Coffee or tea: Anti-inflammatory properties in the context of atherosclerotic cardiovascular disease prevention

Pharmacological Research, Journal Year: 2022, Volume and Issue: 187, P. 106596 - 106596

Published: Dec. 5, 2022

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of premature death worldwide. Inflammation and its biomarkers, like C-reactive protein (CRP), among risk factors, such as hypertension, lipid disorders, diabetes, may be also responsible for residual (CVD) risk. Modern lipid-lowering treatment with statins, ezetimibe, PCSK9 inhibitors, or bempedoic acid does not fully protect against inflammation. The recommendations International Lipid Expert Panel (ILEP) indicate selected nutraceuticals anti-inflammatory properties. Diet have a significant impact on Especially interesting in context inflammation consumption coffee tea. These drinks many observational studies significantly reduced mortality. question whether effects these contribute to observed clinical effects. Thus, this narrative review, we primarily discuss properties consuming tea coffee. Based comprehensive analysis their meta-analyses, inconsistent results were obtained, which makes it impossible conclusively state how clinically potential black green are. A number confounding factors can inconsistency available results. Consumption appears increase adiponectin concentrations, decrease reactive oxygen species, low density lipoprotein (LDL) cholesterol concentrations (effect tea, etc.). Despite still uncertain effect coffee, recommend part healthy diet.

Language: Английский

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Step‐by‐step diagnosis and management of the nocebo/drucebo effect in statin‐associated muscle symptoms patients: a position paper fromthe International Lipid Expert Panel(ILEP)

Journal of Cachexia Sarcopenia and Muscle, Journal Year: 2022, Volume and Issue: 13(3), P. 1596 - 1622

Published: March 10, 2022

Statin intolerance is a clinical syndrome whereby adverse effects (AEs) associated with statin therapy [most commonly statin-associated muscle symptoms (SAMS)] result in the discontinuation of and consequently increase risk cardiovascular outcomes. However, complete occurs only small minority treated patients (estimated prevalence 3-5%). Many perceived AEs are misattributed (e.g. physical musculoskeletal injury inflammatory myopathies), subjective occur as fact that expect them to do so when taking medicines (the nocebo/drucebo effect)-what might be truth even for over 50% all weakness/pain. Clear guidance necessary enable optimal management plasma real-world practice who experience AEs. In this Position Paper International Lipid Expert Panel (ILEP), we present step-by-step patient-centred approach identification SAMS particular focus on strategies prevent manage effect improve long-term compliance lipid-lowering therapy.

Language: Английский

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Bempedoic Acid: for Whom and When

Current Atherosclerosis Reports, Journal Year: 2022, Volume and Issue: 24(10), P. 791 - 801

Published: July 28, 2022

Abstract Purpose of Review The aim creating an orally active non-statin cholesterol-lowering drug was achieved with bempedoic acid, a small linear molecule providing both significant low-density lipoprotein cholesterol (LDL-C) reduction and anti-inflammatory effect by decreasing high-sensitivity C-reactive protein. Bempedoic acid antagonizes ATP citrate-lyase, cytosolic enzyme upstream HMGCoA reductase which is the rate-limiting step biosynthesis. pro-drug converted to its metabolite very-long-chain acyl-CoA synthetase 1 present mostly in liver absent skeletal muscles. This limits risk myalgia myopathy. remit this review give clinical insights on safety efficacy understand for whom it should be prescribed. Recent Findings single daily dose (180 mg) reduces LDL-C mean 24.5% when given alone, 18% top major statin 38–40% fixed-dose combination ezetimibe. does not lead new-onset diabetes, moderately improves glycaemic profile. Summary extensive knowledge mechanism, metabolism side effects has led improved understanding potential benefits agent offers possible alternative cardiologists practitioners somewhat worn out today occurrence muscular statins.

Language: Английский

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2022: The Year in Cardiovascular Disease – The Year of Upfront Lipid Lowering Combination Therapy.

