Clinica e Investigacion en Arteriosclerosis最新文献

{"title":"Estudios de prevención cardiovascular en población con hipertrigliceridemia","authors":"Ovidio Muñiz-Grijalvo","doi":"10.1016/j.arteri.2025.500819","DOIUrl":"10.1016/j.arteri.2025.500819","url":null,"abstract":"<div><div>Although hypertriglyceridemia (&gt;<!--> <!-->150<!--> <!-->mg/dl) has been considered a risk factor for the development of atherosclerotic vascular disease, this relationship is not as linear or robust as that for LDL cholesterol, and the reduction of plasma triglyceride levels has not been consistently related to the reduction of this complication. Thus, in general terms and in the absence of a conclusive clinical benefit, current evidence does not support treatment with fibrates, niacin or omega-3 fatty acids routinely to reduce cardiovascular risk. The recommendation, especially the former, is limited to some subjects already treated with statins and with optimal LDL cholesterol levels in whom elevated triglyceride levels persist. As an exception, only purified icosapent ethyl at a high dose (4<!--> <!-->g daily) has demonstrated a reduction in cardiovascular morbidity and mortality and has been authorized for this indication, following the results of the REDUCE-IT trial.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 ","pages":"Article 500819"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidencia en la prevención cardiovascular con icosapento de etilo","authors":"Jose Luis Díaz-Díaz","doi":"10.1016/j.arteri.2025.500818","DOIUrl":"10.1016/j.arteri.2025.500818","url":null,"abstract":"<div><div>Icosapent ethyl, a highly purified ester of eicosapentoic acid, is the only omega-3 fatty acid authorized by the European Medicines Agency to reduce the risk of cardiovascular events in people at risk, treated with statins and with triglyceridemia ≥ 150<!--> <!-->mg/dl. This authorization comes as a consequence of the clinical benefit observed in the “Reduction of Cardiovascular Events with Icosapent Ethyl Intervention Trial”, in which icosapent ethyl demonstrated - compared to placebo - a 25% reduction in the relative risk of cardiovascular morbidity and mortality, a result consistent and independent of other variables in prespecified analyses and hypothesis generating in post-hoc analyses of several patient profiles. Although the mechanism of action for such benefit is not definitively established, it is known that it acts at different levels in the continuum of atherosclerotic cardiovascular disease (lipid-lowering, vascular endothelium and membrane protection, anti-inflammatory, atherosclerotic plaque stabilizing and antithrombotic effects) and that final anti-atherosclerotic action in the coronary territory has been demonstrated in the study “Effect of Vascepa on Improving Coronary Atherosclerosis in People With High Triglycerides Taking Statin Therapy”.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 ","pages":"Article 500818"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hipertrigliceridemia (> 150 mg/dl) como marcador de riesgo cardiovascular","authors":"José López-Miranda","doi":"10.1016/j.arteri.2025.500822","DOIUrl":"10.1016/j.arteri.2025.500822","url":null,"abstract":"<div><div>In patients who have achieved optimal LDL-<span>C</span> control, there remains a residual risk of atherothrombotic cardiovascular disease (ASCVD) related to alterations in lipid metabolism, among which alterations in triglyceride-rich lipoproteins and the cholesterol they contain, known as remnant cholesterol, play a major role. Remnant cholesterol is related to ASCVD risk that is independent of LDL-C and has been demonstrated in epidemiological and Mendelian randomization studies. Numerous epidemiological and genetic Mendelian randomization studies support that elevated triglyceride-rich lipoproteins (TRL) and remnant cholesterol are causally associated with ASCVD, myocardial infarction, ischemic stroke, aortic valve stenosis, and all-cause mortality. The remnant particles of triglyceride-rich lipoproteins are highly atherogenic due to their ability to enter and be retained in the arterial wall, their high cholesterol content, and their capacity to generate foam cells, induce endothelial dysfunction, a prothrombotic environment, and a vascular inflammatory response. Assessment of remnant cholesterol can provide information about residual ASCVD risk beyond that provided by LDL-C, non-HDL-C, and apoB, particularly in individuals with hypertriglyceridemia, type<!--> <!-->2 diabetes, or metabolic syndrome.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 ","pages":"Article 500822"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Icosapento de etilo: del ensayo REDUCE-IT a la práctica clínica","authors":"Juan Pedro-Botet","doi":"10.1016/j.arteri.2025.500820","DOIUrl":"10.1016/j.arteri.2025.500820","url":null,"abstract":"<div><div>In addition to low-density lipoproteins (LDL), those containing apolipoprotein (Apo) B and with a diameter less than 70 nm, including the smaller triglyceride-rich lipoproteins, remnant particles, and lipoprotein(a), may independently contribute to atherosclerosis because they also cross the endothelium and penetrate the arterial intima. Although mild/moderate hypertriglyceridemia is a recognized vascular risk factor, only two studies, the Japan EPA Lipid Intervention (JELIS) and the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), using pure eicosapentaenoic acid (EPA) or icosapent ethyl (IPE), the stable ethyl ester of EPA, respectively, rather than a combination of docosahexaenoic acid (DHA) and EPA, have demonstrated a reduction in the rate of cardiovascular events. For this reason, it was deemed appropriate to examine the implications and applicability of the REDUCE-IT study in real-life settings. This analysis suggests a transversal therapeutic approach, based on both LDL cholesterol and triglycerides, for patients at very high cardiovascular risk to achieve an effective prevention. Furthermore, among patients in secondary prevention, treatment with IPE should focus on those with the highest vascular risk (recent acute coronary syndrome, post-infarction, angioplasty, and coronary bypass grafting).