Clinica e Investigacion en Arteriosclerosis最新文献

{"title":"Effectiveness and safety of injectable PCSK9 inhibitors in dyslipidaemias’ treatment and cardiovascular disease prevention: An overview of 86 systematic reviews and a network metaanalysis","authors":"Konstantinos Pamporis ,&nbsp;Paschalis Karakasis ,&nbsp;Spyridon Simantiris ,&nbsp;Marios Sagris ,&nbsp;Konstantinos I. Bougioukas ,&nbsp;Nikolaos Fragakis ,&nbsp;Dimitrios Tousoulis","doi":"10.1016/j.arteri.2023.11.003","DOIUrl":"10.1016/j.arteri.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><p>Multiple systematic reviews (SR) have been performed on the effects of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), often providing conflicting findings. This overview and network meta-analysis (NMA) aimed to summarize SR<span> findings on the efficacy and safety of PCSK9i and provide an updated NMA.</span></p></div><div><h3>Materials and methods</h3><p>MEDLINE (Pubmed), Scopus, Cochrane, Epistemonikos and Google Scholar were searched from inception to September 21, 2023 for SRs of randomized controlled trials (RCTs) and from January 1, 2020 to September 21, 2023 for additional RCTs. Double-independent study selection, data extraction and quality assessment were performed. Qualitative analysis was performed for SRs and a frequentist random-effects model NMA was performed for RCTs.</p></div><div><h3>Results</h3><p><span><span>Totally, 86 SRs and 76 RCTs were included. Alirocumab (77/86 [90%]) and </span>evolocumab<span> (73/86 [85%]) were mostly analyzed. Associations from SRs (35/42 [83%]) and the updated NMA indicated PCSK9i benefit on major adverse cardiovascular events (MACEs). Reductions were also noted for cerebrovascular events (47/66 [71%]), coronary revascularization (29/33 [88%]) and myocardial infarction (41/63 [65%]). Alirocumab was associated with reductions on all-cause mortality (RR</span></span> <!-->=<!--> <span>0.82, 95%CI [0.72,0.94]). Data on any CV event reduction were conflicting (7/16 [44%]). Inclisiran appeared effective only on MACEs (RR</span> <!-->=<!--> <span>0.76, 95%CI [0.61,0.94]). No reductions in heart failure were observed (0/16). No increases were identified between PCSK9i<span> and any (0/35) or serious adverse events (0/52). However, PCSK9i were associated with injection-site reactions (20/28 [71%]).</span></span></p></div><div><h3>Conclusion</h3><p>PCSK9i appeared to be effective in CV outcomes and their clinical application was generally safe.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 86-100"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470964","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":"Evaluation of the relationship between atherosclerosis and Helicobacter pylori infection with measurement of growth differentiation factor 15 and atherosclerosis indicators in adults with no comorbidity","authors":"Osman Başpinar ,&nbsp;Ayça Elibol ,&nbsp;Derya Koçer ,&nbsp;Turgut Tursem Tokmak ,&nbsp;Serkan Doğan ,&nbsp;Oğuzhan Sıtkı Dizdar","doi":"10.1016/j.arteri.2023.09.002","DOIUrl":"10.1016/j.arteri.2023.09.002","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to investigate presence of subclinical atherosclerosis by measuring carotid intima-media thickness (CIMT) in patients with <span><span>Helicobacter pylori</span></span><span> (HP) and to assess effects of HP on atherosclerosis by evaluating markers of atherosclerosis and blood growth differentiation factor (GDF-15) levels.</span></p></div><div><h3>Materials and methods</h3><p>This cross-sectional study included 59 patients without comorbid disease who had HP and 30 healthy controls without HP in upper endoscopic biopsy. In order to assess atherosclerosis, the CIMT measurement was performed by sonography. Serum GDF-15 level was measured by ELISA method. In all patients, atherosclerosis markers were recorded. Atherogenic indices were calculated, including Castelli risk index I and II (TG/HDL-c and LDL-c/HDL-c, respectively), plasma atherogenic index (PAI; log TG/HDL-c), non-HDL-c (TH-HDL-c) and atherogenic coefficient (AC; non-HDL-HDL-c).</p></div><div><h3>Results</h3><p>The GDF-15 level and CIMT were significantly higher in HP-positive group when compared to HP-negative group (<em>p</em> <!