosis liver, structures. Successful kidney, allograft these vital organs does not eliminate risk toxicity. Lipid lowering therapy assist protecting organ function before after transplantation.

Language: Английский

Citations

5
Impact of Lipoprotein(a) Level on Low-Density Lipoprotein Cholesterol– or Apolipoprotein B–Related Risk of Coronary Heart Disease DOI
Natalie Arnold, Christopher Blaum, Alina Goßling

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(2), P. 165 - 177

Published: July 1, 2024

Language: Английский

Citations

5
Intra-individual variability in lipoprotein(a): the value of a repeat measure for reclassifying individuals at intermediate risk DOI Creative Commons
Tarek Harb, Efthymios Ziogos, Roger S. Blumenthal

et al.

European Heart Journal Open, Journal Year: 2024, Volume and Issue: 4(5)

Published: Aug. 31, 2024

Abstract Aims Lipoprotein(a) [Lp(a)] levels are predominantly genetically determined and repeat measurements generally considered unlikely to be clinically useful. However, the temporal variation of Lp(a) is not well characterized. Our aim was determine intra-individual variability whether a repeated measure reclassified Lp(a)-specific cardiovascular risk using European Atherosclerosis Society (EAS) consensus statement categories. Methods results This retrospective cohort study analysed initial serum measured same methodology from 609 individuals in Nashville Biosciences database, de-identified electronic medical records database. Baseline follow-up paired values were significantly different (P < 0.05), with an absolute change ≥10 mg/dL 38.1% [95% CI 34.2–42%] >25% 40.5% 36.6–44.3%] individuals. Although categories those whose EAS low-risk high-risk did change, 53% intermediate ‘grey-zone’ category transitioned either (20%) or (33%) category. Black exhibited greater than White women men. There positive correlation between baseline changes Lp(a), (r = 0.59, P 0.01). Conclusion Temporal-related present many A may allow more precise prediction for value EAS-defined should included calculating expected effect sizes future clinical research studies targeting Lp(a).

Language: Английский

Citations

5
In the Beginning, Lipoproteins Cross the Endothelial Barrier DOI Open Access
Ira J. Goldberg, Ainara G. Cabodevilla, Waqas Younis

et al.

Journal of Atherosclerosis and Thrombosis, Journal Year: 2024, Volume and Issue: 31(6), P. 854 - 860

Published: April 12, 2024

Atherosclerosis begins with the infiltration of cholesterol-containing lipoproteins into arterial wall. White blood cell (WBC)-associated inflammation follows. Despite decades research using genetic and pharmacologic methods to alter WBC function, in humans, most effective method prevent initiation progression disease remains low-density lipoprotein (LDL) reduction. However, additional approaches reducing cardiovascular would be useful as residual risk events continues even currently LDL-reducing treatments. Some this may due vascular toxicity triglyceride-rich (TRLs). Another option is that LDL transcytosis continues, albeit at reduced rates lower circulating levels lipoprotein. This review will address these two topics. The evidence TRLs promote atherosclerosis processes allow taken up by endothelial cells leading their accumulation subendothelial space.

Language: Английский

Citations

4
Early-onset atherosclerotic cardiovascular disease DOI Creative Commons
Idine Mousavi, John Suffredini, Salim S. Virani

et al.

European Journal of Preventive Cardiology, Journal Year: 2024, Volume and Issue: unknown

Published: July 20, 2024

Abstract Recent trends indicate a concerning increase in early-onset atherosclerotic cardiovascular disease (ASCVD) among younger individuals (men aged <55 years women <65 years). These findings highlight the pathobiology of ASCVD as process that begins early life and underscores need for more tailored screening methods preventive strategies. Increasing attention has been placed on growing burden traditional cardiometabolic risk factors young while also recognizing unique mediate pre-mature atherosclerosis this demographic such substance use, socioeconomic disparities, adverse pregnancy outcomes, chronic inflammatory states contribute to increasing incidence ASCVD. Additionally, mounting evidence pointed out significant disparities diagnosis management outcomes based sex race. Moving towards personalized approach, emerging data technological developments using diverse tools polygenic scores coronary artery calcium scans have shown potential earlier detection risk. Thus, we review current causal drive improve assessment individuals.

