Journal of clinical lipidology最新文献

{"title":"ApoB, LDL-C, and non-HDL-C as markers of cardiovascular risk","authors":"Daniel Sehayek MD ,&nbsp;Justine Cole MD ,&nbsp;Elias Björnson PhD ,&nbsp;John T. Wilkins MD ,&nbsp;Martin B. Mortensen MD ,&nbsp;Line Dufresne MSc ,&nbsp;Karol M. Pencina PhD ,&nbsp;Michael J. Pencina PhD ,&nbsp;George Thanassoulis MD ,&nbsp;Allan D. Sniderman MD","doi":"10.1016/j.jacl.2025.05.024","DOIUrl":"10.1016/j.jacl.2025.05.024","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Conventional statistical approaches are not designed to compare highly correlated variables such as low-density lipoprotein cholesterol (LDL-C), non-high density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB). Discordance analysis was designed to overcome this limitation by creating groups in which the predictions of 2 markers differ.</div></div><div><h3>OBJECTIVE</h3><div>This systematic review compiled all discordance studies that compare the predictive powers of LDL-C and non-HDL-C vs LDL particle number (LDL P) or apoB as markers of atherosclerotic disease risk to determine which is the most accurate marker of cardiovascular risk.</div></div><div><h3>METHODS</h3><div>A PubMed search completed September 30, 2024, identified 15 studies involving 593,354 participants. These studies encompassed diverse populations, and included patients with and without statin therapy. Several variations of discordance analysis were used including median-based, percentile-based, residual-based, and variance-based approaches.</div></div><div><h3>RESULTS</h3><div>ApoB outperformed LDL-C in 9 of 9 studies whereas LDL P was superior to LDL-C in 2 of 3 comparisons. In 1 study, non-HDL-C was superior to apoB, in 1 study apoB and non-HDL-C were equivalent, whereas in 7 studies, apoB, overall, was a significantly more accurate marker of atherosclerotic cardiovascular disease risk than non-HDL-C.</div></div><div><h3>CONCLUSION</h3><div>Discordance analysis provides robust evidence that apoB is a more accurate marker of cardiovascular risk than either LDL-C or non-HDL-C, notwithstanding these variables are highly intercorrelated. Thus, neither LDL-C nor non-HDL-C are adequate clinical surrogates for apoB. Accordingly, apoB should be the primary measure in clinical care to estimate the cardiovascular risk attributable to the apoB lipoproteins and the adequacy of lipid-lowering therapy to reduce this risk.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 844-859"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667681","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}

{"title":"JCL Roundtable: Dietary recommendations and intermittent fasting and time-restricted eating","authors":"Kevin C. Maki PhD, CLS, MNLA, FTOS, FAHA ,&nbsp;Carol F. Kirkpatrick PhD, MPH, RDN, CLS, FNLA ,&nbsp;Michael J. Wilkinson MD, FACC, FNLA ,&nbsp;Kristina S. Petersen PhD, APD, FAHA","doi":"10.1016/j.jacl.2025.02.018","DOIUrl":"10.1016/j.jacl.2025.02.018","url":null,"abstract":"<div><div><span><span>Lifestyle intervention is the cornerstone of the prevention of atherosclerotic cardiovascular disease (ASCVD). Several health authorities and scientific organizations have provided dietary guidance for </span>ASCVD prevention<span><span>, including recommendations for healthful dietary patterns. Recently, intermittent fasting and time-restricted eating (TRE) have become popular dietary approaches. Findings from clinical studies suggest that intermittent fasting and TRE may result in improvements in cardiometabolic </span>risk factors, especially in patients with metabolic dysfunction. This </span></span><em>Journal of Clinical Lipidology</em> Roundtable presents a conversation between Drs. Carol F. Kirkpatrick, Kevin C. Maki, Kristina S. Petersen, and Michael J. Wilkinson about dietary recommendations, intermittent fasting, and TRE. The discussion highlights the current dietary recommendations for ASCVD prevention and the potential roles of intermittent fasting and TRE for improving cardiometabolic health.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 748-758"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674085","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}

