Journal of clinical lipidology最新文献

{"title":"Mortality, cardiovascular, and hepatic decompensation outcomes of bempedoic acid in patients with cirrhosis: A multi-institutional study","authors":"Mohamad Mahdi Osman DO,&nbsp;Talal Massad MD,&nbsp;Omar T. Sims PhD,&nbsp;Dian J. Chiang MD","doi":"10.1016/j.jacl.2026.06.026","DOIUrl":"10.1016/j.jacl.2026.06.026","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Data on bempedoic acid in cirrhosis are limited.</div></div><div><h3>OBJECTIVE</h3><div>To evaluate associations between bempedoic acid use and clinical outcomes in adults with cirrhosis.</div></div><div><h3>METHODS</h3><div>We conducted a retrospective TriNetX cohort study comparing adults with cirrhosis receiving versus not receiving bempedoic acid. Patients with end-stage renal disease or prior liver transplantation were excluded. Propensity score matching was performed 1:1 using demographic, clinical, medication, and laboratory variables. Outcomes were mortality, hospitalization, hepatic decompensation, and major adverse cardiovascular events.</div></div><div><h3>RESULTS</h3><div>After matching, 325 pairs were analyzed. Bempedoic acid use was associated with lower all-cause mortality (hazard ratio [HR], 0.28; 95% CI, 0.17-0.45; <em>P</em> &lt; 0.001) and all-cause hospitalization (HR, 0.52; 95% CI, 0.40-0.68; <em>P</em> &lt; 0.001). No significant differences were observed in hepatic decompensation (HR, 0.96; 95% CI, 0.62-1.50; <em>P</em> = .86) or MACE (HR, 0.84; 95% CI, 0.50-1.39; <em>P</em> = .49) did not differ.</div></div><div><h3>CONCLUSION</h3><div>Bempedoic acid was associated with lower mortality and hospitalization without increased hepatic decompensation. Residual confounding and immortal time bias limit causal interpretation.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 2041-2045"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projected impact of 2026 ACC/AHA/Multisociety Dyslipidemia Guideline on lipid-lowering therapy eligibility based on Class 1 and 2a recommendations","authors":"Sameer A. Sidiq MD,&nbsp;Geoffrey Y. Zhang BS,&nbsp;Dmitry Abramov MD,&nbsp;Alexander C. Razavi MD PhD,&nbsp;Vijay Nambi MD PhD,&nbsp;Xiaoming Jia MD,&nbsp;Salim S. Virani MD PhD,&nbsp;Christie M. Ballantyne MD,&nbsp;Roger S. Blumenthal MD,&nbsp;Abdul Mannan Khan Minhas MD","doi":"10.1016/j.jacl.2026.07.008","DOIUrl":"10.1016/j.jacl.2026.07.008","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The 2026 American College of Cardiology/American Heart Association/Multisociety Dyslipidemia Guideline introduced pivotal changes to lipid-lowering therapy (LLT) eligibility compared with the 2018 Guideline.</div></div><div><h3>OBJECTIVE</h3><div>We aimed to compare eligibility for Class 1 and 2a LLT indications in the United States between the 2018 and 2026 Dyslipidemia Guidelines.</div></div><div><h3>METHODS</h3><div>We utilized National Health and Nutrition Examination Survey 2011-2018 datato evaluate LLT eligibility among participants aged ≥20 years, excluding pregnant women. Population weighted estimates were generated by indication and by demographic characteristic.</div></div><div><h3>RESULTS</h3><div>Under the 2026 Guideline, 102.9 million adults (46.8%, 95% CI: 45.0-48.6) would be eligible for LLT, including 65.3 million (29.7%, 95% CI: 28.0-31.4) with a Class 1 indication and 37.6 million (17.1%, 95% CI: 15.8-18.4) with a Class 2a indication, compared with 65.3 million adults (29.7%, 95% CI: 28.1-31.3) under the 2018 Guideline, including 60.2 million (27.4%, 95% CI: 25.8-28.9) and 5.1 million (2.3%, 95% CI: 2.0-2.7), respectively. The increase in eligibility was primarily driven by 2 additional Class 2a indications introduced in the 2026 Guideline: individuals with borderline Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) risk (previously classified as Class 2b) and adults aged 30 to 59 years with low PREVENT risk but elevated low-density lipoprotein cholesterol or elevated 30-year atherosclerotic cardiovascular disease risk.