</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 ","pages":"Article 500820"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tratamiento de la hipertrigliceridemia para la reducción del riesgo cardiovascular","authors":"Carlos Guijarro Herráiz","doi":"10.1016/j.arteri.2025.500816","DOIUrl":"10.1016/j.arteri.2025.500816","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 ","pages":"Article 500816"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of familial dyslipidemias, degree of lipid control and relationship with atherosclerotic cardiovascular disease in the general population of Galicia. GALIPEMIAS Study.","authors":"José Luis Díaz-Díaz, M Eugenia Ameneiros, Rosa Argüeso Armesto, José María Mostaza Prieto, Xavier Pintó Sala, Avelino Rodríguez González, José Antonio Díaz-Peromingo, Alberto Del Alamo Alonso, Pablo Fernández Catalina, Manuel Suárez Tembra, Carlos Alberto Názara Otero, Marta Pena Seijo, Javier Muñiz García, Teresa Rosalía Pérez-Castro, Antonio Pose Reino, Juan Pedro-Botet Montoya","doi":"10.1016/j.arteri.2025.500804","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500804","url":null,"abstract":"<p><strong>Objectives: </strong>GALIPEMIAS is a study designed to determine the prevalence of familial dyslipidemias in the adult population of Galicia, evaluate the degree of lipid control according to the criteria of current clinical guidelines and analyze its association with atherosclerotic cardiovascular disease (ASCVD).</p><p><strong>Methods: </strong>Cross-sectional study carried out in the general population over 18years of age residing in Galicia and with a health card from the Galician Health Service (n=1,000). The sample was selected by random cluster sampling. The prevalence of familial combined hyperlipidemia (FCH), hypercholesterolemia with dominant inheritance pattern (HC-DI) and familial hypertriglyceridemia (FHTG), as well as suspected familial dysbetalipoproteinemia (FDB) and the joint prevalence of familial dyslipidemias with dominant inheritance (FDL-DI) were analyzed. For the assessment of cardiovascular risk (CVR), the criteria of the 2021 European guidelines for cardiovascular prevention were followed. The LDL-C control target required according to the CVR level was defined according to the 2019 European ESC/EAS guidelines.</p><p><strong>Results: </strong>The prevalence of FCH was 15.9% (95%CI: 13.6-18.4%), that of HC-DI 5.9% (95%CI: 4.5-7.6%), that of FHTG 1.7% (95%CI: 1.0-2.8%) and that of subjects with suspected FDB 0.9% (95%CI 0.4-1.6%). The joint prevalence of FDL-DI was 23.5% (95%CI: 20.8-26.3%), also present in 1 in 3 subjects with ASCVD. Overall, 60.5% of participants with FDL-DI had high or very high CV risk and 4.6% of them were on target for LDL-C control.</p><p><strong>Conclusions: </strong>The presence of familial dyslipidemia with dominant inheritance is the majority among the adult population living in Galicia with dyslipidemia, with FCH being the most prevalent of them. These subjects are underdiagnosed, are generally at high or very high cardiovascular risk, hardly receive lipid-lowering treatment (1 in 3) and the degree of LDL-C control according to guidelines is very poor. .</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500804"},"PeriodicalIF":1.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myeloproliferative neoplasms: A model of the journey from clonal hematopoiesis to cardiovascular disease and cancer.","authors":"Santiago Redondo","doi":"10.1016/j.arteri.2025.500767","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500767","url":null,"abstract":"<p><p>In the last decade, the coming of next-generation sequencing and its application to large human populations is breaking the barrier between inflammation and cancer. Indeed, acquired mutations in key genes that regulate hematopoiesis and thus confer a selective advantage in the proliferation of hematopoietic progenitors have established the concept of clonal hematopoiesis of indeterminate potential or CHIP. A growing body of clinical and experimental evidence is highlighting the link between CHIP and adverse outcomes, in particular atherosclerotic cardiovascular disease and cancer. The apparent surprise about how these two different entities share common mechanisms can be explained by myeloproliferation and inflammation. These mechanisms are involved not only in the development of myeloid tumors but also in atherogenesis. Myeloproliferative neoplasms or MPN are a type of myeloid tumors where thrombotic risk is increased not only by higher blood counts but also by means of an accelerated atherosclerosis. Therefore, myeloproliferative neoplasms are a model of the link between clonal hematopoiesis and atherosclerotic cardiovascular disease. The concept of CHIP has important clinical applications. A deeper understanding of these mechanisms may pave the way for the future early diagnosis and potential pre-emptive treatments of these two major causes of death.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500767"},"PeriodicalIF":1.