{"title":"Achievement of low-density lipoprotein cholesterol thresholds in very high-risk atherosclerotic cardiovascular disease","authors":"Elisa A. Worledge PharmD ,&nbsp;Sarah J. Billups PharmD ,&nbsp;Oliver J. Titus MS ,&nbsp;Joseph J. Saseen PharmD, MNLA, CLS","doi":"10.1016/j.jacl.2025.04.186","DOIUrl":"10.1016/j.jacl.2025.04.186","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The 2022 American College of Cardiology Expert Consensus Decision Pathway on the Role of Nonstatin Therapies recommended more aggressive management of low-density lipoprotein cholesterol (LDL-C) compared to the 2018 American Heart Association/American College of Cardiology/Multisociety Guideline. In congruence with European guidelines, a target LDL-C threshold of 55 mg/dL is recommended for patients with very high-risk atherosclerotic cardiovascular disease (ASCVD). Real-world status of the early implementation of this recommendation remains uncertain.</div></div><div><h3>OBJECTIVE</h3><div>To determine the proportion of patients with very high-risk ASCVD achieving an LDL-C &lt;55 mg/dL and characterize differences between patients who did and did not achieve this LDL-C value.</div></div><div><h3>METHODS</h3><div>This retrospective cohort study evaluated patients between January 1, 2023, and December 31, 2023, who were ≥ 18 years old with very high-risk ASCVD from the University of Colorado Health system primary care practices. Very high-risk ASCVD was defined as a history of a major ASCVD event with at least 2 high-risk conditions.</div></div><div><h3>RESULTS</h3><div>A total of 8974 patients met inclusion criteria for very high-risk ASCVD. Of these, only 21.0% achieved an LDL-C &lt;55 mg/dL, while 39.5% of patients achieved the previously recommended LDL-C threshold of &lt;70 mg/dL. More than half of patients were prescribed a high-intensity statin-based regimen.</div></div><div><h3>CONCLUSION</h3><div>Within a large, academic health-system, achievement of LDL-C threshold among patients with very high-risk ASCVD was low. Recommendations from the 2022 ACC Expert Consensus Decision Pathway that endorse more aggressive LDL-C lowering and emphasize nonstatin therapies as an adjunct to statins are not fully implemented in real-world clinical practice.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 860-868"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020184","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}

{"title":"A qualitative study to explore the patient experience of hypertriglyceridemia-related acute pancreatitis","authors":"Asia Sikora Kessler PhD ,&nbsp;Daniel Aggio PhD ,&nbsp;Ellen M. Howard PhD ,&nbsp;Daniel E. Soffer MD ,&nbsp;Jordi Alonso MD, PhD ,&nbsp;Sarah Acaster MSc ,&nbsp;Kate Williams PhD","doi":"10.1016/j.jacl.2025.04.190","DOIUrl":"10.1016/j.jacl.2025.04.190","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Hypertriglyceridemia (HTG) is a common cause of acute pancreatitis (AP) and can be exacerbated by acquired metabolic conditions or rare inherited disorders (eg, familial chylomicronemia syndrome [FCS]), leading to HTG-induced AP (HTG-AP). HTG-AP is associated with severe abdominal pain typically requiring hospitalization and significantly impacts health-related quality of life (HRQoL).</div></div><div><h3>OBJECTIVE</h3><div>To understand patients’ perspectives on the HRQoL impacts of HTG-AP.</div></div><div><h3>METHODS</h3><div>Interviews were conducted with adults with severe/very severe HTG and/or FCS, experiencing ≥1 HTG-AP episode in the past 2 years requiring an overnight hospitalization. An interview guide, developed with patient and clinical expert input, explored symptoms, long-term HRQoL impacts, and management of HTG-AP. Participants completed a background questionnaire, the EQ-5D-5L and select items from the PROMIS Profile v1.0-FCS 28 prior to interview. Interview transcripts were analyzed using thematic and content analysis.</div></div><div><h3>RESULTS</h3><div>Twelve participants completed the study (aged 32-66 years), 3 with genetically confirmed FCS. Participants described a sudden onset of HTG-AP episodes and a gradual recovery following medical intervention (up to several weeks). Participants described substantial symptomatic burden during episodes, including severe abdominal pain, fatigue, gastrointestinal symptoms, fever, and appetite loss. These impacted psychological wellbeing, relationships, and daily activities. Many of the symptoms and impacts on HRQoL (eg, pain, work impacts) persisted between episodes and had long-term effects. Participants reported substantial lifestyle restrictions (eg, dietary) to manage symptoms.</div></div><div><h3>CONCLUSION</h3><div>HTG-AP has a substantial symptomatic and HRQoL burden during episodes, which can persist postrecovery. Treatments that reduce the incidence of HTG-AP have potential to improve HRQoL.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 931-941"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086274","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}

