Journal of atherosclerosis and thrombosis最新文献

{"title":"Effects of Nutritional Guidance on Acute Myocardial Infarction: A Retrospective Cohort Study.","authors":"Hiroshi Abe, Tetsuro Miyazaki, Takamasa Suzuki, Mari Sumiyoshi, Tomaru Masato, Midori Kakihara, Masaaki Maki, Ryosuke Shimai, Hiroyuki Isogai, Dai Ozaki, Yuki Yasuda, Fuminori Odagiri, Kiyoshi Takasu, Kazuhisa Takamura, Makoto Hiki, Takashi Tokano, Tohru Minamino","doi":"10.5551/jat.66235","DOIUrl":"https://doi.org/10.5551/jat.66235","url":null,"abstract":"<p><strong>Aim: </strong>This retrospective cohort study aimed to investigate the impact of nutritionist-led dietary guidance on the prognosis of patients with acute myocardial infarction (AMI).</p><p><strong>Methods: </strong>The cohort encompassed 446 consecutive patients with AMI in a single center who underwent emergency coronary angiography and percutaneous coronary interventions from September 1, 2015 to October 31, 2023.</p><p><strong>Results: </strong>Based on defined caloric intake and macronutrient ratios, 54.7% of the patients received nutritional guidance during hospitalization. During a 39-month median follow-up, this study documented 24 (5.9%) and 6 (1.5%) cases of all-cause and cardiovascular mortality, respectively. Furthermore, among the components of the primary composite endpoint, 15 (3.7%), 17 (4.2%), and 20 (4.9%) cases of nonfatal stroke, nonfatal acute coronary syndrome, and hospitalizations for acute decompensated heart failure, respectively, were noted. Kaplan-Meier curves demonstrated that patients without nutritional guidance showed significantly higher incidence rates of mortality and primary composite endpoints. Considering multiple variables, the multivariate Cox regression model identified nutritional guidance as a significant predictor for long-term mortality but not for primary composite endpoints. Patients receiving nutritional guidance exhibited significantly improved albumin and C-reactive protein levels, with a trend toward better survival rate.</p><p><strong>Conclusion: </strong>This study suggests that by addressing dietary factors influencing inflammation and lipid metabolism, structured nutritional guidance can enhance prognosis in patients with AMI. To delineate the dietary components most beneficial for patients with AMI, further research is warranted.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619856","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":"Non-fasting and Fasting Triglyceride Levels and the Risk of Diabetes Mellitus: The Circulatory Risk in Communities Study.","authors":"Jiaqi Li, Hironori Imano, Kazumasa Yamagishi, Mari Tanaka, Mina Hayama-Terada, Isao Muraki, Yuji Shimizu, Tetsuya Ohira, Mitsumasa Umesawa, Tomoko Sankai, Takeo Okada, Masahiko Kiyama, Akihiko Kitamura, Takeshi Tanigawa, Hiroyasu Iso","doi":"10.5551/jat.66064","DOIUrl":"https://doi.org/10.5551/jat.66064","url":null,"abstract":"<p><strong>Aims: </strong>Non-fasting triglyceride measurements have become increasingly common in screening for atherosclerotic cardiovascular disease. However, evidence of its predictive value for diabetes mellitus is limited to only a few studies.</p><p><strong>Methods: </strong>This prospective cohort study included two groups of individuals aged 40-74 years without diabetes mellitus: 7,673 who provided non-fasting blood samples and 4,055 who provided fasting samples. We used annual health checkup data to identify new cases of diabetes mellitus, employed Cox proportional hazard models to estimate hazard ratios, and conducted decision curve analyses to assess clinical utility.</p><p><strong>Results: </strong>During a median follow-up of 13 years, 727 and 444 participants were diagnosed with diabetes mellitus in the non-fasting and fasting groups, respectively. After adjusting for the glucose levels and other potential confounders measured at baseline, both non-fasting and fasting triglyceride levels were positively associated with the hazard of diabetes mellitus; the hazard ratios (95% confidence intervals) for the highest versus lowest quartiles were 1.99 (1.50-2.64) and 1.58 (1.11-2.26), respectively. Adding non-fasting or fasting triglyceride levels to a model based on traditional predictors can slightly improve the net benefit for 15-year risk prediction, corresponding to an approximate gain of 1 to 2 additional individuals per 1,000 screened. The improvement was slightly greater under non-fasting conditions than under fasting conditions.