Statins in patients with established heart failure: Time for reflection DOI Open Access

Bertram Pitt,

Robert S. Rosenson

Journal of Cardiovascular Pharmacology, Journal Year: 2023, Volume and Issue: 82(5), P. 345 - 346

Published: Sept. 1, 2023

The development and clinical application of statins has been one the most significant advances in health care over past quarter a century. Statins have shown to prevent heart failure (HF), reduce risk myocardial infarction stroke, as well mortality patients with without coronary artery disease, independent serum cholesterol.1 Their role established HF is, however, controversial. Although their use is supported by observational studies meta-analyses,2,3 not results pivotal large-scale prospective randomized trials reduced ejection fraction (HFrEF), GISSI-HF (Gruppo Italiano per la Sperimentazione della Streptochinasi nell'Infarto Miocardico—Heart Failure), Controlled Rosuvastatin Multinational Trial (CORONA).4,5 There suggestion from CORONA trial other that mild evidenced relatively low level NT-pro BNP may benefit.6 Current guidelines do therefore recommend statin indications such hypercholesterolemia, diabetes, or atherosclerotic cardiovascular disease.7 data suggest can be continued who are already on treatment.7 Given large number proven benefit they an increasing HF, both those HFrEF preserved currently being treated statin. Thus, it important understand whether these will at increased explanation why clear beneficial effect hypercholesterolemia and/or disease although clearly proven, remains uncertain. In this issue journal, Ahmad et al8 compared physical performance 172 diagnosed chronic (50 122 statin) 59 control patients. They measured handgrip strength, gait speed, short battery plasma biomarkers including sarcopenia marker C-terminal agrin fragment −22 (CAF22), intestinal barrier integrity zonulin, C-reactive protein (CRP) correlated markers performance. Not surprisingly, found had reduction HF. Of interest was finding irrespective etiology, elevation CAF22 zonulin there strong inverse correlation between also CAF22, CRP were each other. However, increase receiving worse than adversely affect neuromuscular junction permeability resultant systemic inflammation. some but all previous animals.9,10Thus, reason consider implications findings apply them clinically yet. Increasing evidence suggests (gut–heart gut–brain axis).11,12 An suggested diagnostic dysfunction, associated lipoprotein polysaccharide, trimethylamine-N-oxide decrease short-chain fatty acids butyrate.11,12 polysaccharide acid adverse effects inflammation; renal fibrosis; platelet activation thrombosis; major depression; cognitive dysfunction Alzheimer's disease.11,12 study implications, should pointed out observational, small (n = 172), even smaller 50), sodium glucose transport inhibitor mineralocorticoid receptor antagonist, which alter microbiome part recommended "4-pillar" therapy need for further adequately powered, placebo-controlled confirm findings. It considerable variation ethnicity, gender, age, diet. Animal statin.11,12 preclinical studies,9,10 outcomes HF1 benefits outweigh risks. especially advanced inflammation statin,11,12 possible risks benefits. confirmed prospective, and, if confirmed, evaluating means lowering cholesterol bypass gut PCSK9 inhibitors13 determine similar mechanisms inducing skeletal muscle mitochondrial dysfunction. effective tolerated numbers inexpensive. Before advocating change we only implied biomarker findings, thrombosis, several signaling pathways. Future research required differences lipophilic versus hydrophilic outcomes, rather before practice.

Language: Английский

Gut microbiota alterations and associations with nutrients in children with celiac disease DOI Creative Commons
Yasemin Ertaş Öztürk, Efsun Karabudak, Ödül Eğritaş

et al.

Food Science & Nutrition, Journal Year: 2024, Volume and Issue: 12(11), P. 8887 - 8902

Published: Sept. 12, 2024

Abstract Celiac disease is a chronic inflammatory condition that not well understood in relation to the microbiome. Our objective was demonstrate changes microbiota and relationships between nutrients children with celiac (CD) who followed gluten‐free diet (GFD). A group of 11 were recently diagnosed CD, ranging age from 3 12, monitored for period 6 months. GFD designed based on individual's specific energy nutrient needs, strict control over dietary adherence. Food consumption, blood, fecal samples taken. Fecal put through 16s rRNA sequencing. Microbial modifications demonstrated using alpha diversity, beta nonmetric multidimensional scaling analysis (NDMS), t ‐test, metastats. Mean 6.4 ± 2.66 years 54.5% male participants. Serological parameters negative after Both unweighted ( p = .019) weighted .021) Unifrac distances higher before GFD, differences reliable according NDMS (stress 0.189). The abundance Bacteroides ovatus increased .014), whereas unidentified Lachnospiraceae , Paeniclostridium Paraclostridium Peptostreptococcus Dielma decreased < .001). Associations several genera species identified. presence genus Bifidobacterium adolescentis inversely associated fat intake .01). Microbiota became evident or absence small bacteria may play role development CD. Modifying children's can potentially influence microbial composition.