-->≤<!--> <!-->0.001). There was a significant correlation between serum GDF-15 level and CIMT (<em>r</em> <!-->=<!--> <!-->0.445; <em>p</em> <!-->≤<!--> <!-->0.001). There was no correlation between other atherosclerosis markers and serum GDF-15 level or CIMT. The bacterial intensity on endoscopic specimen was only correlated with CIMT (<em>p</em> <!-->&lt;<!--> <!-->0.001). Vitamin B12 and D levels were comparable among groups.</p></div><div><h3>Conclusion</h3><p>This study suggested that there was a correlation between GDF-15 level and subclinical atherosclerosis development in patients with HP. However, GDF-15 level, which was found to be elevated while atherogenic indices were normal, can be an earlier marker for subclinical atherosclerosis.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 51-59"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683446","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":"Influencia de la concentración de triglicéridos en la lipoproteína(a) en función de la dislipidemia","authors":"Victoria Marco-Benedí ,&nbsp;Ana Cenarro ,&nbsp;Martín Laclaustra ,&nbsp;Pilar Calmarza ,&nbsp;Ana M. Bea ,&nbsp;Àlex Vila ,&nbsp;Carlos Morillas-Ariño ,&nbsp;José Puzo ,&nbsp;Juan Diego Mediavilla Garcia ,&nbsp;Amalia Inmaculada Fernández Alamán ,&nbsp;Manuel Suárez Tembra ,&nbsp;Fernando Civeira","doi":"10.1016/j.arteri.2023.11.005","DOIUrl":"10.1016/j.arteri.2023.11.005","url":null,"abstract":"<div><h3>Background</h3><p>Recently, an inverse relationship between the blood concentration of lipoprotein(a) (Lp(a)) and triglycerides (TG) has been demonstrated. The larger the VLDL particle size, the greater the presence of VLDL rich in apoliprotein E and in subjects with the apoE2/E2 genotype, the lower Lp(a) concentration. The mechanism of this inverse association is unknown. The objective of this analysis was to evaluate the Lp(a)–TG association in patients treated at the lipid units included in the registry of the Spanish Society of Atherosclerosis (SEA) by comparing the different dyslipidemias.</p></div><div><h3>Patients and methods</h3><p>Five thousand two hundred and seventy-five subjects ≥18 years of age registered in the registry before March 31, 2023, with Lp(a) concentration data and complete lipid profile information without treatment were included.</p></div><div><h3>Results</h3><p>The mean age was 53.0 ± 14.0 years, with 48% women. The 9.5% of subjects (<em>n</em> = 502) had diabetes and the 22.4% (<em>n</em> = 1184) were obese. The median TG level was 130 mg/dL (IQR 88.0–210) and Lp(a) 55.0 nmol/L (IQR 17.9–156). Lp(a) concentration showed a negative association with TG concentration when TG values exceeded 300 mg/dL. Subjects with TG &gt; 1000 mg/dL showed the lowest level of Lp(a), 17.9 nmol/L, and subjects with TG &lt; 300 mg/dL had a mean Lp(a) concentration of 60.1 nmol/L. In subjects without diabetes or obesity, the inverse association of Lp(a)–TG was especially important (<em>p</em> &lt; 0.001). The median Lp(a) was 58.3 nmol/L in those with TG &lt; 300 mg/dL and 22.0 nmol/L if TG &gt; 1000 mg/dL. No association was found between TG and Lp(a) in subjects with diabetes and obesity, nor in subjects with familial hypercholesterolemia. In subjects with multifactorial combined hyperlipemia with TG &lt; 300 mg/dL, Lp(a) was 64.6 nmol/L; in the range of 300–399 mg/dL of TG, Lp(a) decreased to 38. 8 nmol/L, and up to 22.3 nmol/L when TG &gt; 1000 mg/dL.</p></div><div><h3>Conclusions</h3><p>Our results show an inverse Lp(a)–TG relationship in TG concentrations &gt; 300 mg/dL in subjects without diabetes, obesity and without familial hypercholesterolemia. Our results suggest that, in those hypertriglyceridemias due to hepatic overproduction of VLDL, the formation of Lp(a) is reduced, unlike those in which the peripheral catabolism of TG-rich lipoproteins is reduced.