Journal of clinical lipidology最新文献

Familial hypercholesterolemia in Sri Lanka: Addressing evidence gaps and paving the road ahead. 斯里兰卡家族性高胆固醇血症：解决证据差距，铺平道路。

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-07-03 DOI: 10.1016/j.jacl.2025.06.025

Anne Thushara Matthias

引用次数: 0

Lipoprotein profiles across a spectrum of insulin signaling. 胰岛素信号的脂蛋白谱。

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-24 DOI: 10.1016/j.jacl.2025.06.003

Michael Hwang, Robert D Shamburek, Maureen Sampson, Brent S Abel, Marissa Lightbourne, Rebecca J Brown

{"title":"Lipoprotein profiles across a spectrum of insulin signaling.","authors":"Michael Hwang, Robert D Shamburek, Maureen Sampson, Brent S Abel, Marissa Lightbourne, Rebecca J Brown","doi":"10.1016/j.jacl.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.06.003","url":null,"abstract":"Background: Obesity and type 2 diabetes (T2D) are associated with insulin resistance (IR), a risk factor for atherosclerotic cardiovascular disease (ASCVD). In these conditions, IR affects only a subset of insulin signaling pathways, with preserved insulin signaling in others (termed \"pathway-selective IR\"). Consequently, individuals with obesity and T2D develop both hypertriglyceridemia from excess insulin signaling and hyperglycemia from insufficient insulin signaling.Objective: As IR involves biology mediated by both increased and decreased insulin signaling, we created a conceptual rare disease model to better understand whether ASCVD risk in states of IR is predominately driven by excessive insulin action, insufficient insulin action, or a combination of both.Methods: We compared nuclear magnetic resonance lipoprotein profiles (markers of ASCVD risk) in 14 patients (86% female, age 39 ± 17 years) with type B IR (TBIR), a disorder where autoantibodies against the insulin receptor block all insulin signaling (low insulin signaling), which is restored in remission (normal insulin signaling). Age and sex- matched patients with lipodystrophy were included to represent high insulin signaling.Results: Across the spectrum of insulin signaling, from lowest (TBIR active) to intermediate (TBIR remission) to highest (lipodystrophy), there were increases in all triglyceride-rich lipoprotein parameters. We also observed a shift toward smaller high-density lipoprotein (HDL) particles, with reciprocal decreases in large HDL-Ps and increases in small HDL-Ps across groups.Conclusion: Excess insulin signaling contributes to a proatherogenic lipoprotein profile. Interventions that downregulate or rebalance insulin signaling may offer cardiovascular benefits for individuals with severe (lipodystrophy) and mild (obesity and T2D) forms of pathway-selective IR.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discontinuation of lipid-modifying agents and failure to achieve target LDL cholesterol levels across cardiovascular risk groups. 停用脂质调节剂和未能达到心血管危险人群的目标LDL胆固醇水平

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-23 DOI: 10.1016/j.jacl.2025.06.010

Zhomart Orman, Jia Wei Koh, Caroline Trin, Zanfina Ademi, Ella Zomer, Sally Green, Danielle Berkovic, Jenni Ilomaki, J Simon Bell, Danny Liew, Christopher M Reid, Sean Lybrand, Brittany Schoeninger, Stella Talic