Archives of Medical Science, Journal Year: 2022, Volume and Issue: unknown

Published: Oct. 28, 2022

1. Sabouret P, Angoulvant D, Cannon CP, Banach M. Low levels of low-density lipoprotein cholesterol, intracerebral haemorrhage, and other safety issues: is there still a matter debate?Eur Heart J Open2022; 2: oeac038. Google Scholar

Language: Английский

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Targeted Treatment against Lipoprotein (a): The Coming Breakthrough in Lipid Lowering Therapy

Pharmaceuticals, Journal Year: 2022, Volume and Issue: 15(12), P. 1573 - 1573

Published: Dec. 16, 2022

Atherosclerotic cardiovascular diseases (ASCVD) are a very important cause of premature death. The most risk factor for ASCVD is lipid disorders. incidence disorders and constantly increasing, which means that new methods prevention treatment these still being searched for. In the management patients with disorders, primary goal therapy to lower serum LDL-C concentration. Despite available effective lipid-lowering therapies, increased in some patients. A high level lipoprotein (a) (Lp(a)) independent About 20% Europeans have elevated Lp(a) levels, requiring reduce concentrations addition LDL-C. Currently lowering drugs do not sufficiently levels. Hence, based on RNA technology, such as pelacarsen, olpasiran, SLN360 LY3819469, undergoing clinical trials. These concentration satisfactory safety profile, near future they will fill an gap armamentarium drugs.

Language: Английский

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Beyond statins: New pharmacological targets to decrease LDL-cholesterol and cardiovascular events

Pharmacology & Therapeutics, Journal Year: 2023, Volume and Issue: 250, P. 108507 - 108507

Published: Aug. 9, 2023

The pharmacological treatment of dyslipidemia, a major modifiable risk factor for developing atherosclerotic cardiovascular disease (ASCVD), remains debated and controversial issue, not only in terms the most appropriate therapeutic range lipid levels, but also with regard to optimal strategy sequence approach (stepwise vs upstream therapy). Current guidelines management dyslipidemia focus on intensity low-density lipoprotein cholesterol (LDL-C) reduction, stratified according ASCVD. Beyond statins ezetimibe, different medications targeting LDL-C have been recently approved by regulatory agencies potential innovative mechanisms action, including proprotein convertase subtilisin/kexin type 9 modulators (monoclonal antibodies such as evolocumab alirocumab; small interfering RNA molecules inclisiran), ATP-citrate lyase inhibitors (bempedoic acid), angiopoietin-like 3 (evinacumab), microsomal triglyceride transfer protein (lomitapide). An understanding their aspects, benefit-risk profile, impact hard endpoint beyond advantages from patient perspective (e.g., adherence) - this evidence-based review is crucial practitioners across medical specialties minimize inertia support clinical practice.

Language: Английский

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Intensive Statin Therapy Versus Upfront Combination Therapy of Statin and Ezetimibe in Patients With Acute Coronary Syndrome: A Propensity Score Matching Analysis Based on the PL‐ACS Data

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

Published: Sept. 6, 2023

Background We aimed to compare statin monotherapy and upfront combination therapy of ezetimibe in patients with acute coronary syndromes (ACSs). Methods Results The study included consecutive ACS the PL-ACS (Polish Registry Acute Coronary Syndromes), which is a national, multicenter, ongoing, prospective observational registry that mandatory for hospitalized Poland. Data were matched using Mahalanobis distance within propensity score matching calipers. Multivariable stepwise logistic regression analysis, including all variables, was next used analysis. Finally, 38 023 who discharged alive After matching, 2 groups analyzed: (atorvastatin or rosuvastatin; n=768) (n=768 patients). difference mortality between significant during follow-up present at 1 (5.9% versus 3.5%; P=0.041), (7.8% 4.3%; P=0.019), 3 (10.2% 5.5%; P=0.024) years favor therapy, as well overall period. For treatment, rosuvastatin significantly improved prognosis compared atorvastatin (odds ratio [OR], 0.790 [95% CI, 0.732-0.853]). Upfront associated reduction all-cause comparison (OR, 0.526 0.378-0.733]), absolute risk 4.7% after (number needed treat=21). Conclusions lipid-lowering superior ACS. These results suggest high-risk patients, such an approach, rather than should be recommended.