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 71-77"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075418","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":"Is Helicobacter pylori a new kid on the block?","authors":"Manuel Vázquez-Carrera","doi":"10.1016/j.arteri.2024.02.002","DOIUrl":"10.1016/j.arteri.2024.02.002","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 78-79"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916824000184/pdfft?md5=b84713e5c43be2a88e62f50a1aa2b3e1&pid=1-s2.0-S0214916824000184-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-fat diet promotes coagulation and endothelial activation in Sprague Dawley rats: Short-term effects of combined oral contraceptives","authors":"Oyesanmi A. Fabunmi ,&nbsp;Phiwayinkosi V. Dludla ,&nbsp;Bongani B. Nkambule","doi":"10.1016/j.arteri.2023.10.001","DOIUrl":"10.1016/j.arteri.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Combined oral contraceptives (COCs), use in individuals are associated with increased risk of thrombotic events. This highlights the significance of assessing the impact of COC on promoting coagulation and endothelial activation in high-fat diet (HFD)-fed Sprague Dawley rats.</p></div><div><h3>Methods</h3><p>Twenty (20) five-weeks-old female Sprague Dawley rats weighing between 150 and 200<!--> <!-->g were subjected to both LFD and HFD-feeding for 8-weeks to determine its influence on basic metabolic status, hemostatic profile, hemodynamic parameters (blood pressure and heart rate), as well as selected biomarkers of coagulation (tissue factor and D-dimer) and endothelial activation (Von Willebrand factor and nitric oxide). Thereafter HFD-fed animals were treated with receive high dose combined oral contraceptive (HCOC) and low dose combine oral contraceptive (LCOC) for 6 weeks.</p></div><div><h3>Results</h3><p>Our results showed that beyond weight gain, HFD-feeding was associated with hyperglycemia, increased mean arterial pressure, and reduced nitric oxide levels when compared with LFD group (<em>p</em> <!-->&lt;<!--> <!-->0.05). Interestingly, treatment with high dose of COC for 6-weeks did not significantly alter atherothrombotic markers (<em>p</em> <!-->&gt;<!--> <!-->0.05). However, this study is not without limitation as regulation of these markers remains to be confirmed within the cardiac tissues or endothelial cells of these animals.</p></div><div><h3>Conclusion</h3><p>HFD-feeding orchestrate the concomitant release of pro-coagulants and endothelial activation markers in rats leading to haemostatic imbalance and endothelial dysfunction. Short-term treatment with COC shows no detrimental effects in these HFD-fed rats. Although in terms of clinical relevance, our findings depict the notion that the risk of CVD in association with COC may depend on the dosage and duration of use among other factors especially in certain conditions. However, additional studies are required to confirm these findings, especially long-term effects of this treatment within the cardiac tissues or endothelial cells of these animals in certain conditions relating to postmenopausal state.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 2","pages":"Pages 60-70"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211170","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":"Valoración del riesgo aterogénico. ¿Lo podemos mejorar?","authors":"José Puzo Foncillas","doi":"10.1016/j.arteri.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.arteri.2024.01.001","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 1","pages":"Pages 33-34"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139727248","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":"Multizonal observational study conducted by clinical practitioners on Repatha® use in patients with hyperlipidemia (ZERBINI): Colombian results","authors":"Heidy M. Roncancio ,&nbsp;Julián R. Lugo-Peña ,&nbsp;Ángel A. García ,&nbsp;Janeth Leal ,&nbsp;Carlos A. Hoyos ,&nbsp;Johnny A. Beltrán ,&nbsp;César L. Cruz ,&nbsp;Carol Paez-Cano ,&nbsp;Mariana Pineda-Posada ,&nbsp;Eduardo Contreras","doi":"10.1016/j.arteri.2023.06.001","DOIUrl":"10.1016/j.arteri.2023.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular disease (CVD) represents the primary cause of death and disability globally, with elevated cholesterol as one of the leading risk factors for CVD. We describe the clinical characteristics, treatment patterns, and effectiveness of evolocumab in treating hyperlipidemia.