Lipoprotein(a) and Long-Term Cardiovascular Risk in a Multi-Ethnic Pooled Prospective Cohort DOI Creative Commons
Nathan D. Wong, Wenjun Fan,

Xingdi Hu

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(16), P. 1511 - 1525

Published: April 1, 2024

Lipoprotein(a) (Lp[a]) is a causal genetic risk factor for atherosclerotic cardiovascular disease (ASCVD). There are limited long-term follow-up data from large U.S. population cohorts. This study examined the relationship of Lp(a) with ASCVD outcomes in large, pooled, multi-ethnic cohort. The included on and 5 prospective studies: MESA (Multi-Ethnic Study Atherosclerosis), CARDIA (Coronary Artery Risk Development Young Adults), JHS (Jackson Heart Study), FHS-OS (Framingham Study-Offspring), ARIC (Atherosclerosis In Communities). levels were classified basis cohort-specific percentiles. Multivariable Cox regression related composite incident events by group diabetes status. 27,756 persons without previous who aged 20 to 79 years, including 55.0% women, 35.6% Black participants, 7.6% patients diabetes, mean 21.1 years. Compared <50th percentile, 50th <75th, 75th <90th, ≥90th percentiles had adjusted HRs 1.06 (95% CI: 0.99-1.14), 1.18 1.09-1.28), 1.46 1.33-1.59), respectively events. Elevated predicted similarly group, sex, race or ethnic groups, but more strongly vs (interaction P = 0.0056), percentile 1.92 1.50-2.45) 1.41 1.28-1.55), respectively. also individually myocardial infarction, revascularization, stroke, coronary heart death, not total mortality. shows, pooled cohort, that higher associated an increased risk, diabetes.

Language: Английский

Lipoprotein(a) Is Markedly More Atherogenic Than LDL DOI Creative Commons
Elias Björnson, Martin Adiels, Marja‐Riitta Taskinen

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(3), P. 385 - 395

Published: Jan. 1, 2024

Language: Английский

Citations

74
Lipoprotein(a) in Atherosclerotic Diseases: From Pathophysiology to Diagnosis and Treatment DOI Creative Commons
Stamatios Lampsas,

Maria Xenou,

Evangelos Oikonomou

et al.

Molecules, Journal Year: 2023, Volume and Issue: 28(3), P. 969 - 969

Published: Jan. 18, 2023

Lipoprotein(a) (Lp(a)) is a low-density lipoprotein (LDL) cholesterol-like particle bound to apolipoprotein(a). Increased Lp(a) levels are an independent, heritable causal risk factor for atherosclerotic cardiovascular disease (ASCVD) as they largely determined by variations in the gene (LPA) locus encoding apo(a). preferential carrier oxidized phospholipids (OxPL), and its role adversely affects vascular inflammation, lesions, endothelial function thrombogenicity, which pathophysiologically leads (CV) events. Despite this crucial of Lp(a), measurement lacks globally unified method, and, between different laboratories, results need standardization. Standard antilipidemic therapies, such statins, fibrates ezetimibe, have mediocre effect on levels, although it not yet clear whether treatments can affect CV events prognosis. This narrative review aims summarize knowledge regarding mechanisms mediating atherosclerosis thrombosis discuss current diagnostic therapeutic potentials.

Language: Английский

Citations

66
Proteomics and lipidomics in atherosclerotic cardiovascular disease risk prediction DOI Creative Commons
Nick S. Nurmohamed, Jordan M. Kraaijenhof, Manuel Mayr

et al.

