European journal of preventive cardiology最新文献

{"title":"ASCVD Risk Stratification Using Apolipoprotein B and the LDL-C to Total Cholesterol Ratio.","authors":"Bin Wang, Nick S Nurmohamed, Jordan M Kraaijenhof, Dong Li","doi":"10.1093/eurjpc/zwag260","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag260","url":null,"abstract":"<p><strong>Background and aims: </strong>Low-density lipoprotein cholesterol (LDL-C) is causal for atherosclerotic cardiovascular disease (ASCVD), yet substantial risk heterogeneity persists across the LDL-C distribution. We tested whether LDL-related susceptibility is better explained by a dual-axis structure integrating ApoB-defined particle burden with LDL cholesterol composition captured by the LDL-C/total cholesterol (LDL-C/TC) ratio.</p><p><strong>Methods: </strong>We analyzed six US cohorts of adults without cardiovascular disease or receiving lipid-lowering therapy at baseline. ApoB and the LDL-C/TC ratio were dichotomized at 90 mg/dL and 0.60, respectively, to define four phenotypes. Incident ASCVD was assessed using multivariable Cox proportional hazards models, with prespecified subgroup analyses by age, sex, and clinical risk groups.</p><p><strong>Results: </strong>Among 9,238 ARIC participants (2,038 ASCVD events; median follow-up 25.6 years), ApoB and the Martin/Hopkins LDL-C/TC ratio showed stronger per-SD associations with ASCVD (adjusted hazard ratios [HRs] 1.20 and 1.27) than LDL-C levels. Cross-classification of ApoB and the LDL-C/TC ratio identified four phenotypes. Dual-normal participants exhibited the lowest ASCVD incidence, whereas the dual-elevated phenotype showed the highest risk (HR 1.67). Among discordant phenotypes, the low-ApoB/high-ratio group was associated with modestly higher risk (HR 1.28), while the high-ApoB/low-ratio phenotype demonstrated borderline associations.</p><p><strong>Conclusions: </strong>LDL-related atherogenic risk is more coherently explained by a dual-axis framework integrating ApoB-defined particle burden with LDL cholesterol composition captured by the LDL-C/TC ratio. This structure reveals composition-driven vulnerability not apparent from ApoB or contemporary risk scores and supports a scalable strategy in which routine ratio interpretation, coupled with selective ApoB testing, may enhance ASCVD risk stratification within preventive paradigms.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing alcohol consumption and cardiovascular disease by addressing bias in observational data: results from the Multi-Ethnic Study of Atherosclerosis.","authors":"Shantanu Srivatsa, Elizabeth K Farkouh, Tim Stockwell, James R Pike, James M Clay, Ganga Bey, Khurram Nasir, Matthew Budoff, Timothy Naimi, Michael E Farkouh","doi":"10.1093/eurjpc/zwag201","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag201","url":null,"abstract":"<p><strong>Background: </strong>Alcohol and its relationship with cardiovascular disease (CVD) remains contentious. Several observational studies have found cardio-protective associations, while Mendelian Randomization studies have found null or harmful effects of moderate drinking. Biases, including abstainer misclassification and sick quitter effects, may obscure true associations. It is widely understood that former drinkers are often sick quitters. However, removal of former drinkers from analyses addresses bias in the abstainer group but fails to account for induced survivorship among current drinkers. This study sought to determine whether adjusting for biases altered the association between alcohol and CVD by comparing conventional models with those using (1) occasional drinkers as the reference group instead of lifetime abstainers and (2) intention-to-treat (ITT) reallocation of former drinkers based on past drinking patterns.</p><p><strong>Methods: </strong>The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of 6,814 participants aged 45-84 years between 2000-2002 without baseline CVD. 6,755 participants were included after excluding those with missing data. Alcohol consumption was self-reported and classified as lifetime abstainer, former, or current drinker (occasional [≤1 drink/week], light [2-7 drinks/week], moderate [8-14 drinks/week], heavy [>14 drinks/week]). Outcomes included Coronary Artery Calcium (CAC) (0, 1-100, 101-300, and >300), and clinical events (MI, stroke, cardiovascular mortality, composite MACE, and heart failure).</p><p><strong>Results: </strong>Of 6,755 participants, 20.6% were lifetime abstainers, 24.1% former drinkers, and 55.3% current drinkers. Adjusting for biases altered the observed relationship between alcohol and CVD, showing increased harm with light drinking, decreased protection with moderate drinking, and a dose-response relationship between alcohol and CAC, particularly CAC >300 in adjusted models. Protective associations between moderate drinking and MI (HR: 0.64, 95% CI: 0.38-1.06) and cardiovascular mortality (HR: 0.81, 95% CI: 0.53-1.25) were attenuated and became non-significant. Light drinking shifted from null to increased risk for MI (HR: 1.46, 95% CI: 1.11-1.92), stroke (HR: 1.54, 95% CI: 1.17-2.03), MACE (HR: 1.33, 95% CI: 1.12-1.57), and heart failure (HR: 1.42, 95% CI: 1.10-1.84).