{"title":"Evaluation of lipid-lowering therapy in patients with elevated lipoprotein(a) levels","authors":"Michael S. Kelly PharmD ,&nbsp;Ruth N. Jeminiwa PhD ,&nbsp;Fatima Gohar BS ,&nbsp;Mario Fanous BS ,&nbsp;Pablo Ramirez BS ,&nbsp;Dave L. Dixon PharmD","doi":"10.1016/j.jacl.2025.04.200","DOIUrl":"10.1016/j.jacl.2025.04.200","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Elevated lipoprotein(a) (Lp(a)) is a recognized independent risk factor for atherosclerotic cardiovascular disease (ASCVD) and other cardiovascular-related disorders. To mitigate the increased risk associated with elevated Lp(a), intensified treatment is recommended for modifiable ASCVD risk factors, such as hypertension, hyperglycemia, and dyslipidemia. However, limited evidence has assessed how clinicians are modifying lipid-lowering therapy in response to elevated Lp(a) levels.</div></div><div><h3>OBJECTIVE</h3><div>To evaluate changes to lipid-lowering therapy and assess which patient characteristics are associated with intensifying lipid-lowering medications.</div></div><div><h3>METHODS</h3><div>This retrospective, observational case-control study evaluated changes to lipid-lowering therapy in patients with elevated Lp(a) values from January 1, 2020, through May 31, 2024.</div></div><div><h3>RESULTS</h3><div>Of 1042 patients with an Lp(a) value of 30 mg/dL (75 nmol/L) or higher during our study period, 539 met full inclusion eligibility. Of the 539 patients, 120 (22.3%) had their lipid-lowering therapy modified within 30 days of the elevated Lp(a) result. The most common interventions were adding ezetimibe (33.3%) and intensifying statin therapy (32.5%). Elevated low-density lipoprotein cholesterol (LDL-C) was the most significant predictor of whether patients’ lipid medications were modified, concordant with current recommendations for mitigating increased ASCVD risk associated with elevated Lp(a).</div></div><div><h3>CONCLUSION</h3><div>Intensification of lipid-lowering medication within 30 days occurred in less than one-quarter of patients with elevated Lp(a). Future studies are needed to determine if aggressive LDL-C lowering is superior to Lp(a)-lowering to prevent ASCVD events in patients with elevated Lp(a).</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 819-826"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225605","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}

{"title":"Insights from a real-world experience with inclisiran at a large United States lipid clinic","authors":"Donya Mazdeyasnan BS ,&nbsp;Antoinette Birs MD ,&nbsp;Tommy Chiou MD,&nbsp;Lara Diano LVN,&nbsp;Michael J. Wilkinson MD, FACC, FNLA","doi":"10.1016/j.jacl.2025.06.015","DOIUrl":"10.1016/j.jacl.2025.06.015","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>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.</div></div><div><h3>OBJECTIVE</h3><div>Examine patient characteristics and the real-world safety and efficacy of inclisiran.</div></div><div><h3>METHODS</h3><div>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.</div></div><div><h3>RESULTS</h3><div>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 (<em>P</em> &lt; .001). Excluding patients who switched from a PCSK9 inhibitor monoclonal antibody (PCSK9i mAb) within 1 month prior to starting inclisiran treatment (<em>n</em> = 12), a 45% decrease in LDL-C was observed (114 ± 45 mg/dL to 62 ± 41 mg/dL, <em>P</em> &lt; .001). Excluding patients who switched from a PCSK9i mAb (<em>n</em> = 12) and patients on no background lipid-lowering therapy at time of inclisiran initiation (<em>n</em> = 9), LDL-C decreased 47% (102 ± 42 mg/dL to 54 ± 40 mg/dL, <em>P</em> &lt; .001). Three patients (5%) reported mild side-effects that resolved by their second injection.</div></div><div><h3>CONCLUSION</h3><div>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.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 812-818"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","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}