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental pollution and cardiovascular health. Challenges and new perspectives.","authors":"Francisco Gomez-Delgado, Manuel Raya-Cruz, Juan L Romero-Cabrera, Pablo Perez-Martinez","doi":"10.1016/j.arteri.2025.500802","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500802","url":null,"abstract":"<p><p>Environmental pollution is a key factor in cardiovascular disease (CVD) development. Several evidences support its impact at the pathophysiology of arteriosclerosis, highlighting the role of the \"exposome\", a concept that encompasses all environmental factors such as air pollution, water pollution, climate change and noise and light pollution. These factors are associated with an increased risk of ischemic heart disease (IHD), stroke, high blood pressure (HBP), heart failure (HF) and atrial fibrillation (AF). Currently, air pollution is the main environmental factor related to CVD. Components such as particulates matter (PM_0.1, PM_2.5, PM₁₀), sulfur dioxide (SO₂), nitrogen oxide and dioxide (NO_x), carbon monoxide (CO) and ozone (O₃) have a high capacity to penetrate the body and trigger both local and systemic inflammatory processes. These effects promote a proinflammatory, procoagulant state and an increase in oxidative stress. Similarly, aquatic pollution exposes the body to pollutants such as heavy metals, pesticides and microplastics, both through direct contact and via the food chain, thus contributing to the phenomena mentioned above. On the other hand, factors such as noise and light pollution, together with effects caused from climate change (extreme temperatures, wildfires, desertification, among others), have been closely linked to pathophysiological processes that favour the development and progression of atherosclerosis. These mechanisms include sympathetic nervous system (SNS) activation, stress hormones release such as cortisol and catecholamines, as well as chronodisruption. This review analyses the role of factors related to the exposome (air pollution, water pollution, noise and light pollution and phenomena associated with climate change) in atherosclerosis progression, as well as their involvement in the incidence, prevalence and prognosis of CVD. Physicians should promote awareness of environmental pollution impact on cardiovascular health, integrating the assessment of environmental factors into their clinical practice, advocating for sustainable policies to prevent diseases and protect present and future health.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500802"},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values.","authors":"Ángel Arturo López-González, José Ignacio Ramírez-Manent, Emilio Martínez-Almoyna Rifá, Hernán Paublini Oliveira, Cristina Martorell Sánchez, Pedro Juan Tárraga López","doi":"10.1016/j.arteri.2025.500803","DOIUrl":"https://doi.org/10.1016/j.arteri.2025.500803","url":null,"abstract":"<p><strong>Introduction: </strong>Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored.</p><p><strong>Objective: </strong>To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated.</p><p><strong>Results: </strong>A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95% CI 1.36-1.55), physical inactivity (OR 1.90; 95% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95% CI 1.60-1.84) were associated with higher atherogenic index values.</p><p><strong>Conclusions: </strong>The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.</p>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":" ","pages":"500803"},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eficiencia de las combinaciones a dosis fija de estatina y ezetimiba en el tratamiento de la hipercolesterolemia","authors":"Carlos Guijarro ,&nbsp;Angel Diaz ,&nbsp;Eva Moreno ,&nbsp;Paula Gamonal ,&nbsp;Maria Soler ,&nbsp;Neus Vidal-Vilar ,&nbsp;Maria Rosa Fernandez","doi":"10.1016/j.arteri.2024.500753","DOIUrl":"10.1016/j.arteri.2024.500753","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the clinical and economic benefits derived from increasing the use of fixed-dose combinations of high-intensity statins and ezetimibe in patients at high/very high cardiovascular risk, from the perspective of the Spanish National Health System (SNS).</div></div><div><h3>Methods</h3><div>A baseline scenario (current market shares) was compared with scenarios that increased the use of fixed-dose combinations (alternative: 30% increase; optimized: 69% increase). The potential annual increase in the number of controlled patients, cardiovascular events avoided and the associated savings in direct medical costs were estimated, including the cost of pharmacological treatment, follow-up, and managing cardiovascular events over a three-year time horizon.</div></div><div><h3>Results</h3><div>Over the three years of the study, the baseline scenario estimated a total of 1,552,686 controlled patients and 39,449 cardiovascular events, with a total cost to the SNS of €1,841,057,122. In the alternative scenario, controlled patients would increase by 36.1%, and 139 cardiovascular events would be avoided, resulting in savings for the SNS of €36,116,631. In the optimized scenario, there would be a 64% increase in controlled patients and 250<!--> <!-->cardiovascular events would be avoided, leading to savings of €56,415,300 for the SNS.</div></div><div><h3>Conclusion</h3><div>Increased use of high-intensity statin and ezetimibe fixed-dose combinations in patients with high/very high cardiovascular risk may increase the number of controlled patients, reduce cardiovascular events and produce economic savings from an SNS perspective.</div></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"37 3","pages":"Article 500753"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}