</p></div><div><h3>Methods</h3><p>Observational study conducted through a chart review of patients with hyperlipidemia receiving evolocumab as part of clinical management in Colombia.</p></div><div><h3>Results</h3><p>This study included 115 patients treated with evolocumab. A total of 101 patients (87.8%) had a history of CVD, 13 (11.3%) familial hypercholesterolemia (FH), and 23 (20%) type 2 diabetes. Thirty-nine patients reported intolerance to any statin (33.9%). The median value of LDL-C before initiation of evolocumab was 147<!--> <!-->mg/dL (IQR: 122.5–183.7<!--> <!-->mg/dL). Within the first 3 months of treatment, LDL-C value dropped to a median value of 53<!--> <!-->mg/dL (IQR: 34.0–95.5<!--> <!-->mg/dL), showing a reduction of 63.9%. The median LDL-C values remained below 45<!--> <!-->mg/dL until the end of follow-up. Among the patients with available data, up to 61% achieved an LDL-C level below 55<!--> <!-->mg/dL at the 10–12-month follow-up. A total of 72% of patients were persistent with treatment. Safety results showed a low frequency of hospitalizations (≤2%) and treatment-emergent adverse drug reactions (5.2%). No serious adverse events were reported.</p></div><div><h3>Conclusions</h3><p>Evolocumab was associated with reductions in LDL-C levels, with a relative decrease of 63.9% within the first 3 months of treatment. Low rates of interruptions due to adverse events and adequate medication persistence was reported.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 1","pages":"Pages 22-32"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916823000517/pdfft?md5=6ea6bc5dc42de8e64538f70e91a0cee9&pid=1-s2.0-S0214916823000517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widespread xanthomas regression by personalized lipid lowering therapy in heterozygous familial hypercholesterolemia","authors":"Francesco Sbrana,&nbsp;Beatrice Dal Pino,&nbsp;Federico Bigazzi,&nbsp;Tiziana Sampietro","doi":"10.1016/j.arteri.2023.11.002","DOIUrl":"10.1016/j.arteri.2023.11.002","url":null,"abstract":"<div><p><span>“The lower, the better” is the recommended approach in the management of high LDL cholesterol<span>. Unfortunately, this does not always achieve as in the case of a 69-year-old woman referred to our Institute for her lipid profile (LDL cholesterol 412</span></span> <span>mg/dl), bilateral xanthelasma<span> and cutaneous xanthomas. With a maximized and personalized lipid-lowering therapies (rosuvastatin, ezetimibe, PCSK9i and lipoprotein apheresis), after only six months, the patient showed an impressive regression in her cutaneous xanthomas.</span></span></p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 1","pages":"Pages 35-37"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452821","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":"Nuevo índice aterogénico para la predicción de aterosclerosis carotídea basado en la ratio proteína C reactiva no ultrasensible/HDL","authors":"Óscar Fabregat-Andrés ,&nbsp;Pilar Pérez-de-Lucía ,&nbsp;Victor E. Vallejo-García ,&nbsp;Pablo Vera-Ivars ,&nbsp;Alfonso A. Valverde-Navarro ,&nbsp;José María Tormos","doi":"10.1016/j.arteri.2023.07.002","DOIUrl":"10.1016/j.arteri.2023.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Current guidelines recommend cardiovascular risk assessment as a preventive measure for cardiovascular diseases, whose fundamental etiology is arteriosclerosis. One of the tools used to estimate risk in clinical practice are atherogenic indices (AI), ratios between lipid fractions with well-established reference ranges. Despite its widespread use, there is still limited information on its clinical utility. In recent years, some research has reinforced the role of inflammation in the etiology and chronicity of the atherosclerotic process. The inclusion of inflammatory parameters in the AI calculation could improve its diagnostic performance in the detection of arteriosclerosis. We sought to evaluate a new AI as a ratio between C-reactive protein (CRP) values and high-density lipoprotein cholesterol (HDL) values.