Language: Английский

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2023: The year in cardiovascular disease - the year of new and prospective lipid lowering therapies. Can we render dyslipidemia a rare disease by 2024?

Archives of Medical Science, Journal Year: 2023, Volume and Issue: unknown

Published: Nov. 1, 2023

In 2023 there are still even 75% of patients over the target low-density lipoprotein cholesterol (LDL-C), and hypercholesterolemia is most common worst monitored cardiovascular risk factor. How it possible, considering knowledge we have on role in process atherosclerosis, atherosclerotic disease (ASCVD) its complications, methods lipid disorders diagnosis, prevention, treatment. Nowadays, almost 4 million deaths per year attributed to LDL-C, 2/3 all CVD ASCVD, therefore hypothetically should easily prevent few several with early intensive non-pharmacological pharmacological therapies. Moreover, lipidology now, besides oncology, area highest number new ongoing trials effective safe medications that already appeared will soon be available. Therefore, no doubt called prospective lowering therapies (LLTs). this State-of-the-Art paper summarized important trials, studies, recommendations LLTs, suitable graphical summaries might helpful for physicians their practice a look nearest future being under investigation. Let's hope those helps render dyslipidemia rare next years.

Language: Английский

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Targeting Lipoprotein(a): Can RNA Therapeutics Provide the Next Step in the Prevention of Cardiovascular Disease?

Cardiology and Therapy, Journal Year: 2024, Volume and Issue: 13(1), P. 39 - 67

Published: Feb. 21, 2024

Numerous genetic and epidemiologic studies have demonstrated an association between elevated levels of lipoprotein(a) (Lp[a]) cardiovascular disease. As a result, lowering Lp(a) is widely recognized as promising strategy for reducing the risk new-onset coronary heart disease, stroke, failure. consists low-density lipoprotein-like particle with covalently linked apolipoprotein A (apo[a]) B-100, which explains its pro-thrombotic, pro-inflammatory, pro-atherogenic properties. serum concentrations are genetically determined by apo(a) isoform, shorter isoforms having higher rate synthesis. To date, there no approved pharmacological therapies that effectively reduce levels. Promising treatment approaches targeting expression include RNA-based drugs such pelacarsen, olpasiran, SLN360, lepodisiran, currently in clinical trials. In this comprehensive review, we provide detailed overview therapeutic discuss recent advances challenges RNA therapeutics specifically designed to thus

Language: Английский

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Dyslipidaemia management in pregnant patients: a 2024 update

European Heart Journal Open, Journal Year: 2024, Volume and Issue: 4(3)

Published: April 25, 2024

Over several decades, the approach to treating dyslipidaemias during pregnancy remains essentially unchanged. The lack of advancement in this field is mostly related fact that we clinical trials pregnant patients both with available as well new therapies. While there are numerous novel therapies developed for non-pregnant patients, still many limitations dyslipidaemia treatment pregnancy. Besides pharmacotherapy and careful assessment, initiation behavioural modifications pre-conception management very important. Among various lipid-lowering medications, bile acid sequestrants only ones officially approved Ezetimibe fenofibrate can be considered if their benefits outweigh potential risks. Statins contraindicated, primarily due animal studies human case reports. However, recent systematic reviews meta-analyses data on familial hypercholesterolaemia (FH) have indicated use may not harmful could even beneficial certain selected cases. This especially relevant at high cardiovascular risk, such those who already experienced an acute event or homozygous severe forms heterozygous FH. In these cases, decision continue therapy should weigh risks discontinuation. Bempedoic acid, olezarsen, evinacumab, evolocumab alirocumab, inclisiran options consider just before after completed. conclusion, decisions regarding personalized. Despite challenges designing conducting women, a strong need establish safety efficacy

Language: Английский

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