Language: Английский

Citations

0
Pediatric Gastroenterology Research DOI Creative Commons
Vasile Valeriu Lupu, Ömer Faruk Beşer, Simona Gurzu

et al.

Life, Journal Year: 2023, Volume and Issue: 13(9), P. 1810 - 1810

Published: Aug. 25, 2023

For several decades, before the 19th century, pediatric pathology was considered to be an annex of adult and treated as a secondary matter in medical practice [...]

Language: Английский

Citations

0
Statins in patients with established heart failure: Time for reflection DOI Open Access

Bertram Pitt,

Robert S. Rosenson

Journal of Cardiovascular Pharmacology, Journal Year: 2023, Volume and Issue: 82(5), P. 345 - 346

Published: Sept. 1, 2023

The development and clinical application of statins has been one the most significant advances in health care over past quarter a century. Statins have shown to prevent heart failure (HF), reduce risk myocardial infarction stroke, as well mortality patients with without coronary artery disease, independent serum cholesterol.1 Their role established HF is, however, controversial. Although their use is supported by observational studies meta-analyses,2,3 not results pivotal large-scale prospective randomized trials reduced ejection fraction (HFrEF), GISSI-HF (Gruppo Italiano per la Sperimentazione della Streptochinasi nell'Infarto Miocardico—Heart Failure), Controlled Rosuvastatin Multinational Trial (CORONA).4,5 There suggestion from CORONA trial other that mild evidenced relatively low level NT-pro BNP may benefit.6 Current guidelines do therefore recommend statin indications such hypercholesterolemia, diabetes, or atherosclerotic cardiovascular disease.7 data suggest can be continued who are already on treatment.7 Given large number proven benefit they an increasing HF, both those HFrEF preserved currently being treated statin. Thus, it important understand whether these will at increased explanation why clear beneficial effect hypercholesterolemia and/or disease although clearly proven, remains uncertain. In this issue journal, Ahmad et al8 compared physical performance 172 diagnosed chronic (50 122 statin) 59 control patients. They measured handgrip strength, gait speed, short battery plasma biomarkers including sarcopenia marker C-terminal agrin fragment −22 (CAF22), intestinal barrier integrity zonulin, C-reactive protein (CRP) correlated markers performance. Not surprisingly, found had reduction HF. Of interest was finding irrespective etiology, elevation CAF22 zonulin there strong inverse correlation between also CAF22, CRP were each other. However, increase receiving worse than adversely affect neuromuscular junction permeability resultant systemic inflammation. some but all previous animals.9,10Thus, reason consider implications findings apply them clinically yet. Increasing evidence suggests (gut–heart gut–brain axis).11,12 An suggested diagnostic dysfunction, associated lipoprotein polysaccharide, trimethylamine-N-oxide decrease short-chain fatty acids butyrate.11,12 polysaccharide acid adverse effects inflammation; renal fibrosis; platelet activation thrombosis; major depression; cognitive dysfunction Alzheimer's disease.11,12 study implications, should pointed out observational, small (n = 172), even smaller 50), sodium glucose transport inhibitor mineralocorticoid receptor antagonist, which alter microbiome part recommended "4-pillar" therapy need for further adequately powered, placebo-controlled confirm findings. It considerable variation ethnicity, gender, age, diet. Animal statin.11,12 preclinical studies,9,10 outcomes HF1 benefits outweigh risks. especially advanced inflammation statin,11,12 possible risks benefits. confirmed prospective, and, if confirmed, evaluating means lowering cholesterol bypass gut PCSK9 inhibitors13 determine similar mechanisms inducing skeletal muscle mitochondrial dysfunction. effective tolerated numbers inexpensive. Before advocating change we only implied biomarker findings, thrombosis, several signaling pathways. Future research required differences lipophilic versus hydrophilic outcomes, rather before practice.

Language: Английский

Citations

0