</div></div><div><h3>CONCLUSION</h3><div>Future studies should assess whether expanded eligibility improves LLT use and cardiovascular outcomes.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 2046-2050"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578811","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":"Impact of PREVENT-ASCVD vs pooled cohort equations on statin eligibility across demographic groups: Insights from the NIH All of Us Research Program","authors":"Cammie Young BA,&nbsp;Frances Golden MD, MPH,&nbsp;Wenjun Fan MD, PhD,&nbsp;Nathan D. Wong PhD, MPH","doi":"10.1016/j.jacl.2026.07.003","DOIUrl":"10.1016/j.jacl.2026.07.003","url":null,"abstract":"<div><div>We compared the predicting risk of cardiovascular EVENTS-atherosclerotic cardiovascular disease (PREVENT-ASCVD) risk equation with the pooled cohort equation (PCE) for estimating statin eligibility across demographic subgroups in the All of Us Research Program in patients without ASCVD, heart failure, diabetes, or lipid-lowering therapy. Statin eligibility was defined as a 10-year ASCVD risk for PREVENT-ASCVD ≥5% and PCE ≥7.5%. Eligibility estimates were compared across age, sex, and race/ethnicity, and by quintile of polysocial risk score (PsRS). Among 25,188 participants, overall statin eligibility was 23.1% under PREVENT-ASCVD compared with 28.0% under PCE (Δ = 4.9%, <em>P</em> &lt; 0.001). The largest differences were among participants aged 60 to 69 years and among Black participants. Among those with PsRS data (n = 6213), PREVENT-ASCVD estimated lower statin eligibility than PCE across all quintiles (<em>P</em> &lt; 0.05). Differences in statin eligibility between PREVENT-ASCVD and PCE persist even when applying guideline-recommended thresholds, highlighting the importance of incorporating additional risk-enhancing factors beyond those included in either equation to better inform primary prevention decisions.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 2062-2068"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a) and aortic diseases: Epidemiological evidence from observation to causation","authors":"Dexiang Xia MD,&nbsp;Lei Zhang MD, PhD,&nbsp;Junjie Fang MD,&nbsp;Wentao Hu MD,&nbsp;Maohua Li PhD,&nbsp;Yunfan Chen MD,&nbsp;Chang Shu MD, PhD,&nbsp;Jiehua Li MD, PhD,&nbsp;Xin Li MD, PhD","doi":"10.1016/j.jacl.2026.07.014","DOIUrl":"10.1016/j.jacl.2026.07.014","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Aortic aneurysm and dissection (AA/AD) are life-threatening vascular diseases with high mortality, yet no effective drugs to delay progression. Lipoprotein(a) [Lp(a)] is genetically determined and associated with atherosclerotic disease, but high-quality evidence on its causal role in AA/AD remains limited.</div></div><div><h3>OBJECTIVE</h3><div>To investigate the association between Lp(a) and AA/AD and assess potential causal relationships with major aortic disease subtypes.</div></div><div><h3>METHODS</h3><div>A prospective cohort of 312,332 UK Biobank participants was analyzed. Kaplan–Meier curves, Cox regression, and Fine–Gray competing-risk models assessed associations between Lp(a) and incident AA/AD. Two-sample Mendelian randomization (MR) analyses evaluated the potential causal effects of Lp(a) on AA, abdominal aortic aneurysm (AAA), thoracic aortic aneurysm (TAA), and AD.</div></div><div><h3>RESULTS</h3><div>During a median follow-up of 16.5 years, 3122 AA/AD events occurred. Elevated Lp(a) independently predicted AA/AD with a dose–response relationship (hazard ratio [HR] = 1.40 for &gt;180 vs &lt;50 nmol/L; HR = 1.15 per 75 nmol/L increment). Competing-risk analyses yielded consistent results. MR analyses supported a causal association between Lp(a) and AA (odds ratio [OR] = 1.31, 95% CI: 1.08-1.62) and AAA (OR = 1.80, 95% CI: 1.37-2.37), whereas MR analyses did not provide sufficient evidence for causal associations with TAA or AD.