</p><p><strong>Conclusions: </strong>Associations between alcohol and CVD in observational studies are sensitive to methodologic variation. Results from models correcting for abstainer/sick-quitter biases may help explain discrepant results from previous studies.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homozygous familial hypercholesterolemia: Will new LDL-C-lowering drugs replace lipoprotein apheresis?","authors":"Angela Pirillo, Alberico L Catapano","doi":"10.1093/eurjpc/zwag262","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag262","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a) Levels and Epicardial Adipose Tissue Volume in patients living with Diabetes: a discordant relationship. An observational study.","authors":"Antonio Gallo, Sopio Tatulashvili, Marouane Boubaya, Jean-François Perregaux, Emmanuelle Fabre, Imen Rezgani, Mohamed Lamine Mariko, Coralie Bloch-Queyrat, Pierre-Yves Brillet, Hélène Bihan, Emmanuel Cosson","doi":"10.1093/eurjpc/zwag256","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag256","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving beyond Low-Density Lipoprotein cholesterol: apolipoprotein B and Lipoprotein (a) for sex-specific risk assessment of aortic stenosis in the UK Biobank.","authors":"Wence Shi, Huiqiao Han, Jianqiu Pei, Cheng Ding, Younan Yao, Hongliang Zhang, Haiyan Xu, Yongjian Wu, Ziang Li, Bin Zhang","doi":"10.1093/eurjpc/zwag257","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag257","url":null,"abstract":"<p><strong>Background and aims: </strong>Lipid abnormalities-particularly low-density lipoprotein cholesterol (LDL-c) and lipoprotein(a) [Lp(a)]-have been implicated in aortic stenosis (AS), yet translation into clinically actionable risk assessment remains underdeveloped, especially regarding sex-specific evaluation. This study aims to quantify sex-specific associations between a comprehensive lipid profile and the risks of AS and aortic regurgitation (AR), and to identify the most informative markers and marker combinations for improved risk assessment.</p><p><strong>Methods: </strong>In 365,771 UK Biobank participants (mean age 56.1±8.07 years; 55.74% female) free of baseline cardiovascular disease. Routine lipid traits underwent hierarchical clustering and were related to incident AS and AR using sex-stratified Cox models. Discordance analyses and time-dependent concordance index were employed to compare risk assessment performance of different markers.</p><p><strong>Results: </strong>Hierarchical clustering revealed three clusters in both sexes-an apolipoprotein B (apoB)-containing cluster and an apolipoprotein A containing cluster-while Lp(a) occupied an independent branch. During a median follow-up of 13.8 years, there were 3118 incident AS and 1239 AR cases. Total cholesterol, apoB, LDL-c, non-high-density lipoprotein cholesterol in apoB-containing cluster and Lp(a) were each independently associated with higher AS risk in both sexes (all P < 0.01), with Lp(a) conferred additional sex-specific effect (P for interaction = 0.004). Discordance analyses showed that apoB outperformed LDL-c in association with AS. Addition of Lp(a) to ApoB or LDL-c improved AS risk prediction over either marker alone-especially in men. No lipid trait was associated with AR.</p><p><strong>Conclusion: </strong>ApoB may substitute for LDL-c as the primary particle-burden marker, whereas Lp(a) should be incorporated as an independent sex-specific risk enhancer in AS risk assessment. These results support sex-specific, multi-biomarker assessment to optimize AS risk stratification and future preventive strategies.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromuscular electrical stimulation of calf muscles for peripheral artery disease.","authors":"Mary M McDermott","doi":"10.1093/eurjpc/zwag255","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag255","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular-Kidney-Metabolic Syndrome in an Aging Population: What Does Frailty Add?","authors":"Aaron L Troy, Chiadi E Ndumele, John A Dodson","doi":"10.1093/eurjpc/zwag244","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag244","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeated Acute Reductions Do Not Equal Chronic Control: Interpreting the Magnitude of Apheresis effects of Lp(a).","authors":"Bahman Razi, Masoud Eslami, Saeed Aslani, Shahab Alizadeh, Alireza Hatami, Wael Almahmeed, Salim S Virani, Amirhossein Sahebkar","doi":"10.1093/eurjpc/zwag248","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag248","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrosis and hypertension: association but not causation.","authors":"Theodora Bejan-Angoulvant, Jean-Baptiste de Freminville","doi":"10.1093/eurjpc/zwaf198","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf198","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking Out of Silos and Leaning into Multidimensionality: A 24/7 Behavioral Cycle Paradigm for Cardiovascular Disease Prevention.","authors":"Nour Makarem","doi":"10.1093/eurjpc/zwag252","DOIUrl":"https://doi.org/10.1093/eurjpc/zwag252","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}