Language: Английский

Citations

4
Lipoprotein(a) as a Pharmacological Target: Premises, Promises, and Prospects DOI
Antonio Greco, Simone Finocchiaro, Marco Spagnolo

et al.

Circulation, Journal Year: 2025, Volume and Issue: 151(6), P. 400 - 415

Published: Feb. 10, 2025

Atherosclerotic cardiovascular disease is a major health concern worldwide and requires effective preventive measures. Lp(a) (lipoprotein [a]) has recently garnered attention as an independent risk factor for astherosclerotic disease, with proinflammatory prothrombotic mechanisms contributing to its atherogenicity. On equimolar basis, ~5 6 times more atherogenic than particles that have been widely associated adverse outcomes, such LDL (low-density lipoprotein). can enter the vessel wall, leading accumulation of oxidized phospholipids in arterial intima, which are crucial initiating plaque inflammation triggering vascular progression. In addition, may cause atherothrombosis through interactions between apoA (apolipoprotein A) platelet PAR-1 (protease-activated receptor 1) receptor, well competitive inhibition plasminogen. Because mostly determined on genetic bases, 1-time assessment lifetime suffice identify patients elevated levels. Mendelian randomization studies post hoc analyses randomized trials cholesterol–lowering drugs showed causal link concentrations therapeutic reduction expected contribute estimated mitigation. Many Lp(a)-lowering drugs, including monoclonal antibodies, small interfering ribonucleic acids, antisense oligonucleotides, molecules, gene editing compounds, at different stages clinical investigation show promise use. particular, increased testing treatment substantial impact population level, enabling identification high-risk individuals subsequent prevention large number events. Ongoing phase 3 will further elucidate benefits over long term, offering potential avenues targeted interventions improved outcomes.

Language: Английский

Citations

0
Therapeutic PCSK9 targeting: Inside versus outside the hepatocyte? DOI Creative Commons
Alberto Corsini, Henry N. Ginsberg,

M. John Chapman

et al.

Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown, P. 108812 - 108812

Published: Feb. 1, 2025

Language: Английский

Citations

0
Coronary Artery Calcium Scoring in the Context of Widespread Lipoprotein(a) Testing: Clinical Considerations and Implications for Lipid-Lowering Therapies DOI
Srikanth Palanisamy,

Semenawit Burka,

Michael J. Blaha

et al.

Current Cardiology Reports, Journal Year: 2025, Volume and Issue: 27(1)

Published: Feb. 11, 2025

Language: Английский

Citations

0
Rethinking Cardiovascular Risk: The Emerging Role of Lipoprotein(a) Screening DOI Creative Commons

Victoria Clair,

Francis Zirille, Edward A. Gill

et al.

American Journal of Preventive Cardiology, Journal Year: 2025, Volume and Issue: 21, P. 100945 - 100945

Published: Feb. 14, 2025

Lipoprotein(a) [Lp(a)] is a genetically inherited, independent risk factor for cardiovascular disease (CVD), affecting approximately 20-25% of the global population. Elevated Lp(a) levels are associated with 2-3-fold increased myocardial infarction and aortic valve stenosis, comparable to seen in individuals familial hypercholesterolemia. Despite its clinical relevance, integration screening into routine practice has been limited by inconsistent measurement techniques lack targeted treatments. Recent advancements, including improved assays development potential Lp(a)-lowering therapies, have renewed focus on importance screening. This review aims clarify role health examining current evidence who should be screened, when occur, most accurate methods measuring Lp(a). Key recommendations include universal, one-time adults, selective high-risk pediatric patients, special considerations conditions such as hypercholesterolemia chronic kidney disease. Advances assay technology now allow more precise measurement, supporting better stratification. Additionally, emerging therapies that specifically target elevated could lead personalized management CVD risk. Our findings support assessment, highlighting improve early detection prevention strategies across diverse patient populations.

Language: Английский

Citations

0