</div></div><div><h3>CONCLUSION</h3><div>Lp(a) may serve as a promising biomarker for risk assessment and stratification in aortic disease. However, the MR analysis for AD was limited by low statistical power, and the clinical utility of Lp(a) measurement requires further investigation.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 1978-1987"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620376","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":"Birth and first-year outcomes in infants of mothers with familial hypercholesterolemia or atherosclerotic cardiovascular disease in the US: A retrospective cohort study","authors":"Xinyue Liu PhD, MS,&nbsp;Michelle Fanous DO,&nbsp;Manish Ponda MD, MS,&nbsp;Wenqin Qiang MPH,&nbsp;Liang Ni MPH,&nbsp;Alexander Breskin PhD,&nbsp;Xiaoran Yang PhD, MPH,&nbsp;Isha M. Riley MPH,&nbsp;Caitlin Knox PhD, MPH, FISPE","doi":"10.1016/j.jacl.2026.07.032","DOIUrl":"10.1016/j.jacl.2026.07.032","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Infant outcomes among those born to mothers with familial hypercholesterolemia (FH) or atherosclerotic cardiovascular disease (ASCVD) remain unclear.</div></div><div><h3>OBJECTIVE</h3><div>To assess outcomes among infants of mothers living with FH or ASCVD in the US.</div></div><div><h3>METHODS</h3><div>In this retrospective claims-based cohort study, mother-infant singleton pairs (2018-2023) were identified. Infants were followed to death, disenrollment, age 1 year, or the end of 2024. Exposure was classified as maternal prepregnancy diagnosis of FH or ASCVD. Outcomes included preterm birth, low birth weight, macrosomia, neonatal intensive care unit (NICU) admission, major congenital malformations (MCM), infant mortality, and healthcare utilization at 1 year of age. Inverse probability treatment weighting was utilized to compare the FH and ASCVD cohorts with a reference cohort, respectively.</div></div><div><h3>RESULTS</h3><div>Among 275 FH, 878 ASCVD, and 348,683 reference mother-infant pairs, the use of maternal lipid-lowering therapies was rare and declined during pregnancy. No increased risks of adverse outcomes were observed for the FH cohort vs the reference cohort. In contrast, the ASCVD cohort had higher risks of preterm birth (adjusted risk ratio, 1.73 [95% CI, 1.40-2.12]), low birth weight (1.77 [1.28-2.46]), NICU admission (1.48 [1.23-1.77]), and noncardiac MCM (1.58 [1.05-2.37]) than the reference cohort. At 1 year of age, the ASCVD cohort also had higher risks of inpatient admissions, emergency department visits, and urgent care clinic visits.</div></div><div><h3>CONCLUSION</h3><div>Infants of mothers living with ASCVD—but not those with FH—had higher risks of adverse birth outcomes and increased healthcare utilization.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 1827-1839"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations in real-world comparative effectiveness research: insights from the BEYOND-REAL study","authors":"Raechel T. White PharmD, PhC, BCACP,&nbsp;Benedicta O. Ansong PharmD,&nbsp;Kevin Cowart PharmD, MPH, BCACP, CDCES","doi":"10.1016/j.jacl.2026.06.029","DOIUrl":"10.1016/j.jacl.2026.06.029","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 2087-2088"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549364","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":"The return of “goals” in the 2026 ACC/AHA/Multisociety guideline on the management of dyslipidemia","authors":"Zahid Ahmad MD,&nbsp;Abhimanyu Garg MD","doi":"10.1016/j.jacl.2026.06.006","DOIUrl":"10.1016/j.jacl.2026.06.006","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 