European Heart Journal, Journal Year: 2023, Volume and Issue: 44(18), P. 1594 - 1607

Published: March 29, 2023

Given the limited accuracy of clinically used risk scores such as Systematic COronary Risk Evaluation 2 system and Second Manifestations ARTerial disease scores, novel algorithms determining an individual's susceptibility future incident or recurrent atherosclerotic cardiovascular (ASCVD) are urgently needed. Due to major improvements in assay techniques, multimarker proteomic lipidomic panels hold promise be reliably assessed a high-throughput routine. Novel machine learning-based approaches have facilitated use this high-dimensional data resulting from these analyses for ASCVD prediction. More than dozen large-scale retrospective studies using different sets biomarkers statistical methods consistently demonstrated additive prognostic value over traditionally clinical scores. Prospective needed determine utility biomarker panel stratification. When combined with genetic predisposition captured polygenic actual phenotype observed coronary artery imaging, proteomics lipidomics can advance understanding complex multifactorial causes underlying risk.

Language: Английский

Citations

65
The first MASH drug therapy on the horizon: Current perspectives of resmetirom DOI Creative Commons
Salvatore Petta, Giovanni Targher, Stefano Romeo

et al.

Liver International, Journal Year: 2024, Volume and Issue: 44(7), P. 1526 - 1536

Published: April 5, 2024

Abstract The rising prevalence of metabolic dysfunction‐associated steatotic liver disease (MASLD) poses a significant global health challenge, affecting over 30% adults worldwide. MASLD is linked to increased mortality rates and substantial healthcare costs, primarily driven by its progression steatohepatitis (MASH), which can lead severe complications including cirrhosis hepatocellular carcinoma. Despite growing burden, effective pharmacotherapy for MASLD/MASH has been lacking until the recent conditional approval resmetirom FDA. Resmetirom, liver‐targeted thyroid hormone receptor‐β selective drug, shown promise in clinical trials treating non‐cirrhotic MASH with moderate advanced fibrosis. It demonstrated efficacy reducing hepatic fat content, improving histology (both resolution fibrosis improvement), ameliorating biomarkers damage without effects on body weight or glucose metabolism. Notably, also exhibits favourable circulating lipids, potentially cardiovascular risk patients. safety profile appears acceptable, gastrointestinal adverse events being most common, though generally mild moderate. However, long‐term surveillance warranted monitor potential risks related thyroid, gonadal, bone diseases. Clinical implementation faces challenges patient selection monitoring treatment response, will heavily rely non‐invasive tests assessment. Nonetheless, represents landmark breakthrough treatment, paving way future therapeutic strategies aiming mitigate multifaceted associated this complex disease.

Language: Английский

Citations

63
Frequent questions and responses on the 2022 lipoprotein(a) consensus statement of the European Atherosclerosis Society DOI Creative Commons
Florian Kronenberg, Samia Mora, Erik S.G. Stroes

et al.

Atherosclerosis, Journal Year: 2023, Volume and Issue: 374, P. 107 - 120

Published: April 28, 2023

In 2022, the European Atherosclerosis Society (EAS) published a new consensus statement on lipoprotein(a) [Lp(a)], summarizing current knowledge about its causal association with atherosclerotic cardiovascular disease (ASCVD) and aortic stenosis. One of novelties this is risk calculator showing how Lp(a) influences lifetime for ASCVD that global may be underestimated substantially in individuals high or very concentration. The also provides practical advice concentration can used to modulate factor management, given specific highly effective mRNA-targeted Lp(a)-lowering therapies are still clinical development. This counters attitude: "Why should I measure if can't lower it?". Subsequent publication, questions have arisen relating recommendations impact everyday practice management. review addresses 30 most frequently asked epidemiology, contribution risk, measurement, management existing therapeutic options.

Language: Английский

Citations

58
Nutrition interventions for adults with dyslipidemia: A Clinical Perspective from the National Lipid Association DOI Creative Commons
Carol F. Kirkpatrick, Geeta Sikand, Kristina Petersen

et al.