</p></div><div><h3>Methods</h3><p>A total of 282 asymptomatic patients with no history of cardiovascular disease were included in the study. Laboratory tests with lipid profile and CRP, and carotid ultrasound to assess the presence of atheromatosis were performed in all of them. The new AI is established as the ratio between non-ultrasensitive CRP value in mg/dL (multiplied by 100) and HDL value in mg/dL. It was compared with the Castelli I and II indices, and the plasma atherogenic index. The optimal cut-off point of the new AI was value<!--> <!-->=<!--> <!-->1 as determined by ROC curve, with an area under the curve of 0.678 (95% CI 0.60-0.75; p<!--> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Results</h3><p>Mean age of patients was 60.4<!--> <!-->±<!--> <!-->14.5 years. A total of 118 patients (41.8% of total) had carotid arteriosclerosis. When evaluating the diagnostic performance of different AIs, we found that CRP·100/HDL ratio showed the highest values of sensitivity and positive predictive value (0.73 and 0.68, respectively) compared to the Castelli I and II indices, and the plasma atherogenic index. It was also the only predictor of carotid atheromatosis both when considering its values quantitatively (with OR 1.4 [95% CI 1.1-1.7]; p<!--> <!-->=<!--> <!-->0.005), and qualitatively (with OR 2.9 [95% CI 1.5-5.5]; p<!--> <!-->&lt;<!--> <!-->0.001) in patients with a CRP·100/HDL ratio<!--> <!-->&gt;<!--> <!-->1.</p></div><div><h3>Conclusions</h3><p>The new PCR·100/HDL index showed the best diagnostic performance in the detection of carotid atheromatosis compared to other classic AIs in this Spanish population of asymptomatic patients.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 1","pages":"Pages 12-21"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10070315","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":"Perfil clínico de la hipercolesterolemia severa en 156.000 adultos en atención primaria","authors":"Teresa Gijón-Conde ,&nbsp;Carolina Ferré Sánchez ,&nbsp;Isabel Ibáñez Delgado ,&nbsp;Berenice Rodríguez Jiménez ,&nbsp;José R. Banegas","doi":"10.1016/j.arteri.2023.08.002","DOIUrl":"10.1016/j.arteri.2023.08.002","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the frequency of severe hypercholesterolemia (HS) and its clinical profile, and the phenotype of familial hypercholesterolemia (FH), in the primary-care setting in a large health area of the Community of Madrid (CAM).</p></div><div><h3>Material and methods</h3><p>Multicenter study of subjects with a health card assigned to 69 health centers (Northwest/CAM area). HS was defined as cholesterol ≥<!--> <!-->300<!--> <!-->mg/dL or LDL-cholesterol ≥<!--> <!-->220<!--> <!-->mg/dL in any analysis performed (1-1-2018 to 12-30-2021); and FH phenotype as c-LDL ≥<!--> <!-->240<!--> <!-->mg/dL (≥<!--> <!-->160<!--> <!-->mg/dL if lipid-lowering treatment) with triglycerides &lt;<!--> <!-->200<!--> <!-->mg/dL and TSH &lt;<!--> <!-->5<!--> <!-->μIU/mL.</p></div><div><h3>Results</h3><p>156,082 adults ≥<!--> <!-->18<!--> <!-->years with an available lipid profile were analyzed. 6187 subjects had HS (3.96% of the laboratory tests studied, 95%<!--> <!-->CI: 3.87-4.06%). The mean evolution time of the diagnosis of hyperlipidemia in the computerized clinical record was 10.8<!--> <!-->years, 36.5% had hypertension, 9.5% diabetes and 62.9% overweight/obesity. 83.7% were taking lipid-lowering drugs (65.7% low/moderate and 28.6% high/very high intensity). 6.1% had cardiovascular disease (94.2% treated with lipid-lowering agents), with LDL-cholesterol &lt;<!--> <!-->55, &lt;<!--> <!-->70 and &lt;<!--> <!-->100<!--> <!-->mg/dL of 1.8%, 5.8% and 20.2%, respectively (vs. 1%, 2.3% and 11.2% if no cardiovascular disease). 1600 subjects had FH phenotype (95%<!--> <!-->CI: 1.03%, 0.98-1.08%).</p></div><div><h3>Conclusions</h3><p>Four out of 100 patients analyzed in primary care have HS, with high treatment level, but insufficient intensity, and poor achievement of treatment goals. One in 100 have the FH phenotype. The identification of both dyslipidemias by computerized records would allow their more precise and early detection and establish cardiovascular preventive strategies.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 1","pages":"Pages 1-11"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139487","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}