15-19"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578773","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":"Diagnostic performance of serum sterols, including oxysterols, for identifying cerebrotendinous xanthomatosis and monitoring treatment efficacy","authors":"Rieko Sagara PhD,&nbsp;Satoshi Hirayama MD, PhD,&nbsp;Yoshifumi Fukushima MD, PhD,&nbsp;Tsuyoshi Ueno MT, PhD,&nbsp;Naoko Kuwabara PhD,&nbsp;Saori Nakagawa PhD,&nbsp;Hayato Tada MD, PhD,&nbsp;Shingo Koyama MD, PhD,&nbsp;Kazuyuki Noda MD, PhD,&nbsp;Minoru Takemoto MD, PhD,&nbsp;Tomoyo Hashimoto MD, PhD,&nbsp;Yukio Iwanaka MD,&nbsp;Hiroaki Adachi MD, PhD,&nbsp;Yukihito Higashi MD, PhD,&nbsp;Yoshiki Sekijima MD, PhD,&nbsp;Takashi Miida MD, PhD","doi":"10.1016/j.jacl.2026.06.021","DOIUrl":"10.1016/j.jacl.2026.06.021","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Cerebrotendinous xanthomatosis (CTX) is caused by biallelic mutations in the <em>CYP27A1</em> gene, which encodes sterol 27-hydroxylase. Reduced activity of this enzyme decreases bile acid synthesis and increases cholestanol production. Cholestanol, a metabolic intermediate, can be used as a diagnostic marker; however, patients with CTX have been reported to have normal cholestanol levels. Cholesterol and bile acid metabolism is likely to be extensively disrupted even in these patients with CTX.</div></div><div><h3>OBJECTIVE</h3><div>We aimed to clarify whether sterol markers, including oxysterols, can be used to screen for and diagnose CTX and assess treatment efficacy.</div></div><div><h3>METHODS</h3><div>Fourteen patients with CTX (homozygotes, n <em>= 7</em>; compound heterozygotes, n <em>= 5</em>; unidentified, n <em>=</em> 2)<em>,</em> 6 carriers, and 24 healthy controls were enrolled. We analyzed 9 sterol markers, including 4 oxysterols, using gas chromatography-mass spectrometry. We measured these markers in patients with CTX before and after treatment with chenodeoxycholic acid (CDCA) and/or lipid-lowering agents.</div></div><div><h3>RESULTS</h3><div>Cholestanol and sterol markers of cholesterol synthesis and absorption were 1.3 to 8.3 times higher in patients with CTX than in carriers and controls. These marker levels decreased significantly in patients with CTX after treatment. Compared to carriers and controls, patients with CTX had extremely low levels of 27-hydroxycholesterol (27-OHC) and extremely high levels of 7α-hydroxycholesterol (7α-OHC). During treatment, 7α-OHC levels decreased significantly, while 27-OHC levels remained low. Receiver operating characteristic analysis demonstrated excellent diagnostic performance. The area under the curve was 1.000 for low 27-OHC and 0.991 for elevated 7α-OHC, outperforming cholestanol (0.903).</div></div><div><h3>CONCLUSION</h3><div>Sterol markers, including oxysterols, can be used to screen for and diagnose CTX and to assess treatment efficacy with CDCA and/or lipid-lowering agents.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 1840-1849"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591745","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":"Where we have come from and where we are going in lipid therapeutics","authors":"Anne Carol Goldberg MD, MNLA,&nbsp;P. Barton Duell MD, MNLA","doi":"10.1016/j.jacl.2026.09.001","DOIUrl":"10.1016/j.jacl.2026.09.001","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 1741-1743"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056562","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":"HDL function after PCSK9 inhibition: Assay scope, normalization, and clinical interpretation","authors":"Mengna Li,&nbsp;Yongfu Fan MD","doi":"10.1016/j.jacl.2026.05.227","DOIUrl":"10.1016/j.jacl.2026.05.227","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"20 9","pages":"Pages 2089-2090"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149056346","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}