</p><p><strong>Conclusion: </strong>Both the non-fasting and fasting triglyceride levels were associated with an increased hazard of diabetes mellitus. Adding the triglyceride levels can therefore provide modest but potentially useful supplementary information for diabetes prediction, particularly under non-fasting conditions.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455957","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":"Association between the Lactate-to-hematocrit Ratio and the Outcomes in Ischemic Stroke Patients: Insights from MIMIC-IV.","authors":"Yumiao Teng, Qing Wang","doi":"10.5551/jat.65917","DOIUrl":"https://doi.org/10.5551/jat.65917","url":null,"abstract":"<p><strong>Aims: </strong>Ischemic stroke (IS) is a leading global cause of death and disability. The lactate-to-hematocrit ratio (LHR), which potentially reflects the oxygen metabolism and tissue perfusion, has not yet been sufficiently studied for IS prognosis prediction. To investigate the association between LHR and the 28-day all-cause mortality in patients with IS.</p><p><strong>Methods: </strong>This MIMIC-IV database-based study included 866 patients with IS. Kaplan-Meier curves were used to compare survival between the log (LHR) subgroups. Multivariate Cox regression was performed with adjustment for the Glasgow Coma Scale (GCS) score, and robustness verification was further implemented by controlling for the SOFA score. An RCS analysis was used to explore the underlying nonlinear associations, followed by subgroup and mediation analyses.</p><p><strong>Results: </strong>A survival analysis demonstrated a significantly higher 28-day mortality in log (LHR)≥ 2.32 than in the log (LHR) ＜2.32 groups (log-rank P = 0.017). In the Cox regression analysis with full adjustment for confounding factors, for every unit increase in log (LHR), the 28-day mortality risk increased by 38.1% (HR = 1.381, 95% CI: 1.111-1.718). The mortality risk of patients with log (LHR) ≥ 2.32 increased by 47.8% compared to those with log (LHR) ＜2.32 (HR = 1.478, 95% CI: 1.075-2.031). The RCS analysis showed no significant non-linear relationship between log (LHR) and the 28-day mortality rate (P-non-linear = 0.859). No significant interaction was observed in the subgroup analyses, and the relevant associations remained statistically significant within the severe stroke subgroup. After adjusting for the GCS and SOFA scores, the independent prognostic value of log (LHR) remained consistent. A mediation analysis showed that white blood cell count (mediation ratio, 33.54%) and blood urea nitrogen (mediation ratio, 18.69%) partially mediated the relationship between log (LHR) and mortality risk. The original LHR was also independently correlated with the mortality rate (HR = 1.018, 95% CI: 1.006-1.030).</p><p><strong>Conclusions: </strong>LHR was positively correlated with 28-day mortality in patients with IS, independent of stroke severity, sepsis, and systemic organ failure, and inflammation, and renal dysfunction may jointly mediate this association. As an easily accessible composite indicator, LHR has potential clinical application value in early risk stratification.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455996","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":"Pyruvate kinase M2 and Serine Dehydratase are Upregulated in the Macrophages of Human Aortic Atherosclerotic Lesions via Inflammatory Stimuli.","authors":"Eriko Nakamura, Masanori Nishimura, Kazunari Maekawa, Toshihiro Gi, Nobuyuki Oguri, Murasaki Aman, Sayaka Moriguchi-Goto, Michikazu Nakai, Koji Furukawa, Atsushi Yamashita","doi":"10.5551/jat.66119","DOIUrl":"https://doi.org/10.5551/jat.66119","url":null,"abstract":"<p><strong>Aim: </strong>An altered vascular metabolism is closely linked to the cellular function in atherosclerotic lesions. The plasma pyruvate levels have been associated with aortic aneurysm progression in clinical studies. Pyruvate kinase M2 (PKM2) and serine dehydratase (SDS) catalyze the final steps of pyruvate production. While PKM2's role has been examined in experimental atherosclerosis or aneurysms, the involvement of SDS in atherosclerosis and the expression of PKM2 and SDS in human aortic lesions remain unknown.