{"title":"Discontinuation of lipid-modifying agents and failure to achieve target LDL cholesterol levels across cardiovascular risk groups.","authors":"Zhomart Orman, Jia Wei Koh, Caroline Trin, Zanfina Ademi, Ella Zomer, Sally Green, Danielle Berkovic, Jenni Ilomaki, J Simon Bell, Danny Liew, Christopher M Reid, Sean Lybrand, Brittany Schoeninger, Stella Talic","doi":"10.1016/j.jacl.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.06.010","url":null,"abstract":"Background: Low-density lipoprotein cholesterol (LDL-C) control remains suboptimal, with limited evidence on how adherence to lipid-modifying agents (LMAs) varies by atherosclerotic cardiovascular disease (ASCVD) risk.Objective: To examine the relationship between LDL-C levels, adherence to LMAs, and ASCVD risk.Methods: Adults (n = 4,262) prescribed LMAs between 2013 and 2023 (median age 60 years, 49% male) were categorised into low (<5%), borderline (5% to <7.5%), intermediate (7.5% to <20%), and high (≥20%) 10-year ASCVD risk groups. Adherence was defined as having ≥1 prescription of LMA every 6 months, with adherence trajectories identified over 5 years using group-based trajectory analysis: gradual decline, rapid decline, and early discontinuation.Results: Average LDL-C decreased from 3.6 ± 1.1 mmol/L (139.2 ± 42.5 mg/dL) to 2.7 ± 1.1 mmol/L (104.4 ± 42.5 mg/dL) across all risk groups, with only 23% achieving <1.8 mmol/L (69.6 mg/dL) and 18% achieving ≥50% reduction. LDL-C was highest in the early discontinuation trajectory, across all ASCVD risk groups, averaging 2.9 mmol/L (112.1 mg/dL) in the low ASCVD risk group (42%), 2.8 mmol/L (108.3 mg/dL) in the borderline (13%), 2.5 mmol/L (96.7 mg/dL) in the intermediate (33%), and 2.3 mmol/L (88.9 mg/dL) in the high-risk group (11%). Higher LDL-C was associated with younger age, being male, non-smoking status, absence of diabetes, untreated blood pressure, early LMA discontinuation, higher total cholesterol ratio, and lower high-density lipoprotein cholesterol.Conclusion: Long-term adherence to LMAs remains a challenge, particularly in low-risk. Target achievement was poor, highlighting gaps in therapeutic optimization, patient engagement, and monitoring.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patients' and families' virtual care experiences for hypercholesterolemia management during the COVID-19 pandemic. COVID-19大流行期间患者和家属高胆固醇血症管理的虚拟护理体验

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-18 DOI: 10.1016/j.jacl.2025.06.013

Nita Chahal, Arnelle Lardizabal, Janet Rush, Christian Delayun, Rayan Rahman, Rita Nobile, Brian W McCrindle

{"title":"Patients' and families' virtual care experiences for hypercholesterolemia management during the COVID-19 pandemic.","authors":"Nita Chahal, Arnelle Lardizabal, Janet Rush, Christian Delayun, Rayan Rahman, Rita Nobile, Brian W McCrindle","doi":"10.1016/j.jacl.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.06.013","url":null,"abstract":"Background: Virtual care (VC) in an ambulatory pediatric lipid clinic was rapidly implemented in response to the COVID-19 pandemic, prompting health evaluation and to inform future care planning.Objective: To assess the impact of VC by analyzing longitudinal changes in lipid profiles and exploring patients' and parents' experiences through surveys and interviews.Methods: A descriptive, mixed-methods approach examined lipid biomarkers from patients who attended both in-person and VC appointments at a pediatric hospital in Toronto, Canada from 2020 to 2024. This included a retrospective chart review, postpandemic parent survey, and semi-structured interviews. Generalized estimating equations (GEE) were used to model repeated non-high-density lipoprotein (non-HDL) cholesterol levels over time, examining associations with the number of VC visits. The Six-Pillar Framework for VC guided the interview development and qualitative content analysis.Results: Among the 150 patients (mean age 11 years, SD = 3; 49% female), the trajectory of non-HDL cholesterol levels over time did not significantly differ between those with >3 VC visits and those with fewer visits. However, suboptimal lifestyle behavior patterns were associated with higher non-HDL cholesterol levels. Qualitative data (9 patients, 10 parents) revealed 4 themes: (1) convenient but less effective; (2) managing physical and psychosocial health, (3) situational acceptance, and 4) participant recommendations.Conclusions: While VC visit frequency alone was not associated with significant changes in non-HDL cholesterol over time, lifestyle factors remained important predictors of lipid outcomes. Recommendations suggested the importance of considering factors such as families' knowledge, privacy, availability of technology, and internet accessibility when planning VC.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Insights from a real-world experience with inclisiran at a large United States lipid clinic. 见解从现实世界的经验与inclisiran在一个大型的美国脂质诊所。

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-18 DOI: 10.1016/j.jacl.2025.06.015