Journal of clinical lipidology, Journal Year: 2023, Volume and Issue: 17(4), P. 428 - 451

Published: June 2, 2023

Lifestyle habits can have a profound impact on atherosclerotic cardiovascular disease (ASCVD) risk. The National Lipid Association previously published recommendations for lifestyle therapies to manage dyslipidemia. This Clinical Perspective provides an update with focus nutrition interventions the three most common dyslipidemias in adults: 1) low-density lipoprotein cholesterol (LDL-C) elevation; 2) triglyceride (TG) elevation, including severe hypertriglyceridemia chylomicronemia; and 3) combined dyslipidemia, elevations both LDL-C TG levels. Lowering non-high-density are primary objectives reducing ASCVD With elevation (≥500 mg/dL), objective is prevent pancreatitis risk reduction secondary. Nutrition that lower levels include cholesterol-raising fatty acids dietary cholesterol, as well increasing intakes of unsaturated acids, plant proteins, viscous fibers, adiposity patients overweight or obesity. Selected supplements may be employed adjuncts. all elevated restricting alcohol, added sugars, refined starches. Additional factors reduce participating daily physical activity For hypertriglyceridemia, individualized approach essential. addressing concurrent combination strategies described lowering TG. A multidisciplinary recommended facilitate success making sustaining changes assistance registered dietitian nutritionist highly recommended.

Language: Английский

Citations

50
Clinical Trial Design for Lipoprotein(a)-Lowering Therapies DOI Creative Commons
Waqas Malick, Sascha N. Goonewardena, Wolfgang Köenig

et al.

Journal of the American College of Cardiology, Journal Year: 2023, Volume and Issue: 81(16), P. 1633 - 1645

Published: April 1, 2023

Language: Английский

Citations

46
Lipoprotein(a) Testing Trends in a Large Academic Health System in the United States DOI Creative Commons
Harpreet Bhatia, Samantha Hurst,

Paresh Desai

et al.

Journal of the American Heart Association, Journal Year: 2023, Volume and Issue: 12(18)

Published: Sept. 13, 2023

Background Despite its high prevalence and clinical significance, measurement of lipoprotein(a) is rare but has not been systematically quantified. We assessed the testing overall, in those with various cardiovascular disease (CVD) conditions undergoing cardiac across 6 academic medical centers associated University California, total by year from 2012 to 2021. Methods Results In this observational study, data California Health Data Warehouse on number individuals unique testing, CVD diagnoses (using

Language: Английский

Citations

46
Lipoprotein(a) is linked to atherothrombosis and aortic valve stenosis independent of C-reactive protein DOI Open Access
P. E. Thomas, Signe Vedel‐Krogh, Pia R. Kamstrup

et al.

European Heart Journal, Journal Year: 2023, Volume and Issue: 44(16), P. 1449 - 1460

Published: Feb. 21, 2023

Recent evidence suggest that the lipoprotein(a)-associated risk of atherosclerotic cardiovascular disease (ASCVD) may be observed only in individuals with low-grade systemic inflammation. It was hypothesized high lipoprotein(a) is a main driver for ASCVD, myocardial infarction, and aortic valve stenosis irrespective C-reactive protein levels.A total 68 090 from Copenhagen General Population Study, prospective cohort study, were included. During median follow-up 8.1 years, 5104 developed 2432 1220 stenosis. The increased higher values both protein. For 91st-100th percentiles (≥70 mg/dl, ≥147 nmol/l) vs. 1st-33rd (≤6 ≤9 nmol/l), multivariable-adjusted hazard ratio ASCVD 1.61 (95% confidence interval 1.43-1.81) those <2 mg/l 1.57 (1.36-1.82) ≥2 (P interaction = 0.87). corresponding 2.08 (1.76-2.45) 1.65 (1.34-2.04) 2.01 (1.59-2.55) 1.73 (1.31-2.27) stenosis, respectively 0.15 0.18). highest absolute 10-year risks found men aged 70-79 years levels mg/l, 34% 19% 13% women 20%, 10%, 8%, respectively.High independent levels.

Language: Английский

Citations

42
Lipoprotein(a) and Major Adverse Cardiovascular Events in Patients With or Without Baseline Atherosclerotic Cardiovascular Disease DOI Creative Commons
Adam N. Berman, David Biery, Stephanie A. Besser

et al.

Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 83(9), P. 873 - 886

Published: Feb. 26, 2024

Language: Английский

Citations

31