</p><p><strong>Methods: </strong>Human aortic samples from vascular surgery were classified as early (n = 10), advanced (n = 9), or aneurysmal (n = 15) lesions. PKM2 and SDS expression were analyzed using immunohistochemistry.</p><p><strong>Results: </strong>Immunopositive areas for these enzymes were larger in advanced and aneurysmal lesions than in early lesions and were predominantly expressed in macrophages. PKM2 was also detected in some smooth muscle cells and lymphocytes. In cultured human monocyte-derived macrophages, stimulation with tumor necrosis factor-α and interferon-γ increased the PKM2 and SDS expression levels. PKM2 silencing enhanced monocyte chemoattractant protein-1, interleukin-6, and SDS expression, and reduced transforming growth factor-β expression. SDS silencing significantly reduced the reactive oxygen species levels.</p><p><strong>Conclusions: </strong>The PKM2 and SDS expression levels increase in advanced human aortic atherosclerotic lesions and they are predominantly expressed in macrophages. The inflammatory microenvironment in atherosclerotic lesions upregulates the PKM2 and SDS expression in human macrophages. PKM2 may act as a negative regulator of vascular inflammation, and SDS may affect oxidative stress in inflammatory-stimulated macrophages.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411969","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":"Isolated Low Levels of High-density Lipoprotein Cholesterol are Associated with an Increased Risk of Ischemic Cardiovascular Events: The Shizuoka Kokuho Database Study.","authors":"Yasuharu Tabara, Sayaka Nagao-Sato, Aya Shoji-Asahina, Yoko Sato","doi":"10.5551/jat.66249","DOIUrl":"https://doi.org/10.5551/jat.66249","url":null,"abstract":"<p><strong>Aim: </strong>Isolated low high-density lipoprotein cholesterol (HDL-C) refers to low HDL-C levels with normal levels of triglycerides and low-density lipoprotein cholesterol. However, its prognostic significance remains controversial. This study aimed to investigate the association between isolated low HDL-C levels and the incidence of stroke and coronary artery disease (CAD).</p><p><strong>Method: </strong>This study included 496,973 Japanese individuals (mean age: 66.4 years) enrolled in municipal health insurance programs. Data on baseline clinical characteristics and cardiovascular outcomes were obtained from annual health checkup and health insurance claims data, respectively. Isolated low HDL-C was defined as HDL-C ＜40 mg/dL with normal levels of triglyceride and low-density lipoprotein cholesterol (LDL-C).</p><p><strong>Result: </strong>The frequency of isolated low HDL-C was 1.3%. Isolated low HDL-C was independently associated with the CAD incidence (hazard ratio [HR] = 1.87, P＜0.001). This association remained significant in age- and sex-separate analyses, as well as in the analysis of participants who were not taking lipid-lowering drugs and had severe comorbidities at baseline. Conversely, isolated low HDL-C levels were not associated with the incidence of ischemic stroke (HR = 1.08, P = 0.266) or hemorrhagic stroke (HR = 1.16, P = 0.223) in all participants. However, it showed a significant association with ischemic stroke in the subgroup analysis of those aged ＜65 years (HR = 2.21, P＜0.001) and men (HR = 1.17, P = 0.035).</p><p><strong>Conclusion: </strong>Isolated low HDL-C was associated with the incidence of CAD and ischemic stroke despite normal plasma levels of triglyceride and low-density lipoprotein cholesterol.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390826","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":"Knowledge Gaps and Nonadherence Among Japanese Patients with Atherosclerotic Cardiovascular Disease.","authors":"Mitsutoshi Toda, Kazuma Iekushi, Yuri Takahashi, Shun Kohsaka","doi":"10.5551/jat.66074","DOIUrl":"https://doi.org/10.5551/jat.66074","url":null,"abstract":"<p><strong>Aim: </strong>Reducing low-density lipoprotein cholesterol (LDL-C) levels is crucial for preventing atherosclerotic cardiovascular disease (ASCVD). Recommended lipid-lowering therapy (LLT) includes both oral (e.g., statins) and injectable agents. However, patient awareness of LDL-C management and adherence to it remain uncertain.</p><p><strong>Methods: </strong>This cross-sectional study surveyed 415 Japanese patients with ASCVD using a web-based platform. The participants reported their understanding of LDL-C target values and the effects of LLT. Medication adherence was evaluated using the Extent of Nonadherence scale, and a binomial logistic regression analysis was performed to identify the factors associated with nonadherence.