{"title":"Contributing factors to the short-term progression of carotid plaque and its relation to cardiovascular outcomes","authors":"Jong-Il Park MD ,&nbsp;Kyu-Hwan Park MD ,&nbsp;Ung Kim MD, PhD ,&nbsp;Hong-Ju Kim MD, PhD ,&nbsp;Kang-Un Choi MD, PhD ,&nbsp;Jong-Ho Nam MD ,&nbsp;Chan-Hee Lee MD, PhD ,&nbsp;Jang-Won Son MD, PhD ,&nbsp;Jong-Seon Park MD, PhD","doi":"10.1016/j.jacl.2025.04.191","DOIUrl":"10.1016/j.jacl.2025.04.191","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The temporal changes in carotid plaque progression (PP) and its association with cardiovascular events are not well understood.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to evaluate the factors affecting short-term carotid PP and its relation to cardiovascular events.</div></div><div><h3>METHODS</h3><div>A total of 650 patients who underwent serial carotid ultrasonography over a period of at least 12 months were enrolled and analyzed. The study population was stratified into 2 groups: those with carotid PP (n = 304) and those without PP (n = 346). PP was defined as an increase of plaque number or a ≥20% increase in total plaque thickness compared to previous ultrasonography. The primary endpoint was a 4-year incidence of major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, coronary revascularization, or stroke.</div></div><div><h3>RESULTS</h3><div>Among all patients, the initial mean plaque thickness and number were 6.0 ± 6.7 mm and 2.7 ± 2.7, respectively. Upon follow-up, the PP rate was 46.7%, plaque regression was 16.5%, and no change was observed in 36.8%. The incidence of MACE over 4 years was significantly higher in the PP group (26.6%) compared to the no-PP group (13.0%), with a hazard ratio (HR) of 2.19 (95% CI, 1.52-3.15; <em>P</em><span> &lt; .001). Independent predictors of MACE included age, chronic kidney disease, coronary artery disease, previous stroke, and PP (HR, 2.05; 95% CI, 1.42-2.95; </span><em>P</em> &lt; .001). Age (HR, 1.02; 95% CI, 1.00-1.03; <em>P</em> = .038) and coronary artery disease (HR, 1.42; 95% CI, 1.04-1.95; <em>P</em> =.030) were independent predictors of PP.</div></div><div><h3>CONCLUSION</h3><div>Older age and coronary artery disease tended to increase the likelihood of PP during short-term follow-up, which was significantly associated with cardiovascular events.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 878-887"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284529","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}

{"title":"Lomitapide-induced fatty liver is a reversible condition: Evidence from a case of familial chylomicronemia syndrome","authors":"Daniele Tramontano MD ,&nbsp;Michele di Martino MD ,&nbsp;Francesco Baratta MD, PhD ,&nbsp;Alessia Di Costanzo BSc, MD ,&nbsp;Nicholas Cocomello MD ,&nbsp;Daniela Commodari BPharm ,&nbsp;Simone Bini MD ,&nbsp;Ilenia Minicocci BSc, PhD ,&nbsp;Marcello Arca MD ,&nbsp;Laura D’Erasmo MD, PhD","doi":"10.1016/j.jacl.2025.05.004","DOIUrl":"10.1016/j.jacl.2025.05.004","url":null,"abstract":"<div><div>Familial chylomicronemia syndrome (FCS) is a rare autosomal recessive disorder characterized by severe hypertriglyceridemia. It is caused by loss-of-function variants in the genes encoding the lipoprotein lipase (LPL) enzyme and its cofactors, which severely impair the hydrolysis of triglycerides (TG). Its main complication is represented by acute pancreatitis (AP), a potentially life-threatening condition. Conventional TG-lowering therapies are poorly effective in FCS, thus requiring the search of novel treatments.</div><div>Lomitapide, an inhibitor of microsomal triglyceride transfer protein (MTP), has demonstrated efficacy in reducing TG levels in FCS. However, it is associated with hepatic side effects, namely liver fat accumulation. Here we present a case study of a 71-year-old female patient with genetically confirmed FCS, baseline TG level of 2300 mg/dL (25.97 mmol/L) and a history of AP, who was treated with lomitapide for almost 5 years. The treatment allowed a marked reduction of TG (about 90%) and no recurrence of AP. However, hepatic monitoring during treatment revealed a progressive worsening of liver fat accumulation as detected by magnetic resonance imaging (MRI), which was associated with pronounced increases in liver transaminases and liver stiffness (up to 15 kPa). Due to these hepatic adverse events, it was decided to discontinue therapy with lomitapide. An MRI scan repeated after 70 days of drug withdrawal revealed complete resolution of fatty liver disease associated with normalization of liver stiffness (4.1 kPa) and liver transaminases.</div><div>This case demonstrates the reversibility of lomitapide-induced fatty liver and underscores the importance of regular monitoring of the liver safety during lomitapide to guide timely interventions.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 1164-1170"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275006","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}