Donya Mazdeyasnan, Antoinette Birs, Tommy Chiou, Lara Diano, Michael J Wilkinson

{"title":"Insights from a real-world experience with inclisiran at a large United States lipid clinic.","authors":"Donya Mazdeyasnan, Antoinette Birs, Tommy Chiou, Lara Diano, Michael J Wilkinson","doi":"10.1016/j.jacl.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.06.015","url":null,"abstract":"Background: Inclisiran is a Food and Drug Administration-approved small interfering RNA targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) that lowers low-density lipoprotein cholesterol (LDL-C) by ∼50% in clinical trials. Real-world studies with inclisiran are limited.Objective: Examine patient characteristics and the real-world safety and efficacy of inclisiran.Methods: From 3/2022 to 11/2023, 60 patients at University of California San Diego Health met inclusion criteria of at least one follow-up LDL-C measurement ≥30 days after initiating inclisiran. Patients were examined for baseline characteristics and follow-up lipid levels measured as part of routine medical care.Results: Patients were a mean (± SD) age of 71 ± 9.2 years, 31 (52%) were women, and 54 (90%) were White individuals. A total of 52 (87%) had a history of atherosclerotic cardiovascular disease. Mean ± SD LDL-C decreased 38% from 107 ± 47 mg/dL at baseline to 66 ± 41 mg/dL at first follow-up (P < .001). Excluding patients who switched from a PCSK9 inhibitor monoclonal antibody (PCSK9i mAb) within 1 month prior to starting inclisiran treatment (n = 12), a 45% decrease in LDL-C was observed (114 ± 45 mg/dL to 62 ± 41 mg/dL, P < .001). Excluding patients who switched from a PCSK9i mAb (n = 12) and patients on no background lipid-lowering therapy at time of inclisiran initiation (n = 9), LDL-C decreased 47% (102 ± 42 mg/dL to 54 ± 40 mg/dL, P < .001). Three patients (5%) reported mild side-effects that resolved by their second injection.Conclusion: Inclisiran in real-world practice was well-tolerated and patients on background lipid-lowering therapy who were not switching from a PCSK9i mAb to inclisiran observed LDL-C reductions of approximately 50%, consistent with clinical trials.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When 'good' cholesterol goes awry: Cross-sectional association of high HDL-C with prevalent sarcopenia in U.S. adults. 当“好”胆固醇出错时：高HDL-C与美国成年人普遍肌肉减少症的横断面关联。

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-16 DOI: 10.1016/j.jacl.2025.06.005

Rong-Zhen Xie, Xu-Song Li, Wei-Qiang Zhao, Yu-Feng Liang, Jiang Hua, Jie-Feng Huang

{"title":"When 'good' cholesterol goes awry: Cross-sectional association of high HDL-C with prevalent sarcopenia in U.S. adults.","authors":"Rong-Zhen Xie, Xu-Song Li, Wei-Qiang Zhao, Yu-Feng Liang, Jiang Hua, Jie-Feng Huang","doi":"10.1016/j.jacl.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.06.005","url":null,"abstract":"Background: Sarcopenia-the progressive loss of muscle mass and function-is linked to metabolic dysregulation. Although high-density lipoprotein cholesterol (HDL-C) is usually protective, emerging data suggest a \"U-shaped\" association with adverse outcomes. We examined the relation between HDL-C and sarcopenia and evaluated mediation by neutrophil-to-lymphocyte ratio (NLR) and homeostasis model assessment of insulin resistance (HOMA-IR).Methods: We analyzed 2167 National Health and Nutrition Examination Survey 2011 to 2014 adults (≥20 years) with complete dual-energy X-ray absorptiometry, grip-strength, and lipid data. Sarcopenia followed European Working Group on Sarcopenia in Older People 2 criteria. Survey-weighted logistic models progressed from age-sex-ethnicity (Model 1) to body mass index (BMI) (Model 2) and full socioeconomic and clinical covariates (Model 3). HDL-C was treated continuously and as 5 bands (<40, 40-50, 50-60, 60-70, >70 mg/dL). Bias-corrected bootstrap mediation tested indirect effects via NLR and HOMA-IR.Results: HDL-C was positively associated with sarcopenia in univariate analysis, but the relation disappeared after full adjustment; adding BMI reduced the coefficient by 23%. HDL-C > 70 mg/dL (n = 327) independently predicted sarcopenia (odds ratio: 1.04 per 1 mg/dL, 95% CI, 1.00-1.08). Lower strata were non-significant. NLR showed no mediation. HOMA-IR exerted a small, negative indirect effect (<1% of total).Conclusion: Extremely elevated HDL-C levels have been associated with an increased risk of sarcopenia, indicating a potentially complex underlying relationship. HOMA-IR may partially mediate this association, highlighting the need for further mechanistic investigations. These findings underscore the importance of considering insulin resistance and overall metabolic health in the assessment and management of sarcopenia risk.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sitosterolemia caused by compound heterozygosis of 2 allelic variants in the ABCG5 gene-21 years of follow-up. ABCG5基因中2个等位变异的复合杂合引起的谷固醇血症-21年随访