</p><p><strong>Results: </strong>Approximately 58.1%-60.2% of the participants reported confidence in knowing their correct lipid target values and managing dyslipidemia appropriately. However, only 22.2% reported LDL-C targets of ＜50 or ＜70 mg/dL, and 43.4% believed their targets to be ＜50, ＜70, or ＜100 mg/dL. In contrast, 56.7% either reported LDL-C targets of ＜120, ＜140, or ＜160 mg/dL or did not know their targets. Regarding LLT, 65.8% were unaware that extreme lowering of LDL-C levels with LLT had no disadvantages, and 74.2% were unaware that injectable LLTs were available. Overall, 39.0% of the participants were nonadherent. Higher out-of-pocket costs (≥ 3,001 yen; adjusted odds ratio [OR]: 1.83, p = 0.024) and experience with self-injections (adjusted odds ratio: 2.34, p = 0.027) were significantly associated with nonadherence.</p><p><strong>Conclusions: </strong>Our findings highlight a considerable gap in patient knowledge and adherence to dyslipidemia management strategies. Interventions that promote patient education and shared decision-making are essential for improving adherence and achieving optimal LDL-C targets.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368541","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":"Switching from Conventional Fibrates to Pemafibrate Improves Lipid Profiles, Liver Enzymes, Renal Function, and Fibrosis Markers in Dyslipidemic Patients with MASLD: A Multicenter Real-World Study.","authors":"Takao Sato, Toshihiro Miyamoto, Ryoma Fukuoka, Kazumasa Sugimoto, Yoko Tanimoto, Takashi Nakayama, Kojiro Tanimoto, Koichiro Sugimura, Yoshihide Fujimoto, Takahiko Kiyooka, Akio Kawamura","doi":"10.5551/jat.66030","DOIUrl":"10.5551/jat.66030","url":null,"abstract":"<p><strong>Aims: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent worldwide. Conventional fibrates effectively lower triglycerides but may elevate liver enzymes and creatinine, limiting long-term use. Pemafibrate, a selective PPARα modulator (SPPARMα), offers potent triglyceride reduction with favorable hepatic and renal safety. This study evaluated the effects of switching from conventional fibrates to pemafibrate on lipid profiles, liver enzyme, fibrosis indices(Fibrosis-4 index) with particular emphasis on renal safety in clinical practice.</p><p><strong>Methods: </strong>We retrospectively analyzed 144 patients with dyslipidemia, including those with MASLD or chronic kidney disease, who were switched from bezafibrate 200mg (N = 24) or 400mg (N = 30), or fenofibrate 80mg (N = 51) or 160mg (N = 39), to pemafibrate (0.2mg/day). Laboratory parameters were assessed at baseline and 6 months post-switch.</p><p><strong>Results: </strong>Triglycerides decreased significantly, particularly in the bezafibrate 200 mg and fenofibrate 80 mg groups, while other lipid profiles remained stable. Serum alanine aminotransferase decreased significantly with bezafibrate 200mg (29±27 to 17±13U/L, p＜0.05) and fenofibrate 80mg (26±18 to 20±10 U/L, p＜0.05), whereas treatment with bezafibrate (400mg) and fenofibrate (160mg) showed a trend toward reduction. The glutamyl transferase showed a similar trend. The Fibrosis-4 index showed reductions across all groups, reaching statistical significance in bezafibrate200mg (1.51±0.63→1.36±0.47, p = 0.02) and fenofibrate 80mg (1.17±0.37→1.07±0.33, p = 0.001). Renal function remained stable across all groups, with no clinically significant deterioration in estimated glomerular filtration rate, supporting the renal safety of pemafibrate.</p><p><strong>Conclusion: </strong>Switching from conventional fibrates to pemafibrate improved triglyceride levels, liver enzymes, and fibrosis indices in patients with MASLD, while maintaining a favorable renal safety profile.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"968-978"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy with Evolocumab among Japanese Patients in PROFICIO: A Pooled Analysis of 1,040 Patients.","authors":"Kazuma Oyama, Masayuki Yoshida, Arihiro Kiyosue, Nobuhiro Osada, Feng Sheng, Naozumi Harada, Kazumasa Miyawaki, Junichiro Shimauchi, Yang Fu, Shizuya Yamashita","doi":"10.5551/jat.66069","DOIUrl":"10.5551/jat.66069","url":null,"abstract":"<p><strong>Aims: </strong>Lowering low-density lipoprotein cholesterol (LDL-C) is essential for reducing the risk of atherosclerotic cardiovascular disease (ASCVD). This study assessed the clinical efficacy of evolocumab, a human monoclonal antibody targeting PCSK9, in Japanese patients using data from the PROFICIO program.