{"title":"Association between uric acid to high-density lipoprotein cholesterol ratio and abdominal aortic calcification: A cross-sectional study","authors":"Yuanming Li BS ,&nbsp;Lishan Bai BS","doi":"10.1016/j.jacl.2025.05.017","DOIUrl":"10.1016/j.jacl.2025.05.017","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The association between uric acid to high-density lipoprotein cholesterol ratio (UHR) and abdominal aortic calcification (AAC) is not fully understood. This study aimed to explore the potential association between UHR and AAC in adults older than 40 years.</div></div><div><h3>METHODS</h3><div>In this cross-sectional study, data were collected from the 2013 to 2014 National Health and Nutrition Examination Survey (NHANES). UHR equals uric acid (mg/dL) divided by high-density lipoprotein cholesterol (mg/dL). We used weighted multiple logistic regression or linear regression analysis to investigate the association between UHR and AAC. We conducted subgroup and interaction analyses to investigate whether these associations varied by different confounders. Receiver operating characteristic curve studies were used to compare the diagnostic power of the Framingham scoring model with the Framingham and UHR models for AAC and severe abdominal aortic calcification (SAAC). Sensitivity analyses were conducted to determine the robustness of the UHR and AAC association results.</div></div><div><h3>RESULTS</h3><div>The final evaluation covered 2294 participants older than 40 years (mean age: 59.01 years; 52.57% female). A 1-unit rise in the log-UHR led to a 0.80 increase in the AAC scores (<em>β</em> [95% CI]: 0.80 [0.46, 1.13]) and a 90% higher risk of AAC (odds ratio [OR] [95% CI]: 1.90 [1.42, 2.54]), and the risk of SAAC increased by 95% (OR [95% CI]:1.95 [1.37, 2.77]). Subgroup analyses showed that the association between log-UHR and AAC scores with SAAC varied by sex.</div></div><div><h3>CONCLUSIONS</h3><div>This study identified a positive association between UHR and AAC risk, whereas the association of UHR with AAC scores and SAAC was significant only in the female subgroup.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 899-911"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512031","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}

{"title":"Multiple coronary artery aneurysms in a young patient with Kawasaki disease and heterozygous familial hypercholesterolemia: A case study","authors":"Julianna West MD ,&nbsp;Amit Khera MD ,&nbsp;Weiyi Tan MD ,&nbsp;Abhimanyu Garg MD","doi":"10.1016/j.jacl.2025.05.019","DOIUrl":"10.1016/j.jacl.2025.05.019","url":null,"abstract":"<div><div><span><span>Kawasaki disease<span> is an acute febrile systemic vasculitis affecting small and medium-sized arteries that predominately occurs in children and can result in coronary artery aneurysms. The etiology and pathogenesis of Kawasaki disease is unknown. Familial hypercholesterolemia (FH) is an autosomal dominant disorder that causes marked elevation in low-density lipoprotein (LDL) cholesterol and coronary </span></span>atherosclerosis<span>, and rarely coronary artery aneurysms and ectasia. A 20-year-old male presented with an acute ST-elevation myocardial infarction and was found to have coronary artery aneurysms affecting multiple vessels and thrombosis on coronary catheterization consistent with Kawasaki disease. Further investigation showed marked elevation of serum LDL cholesterol and genetic testing revealed a heterozygous pathogenic variant c.621C&gt;T (p.Gly207=; rs121908044) in </span></span><em>LDLR</em> confirming FH. Over the next 11 years, despite oral anticoagulation and lipid lowering therapy, he had 3 episodes of myocardial infarction and continued to have angina requiring 2 coronary stents and coronary artery bypass graft surgery. This extremely rare association of multiple coronary artery aneurysms due to Kawasaki disease and heterozygous FH in a young patient has not been reported previously. Management of such patients is challenging and requires aggressive anti-coagulation to prevent coronary aneurysm thrombosis and LDL-cholesterol lowering to prevent atherosclerosis.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 4","pages":"Pages 1174-1178"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564819","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}