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-15 DOI: 10.1016/j.jacl.2025.06.007

Jean G V Coutinho, Ana C S Costa, Milka M M Issa, Neiva P Paim, Elisangela P S Quedas, Valeria S Nunes, Alexander A L Jorge, Edna R Nakandakare, Alexandre J F Carrilho

{"title":"Sitosterolemia caused by compound heterozygosis of 2 allelic variants in the ABCG5 gene-21 years of follow-up.","authors":"Jean G V Coutinho, Ana C S Costa, Milka M M Issa, Neiva P Paim, Elisangela P S Quedas, Valeria S Nunes, Alexander A L Jorge, Edna R Nakandakare, Alexandre J F Carrilho","doi":"10.1016/j.jacl.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.06.007","url":null,"abstract":"Background: Sitosterolemia is a rare autosomal recessive disease characterized by elevated phytosterol levels in the bloodstream and tissues due to increased absorption and reduced biliary excretion. This condition arises from mutations in one of two genes, ABCG5 or ABCG8, located on chromosome 2p21.Objective: We report the case of a patient, and his first-degree relatives, diagnosed with sitosterolemia at the age of 23.Methods: The patient was monitored for 21 years, during which he was advised to adopt a low-plant sterol diet and was treated with ezetimibe.Results: Over this period, he experienced resolution of splenomegaly and thrombocytopenia, stabilization or reduction in xanthoma growth, and absence of cardiovascular events. Despite these clinical improvements, plasma concentrations of campesterol and β-sitosterol remained above normal levels. Genetic analysis identified two variants in the ABCG5 gene (NM_022436.3): c.64C>T:p.(Gln22*) in exon 1 (rs781098379), a known pathogenic variant, and c.1217G>A p.(Arg406Gln) in exon 9 (rs375364242), described as likely pathogenic.Conclusion: We propose that the exon 9 variant is indeed pathogenic.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cholesteryl ester transfer protein activity correlates inversely with apolipoprotein A5 levels. 胆固醇酯转移蛋白活性与载脂蛋白A5水平呈负相关。

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-15 DOI: 10.1016/j.jacl.2025.06.008

Yi Wen, Hongxia Li, Sydney Smith, Yanzhu Lin, Yan Q Chen, Melissa Bellinger, Eugene Y Zhen, Thomas P Beyer, Robert W Siegel, Yuewei Qian, Giacomo Ruotolo, Robert J Konrad