</p><p><strong>Methods: </strong>Data were pooled from Japanese participants enrolled in five clinical trials: YUKAWA-1, YUKAWA-2, OSLER-1, OSLER-2, and FOURIER. The primary endpoint was percent change in LDL-C from baseline to Week 12. Secondary endpoints included changes in other lipid parameters, achievement of LDL-C targets, incidence of major adverse cardiovascular events (MACE), and subgroup analyses.</p><p><strong>Results: </strong>A total of 1,040 patients with high cardiovascular risk or established ASCVD were included. At Week 12, the mean percent reduction in LDL-C was 75.7% with evolocumab compared with 1.3% with placebo (least-square mean treatment difference: ‑75.0%; 95% confidence interval [CI]: -76.7 to -73.4; p＜0.001), which was consistent across subgroups. Other lipid parameters showed directionally consistent percent changes, with variable magnitudes across markers. Overall, 92.9% of patients treated with evolocumab achieved an LDL-C ＜55 mg/dL at Week 12 compared with 0.8% of patients in the placebo group. In FOURIER, over a median follow-up of 2.1 years, incidence of MACE was lower with evolocumab than placebo (5.9% vs. 12.4%; hazard ratio: 0.47; 95% CI: 0.24-0.92). Treatment effects on MACE were consistent in both primary and secondary prevention groups (pooled odds ratio: 0.42; 95% CI: 0.23-0.79).</p><p><strong>Conclusion: </strong>Evolocumab significantly and consistently lowered LDL-C and reduced the risk of MACE in Japanese patients.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"979-991"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Clinical Characterization and Therapeutic Strategies between Homozygous Familial Hypercholesterolemia and Heterozygous Familial Hypercholesterolemia.","authors":"Daisuke Shishikura, Mariko Harada-Shiba, Masahito Michikura, Kenta Sakaguchi, Hirofumi Kusumoto, Shimpei Fujioka, Tomohiro Fujisaka, Yumiko Kanzaki, Hideaki Morita","doi":"10.5551/jat.65959","DOIUrl":"10.5551/jat.65959","url":null,"abstract":"<p><strong>Aims: </strong>Homozygous Familial hypercholesterolemia (HoFH) is a rare genetic disease characterized by very high levels of low-density lipoprotein cholesterol (LDL-C). Owing to LDL receptor activity being completely or nearly all lost in HoFH, LDL-C levels greatly exceed normal levels, and are even higher than in heterozygous (HeFH), which can cause fatal cardiovascular disease even in infancy. The current study updates differences in clinical characterization, therapeutic strategies and cardiovascular outcomes between HoFH and HeFH.</p><p><strong>Methods: </strong>A total of 157 patients who were genetically or clinically diagnosed with FH (HoFH: 15, HeFH: 142) were retrospectively analyzed. Clinical characteristics, lipid profiles and atherosclerotic prognosis were evaluated between HoFH and HeFH patients.</p><p><strong>Results: </strong>Age and sex were similar between the two groups. Untreated LDL-C in HoFH was about double that in HeFH (498.4±164.3 vs. 232.0±60.5 mg/dL, p＜0.001), while on-treatment LDL-C with lipid lowering therapies did not differ significantly (83.8±59.1 vs. 127.1±59.6 mg/dL, p = 0.15). There was wide diversity in lipid lowering therapies between the two groups and a significantly higher prevalence of coronary artery and valvular disease in HoFH. Consequently, HoFH patients were more likely to receive percutaneous and surgical interventions at a younger age compared to HeFH patients.</p><p><strong>Conclusions: </strong>The findings of this observational study show the clinical relevance of FH. Although both HeFH and HoFH are inherited disorders of lipoprotein metabolism, HoFH should be treated with a different, stricter therapeutic strategy to prevent premature ASCVD.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"884-894"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Improved Prognosis in Subjects With Homozygous Familial Hypercholesterolemia Associated With Advances in LDL-Lowering Therapy.","authors":"Hayato Tada, Masayuki Takamura","doi":"10.5551/jat.ED302","DOIUrl":"10.5551/jat.ED302","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"882-883"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}