{"title":"Cholesteryl ester transfer protein activity correlates inversely with apolipoprotein A5 levels.","authors":"Yi Wen, Hongxia Li, Sydney Smith, Yanzhu Lin, Yan Q Chen, Melissa Bellinger, Eugene Y Zhen, Thomas P Beyer, Robert W Siegel, Yuewei Qian, Giacomo Ruotolo, Robert J Konrad","doi":"10.1016/j.jacl.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.06.008","url":null,"abstract":"Background: Cholesteryl ester transfer protein (CETP) mediates the exchange of triglycerides (TG) from apolipoprotein B (ApoB)-containing lipoproteins to high-density lipoproteins (HDL) and the reciprocal exchange of cholesterol (C) from HDL to ApoB-containing lipoproteins. CETP inhibition increases HDL-C and decreases low-density lipoprotein cholesterol (LDL-C) while modestly decreasing TG. Considering that CETP inhibitors block removal of TG from TG-rich lipoproteins (TRL), it is interesting that CETP inhibition decreases TG concentrations. TG levels are largely regulated by lipoprotein lipase (LPL), the enzyme primarily responsible for hydrolyzing TG. The angiopoietin-like 3/8 complex (ANGPTL3/8) is the most potent circulating LPL inhibitor, while the TG-lowering apolipoprotein A5 (ApoA5) acts by suppressing ANGPTL3/8-mediated LPL inhibition.Methods: To better understand CETP biology, we studied the effects of CETP overexpression and CETP inhibition on the levels of ANGPTL3/8 and ApoA5 in circulation using dedicated immunoassays.Results: CETP-overexpressing transgenic mice had increased TG and normal ANGPTL3/8 levels but manifested dramatically reduced ApoA5 concentrations. Administration of the CETP inhibitor evacetrapib had no effect on ANGPTL3/8 levels in CETP-overexpressing mice or in humans. However, evacetrapib administration increased ApoA5 concentrations in both species. In human subjects, evacetrapib treatment increased circulating ApoA5 levels in the late-stage ACCELERATE and ACCENTUATE studies by 160.1% and 204.7%, respectively.Conclusions: Our results uncover a previously unrecognized link between CETP and ApoA5 by showing that CETP overexpression reduces ApoA5 levels while CETP inhibition increases ApoA5 concentrations.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Age and effect of intensive statin in acute mild ischemic stroke or transient ischemic attack: Subgroup analysis of the INSPIRES trial. 年龄和强化他汀类药物在急性轻度缺血性卒中或短暂性缺血性发作中的作用：inspire试验的亚组分析。

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-09 DOI: 10.1016/j.jacl.2025.05.016

Lingling Jiang, Yuanwei Wang, Ying Gao, S Claiborne Johnston, Pierre Amarenco, Philip M Bath, Hongyi Yan, Xuan Wang, Yingying Yang, Tingting Wang, Yuesong Pan, Yongjun Wang, Weiqi Chen, Yilong Wang

{"title":"Age and effect of intensive statin in acute mild ischemic stroke or transient ischemic attack: Subgroup analysis of the INSPIRES trial.","authors":"Lingling Jiang, Yuanwei Wang, Ying Gao, S Claiborne Johnston, Pierre Amarenco, Philip M Bath, Hongyi Yan, Xuan Wang, Yingying Yang, Tingting Wang, Yuesong Pan, Yongjun Wang, Weiqi Chen, Yilong Wang","doi":"10.1016/j.jacl.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.jacl.2025.05.016","url":null,"abstract":"Background: It is unclear whether immediate-intensive statin is safe and effective for patients age 65 years and older with acute cerebral ischemia associated with atherosclerosis.Methods: Patients from the Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis (INSPIRES) trial were divided into an elderly group (≥ 65 years, n = 2960) and a younger group (< 65 years, n = 3140). Primary exposures were age category and statin treatment allocation. The primary efficacy outcome (new stroke within 90 days), and the primary safety outcome (moderate-to-severe bleeding), were analyzed through Cox proportional hazards models. Secondary outcomes included composite vascular event and any bleeding (Cox regression), plus poor functional outcome (binary logistic regression). Age-treatment interactions were tested by Cox models.Results: In elderly patients, higher proportions of stroke (hazard ratio [HR], 1.22; 95% CI, 1.02-1.47; P = .03), composite vascular event (HR, 1.26; 95% CI, 1.05-1.51; P = .01), poor functional outcome, and any bleeding were observed. Specifically, 124 (8.3%) elderly patients who received immediate statin therapy and 138 (9.4%) patients with delayed statin therapy experienced a stroke within 90 days, while in younger patients, 121 (7.7%) patients with immediate statin therapy and 118 (7.5%) patients with delayed statin therapy suffered a new stroke. There were no age and treatment interactions for risk of new stroke, moderate-to-severe bleeding, composite vascular event, poor functional outcome, and any bleeding events.Conclusion: Immediate vs delayed intensive statin therapy demonstrates comparable safety and treatment response profiles in older and younger patients.","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Shorter prepubertal children have higher cholesterol levels. 较矮的青春期前儿童胆固醇水平较高。

IF 3.6 3区医学

Journal of clinical lipidology Pub Date : 2025-06-06 DOI: 10.1016/j.jacl.2025.05.025

Jan Kafol, Mia Becker, Urh Groselj

引用次数: 0