Clinica e Investigacion en Arteriosclerosis最新文献

{"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}

{"title":"Sueño y riesgo cardiometabólico. Revisión narrativa","authors":"J. Ildefonzo Arocha Rodulfo ,&nbsp;Gestne Aure Fariñez ,&nbsp;Fernando Carrera","doi":"10.1016/j.arteri.2023.08.001","DOIUrl":"10.1016/j.arteri.2023.08.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Sleep disturbances, including disrupted sleep and short sleep duration, are highly prevalent and are prospectively associated with an increased risk for various chronic diseases, including cardiometabolic, neurodegenerative, and autoimmune diseases.</p></div><div><h3>Material and methods</h3><p>This is a narrative review of the literature based on numerous articles published in peer-reviewed journals since the beginning of this century.</p></div><div><h3>Results</h3><p>The relationship between sleep disorders and metabolic dysregulation has been clearly established, mainly in the setting of modern epidemic of cardiometabolic disease, a cluster of conditions include obesity, insulin resistance, arterial hypertension, and dyslipidaemia, all of them considered as main risk factor for atherosclerotic cardiovascular disease (ACVD) and its clinical expression such as ischemic ictus, myocardial infarction and type 2 diabetes. Clinically viable tools to measure sleep duration and quality are needed for routine screening and intervention.</p></div><div><h3>Conclusions</h3><p>In view of what has been exposed in this review, it is evident that the timing, amount, and quality of sleep are critical to reduce the burden of risk factors for several chronic disease, including ACVD and type 2 diabetes, and most relevant in young people. Future research studies should elucidate the effectiveness of multimodal interventions to counteract the risk of short sleep for optimal patient outcomes across the healthcare continuum, especially in young people.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"36 1","pages":"Pages 38-49"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212080","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":"Análisis del programa de apoyo al paciente de evolocumab (Repatha®) para pacientes con enfermedades cardiovasculares en Colombia","authors":"Ángel Alberto García-Peña ,&nbsp;Mariana Pineda-Posada ,&nbsp;Carol Páez-Canro ,&nbsp;César Cruz ,&nbsp;Daniel Samacá-Samacá","doi":"10.1016/j.arteri.2023.04.005","DOIUrl":"10.1016/j.arteri.2023.04.005","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular diseases are considered the leading cause of death globally. This study describes the demographic characteristics, treatment patterns, self-reported compliance and persistence, and to explore variables related to non-adherence of patients enrolled in the cardiovascular patient support program (PSP) for evolocumab treatment in Colombia.</p></div><div><h3>Methods</h3><p>This retrospective observational of the data registry of patients who entered the evolocumab PSP program.</p></div><div><h3>Results</h3><p>The analysis included 930 patients enrolled in the PSP (2017-2021). Mean age was 65.1 (SD<!--> <!-->±<!--> <!-->13.1) and49.1% patients were female. The mean compliance rate to evolocumab treatment was 70.5% (SD<!--> <!-->±<!--> <!-->21.8). A total of 367 patients (40.5%) reported compliance higher than 80%. Persistence analysis included 739 patients (81.5%) where 87.8% of these patients were considered persistent to treatment. A total of 871 patients (93.7%) reported the occurrence of at least one adverse event during the follow-up period (mostly non-serious).</p></div><div><h3>Conclusion</h3><p>This is the first real-life study describing patient characteristics, compliance and continuity of treatment for dyslipidemia in a patient support program in Colombia. The overall adherence found was higher than 70%; similar to findings reported in other real-life studies with iPCSK9. However, the reasons for low compliance were different, highlighting the high number of administrative and medical reasons for suspension or abandonment of treatment with evolocumab.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 6","pages":"Pages 280-289"},"PeriodicalIF":1.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935001","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":"Percepción de los médicos frente al consumo de vino tinto y la salud cardiovascular","authors":"Javier Espíldora-Hernández ,&nbsp;Salvador Martín-Cortés ,&nbsp;María José Benítez-Toledo ,&nbsp;Inmaculada Coca-Prieto ,&nbsp;Miguel Ángel. Sánchez-Chaparro ,&nbsp;Pedro Valdivielso","doi":"10.1016/j.arteri.2023.05.002","DOIUrl":"10.1016/j.arteri.2023.05.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The consumption of red wine has historically been associated with a reduction in cardiovascular risk, with sometimes controversial scientific evidence.</p></div><div><h3>Method</h3><p>A survey was carried out via whatsapp dated 09/01/22 to a cohort of doctors from the province of Malaga, asking about possible healthy red wine consumption habits, differentiating: never, 3-4 glasses per week, 5 -6 weekly drinks and one daily drink.</p></div><div><h3>Results</h3><p>A total of 184 physicians answered, with a mean age of 35 years ± 11.1, of which 84 (45.6%) were women, distributed in different specialties, the majority being internal medicine with 52 (28.2%). The most frequently chosen option was D (59.2%), followed by A (21.2%), C (14.7%) and B (5%).</p></div><div><h3>Conclusions</h3><p>More than half of the doctors surveyed recommended zero consumption, and only 20% indicated that a daily drink could be healthy in non-drinkers.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 6","pages":"Pages 290-293"},"PeriodicalIF":1.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9648936","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":"Long-term treatment persistence and maintained reduction of LDL-cholesterol levels with evolocumab over 30 months: Results from the Spanish cohort of the European prospective HEYMANS study","authors":"Agustín Blanco Echevarría ,&nbsp;Juan De Dios García Díaz ,&nbsp;Assumpta Caixas ,&nbsp;Núria Plana Gil ,&nbsp;Miguel Ángel Rico Corral ,&nbsp;Ian Bridges ,&nbsp;Nafeesa Dhalwani ,&nbsp;Sònia Gatell Menchen ,&nbsp;Kausik K. Ray","doi":"10.1016/j.arteri.2023.04.004","DOIUrl":"10.1016/j.arteri.2023.04.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;p&gt;Limited data exist on low-density lipoprotein-cholesterol (LDL-C) level variability or long-term persistence with the monoclonal antibody evolocumab in routine clinical practice. HEYMANS (&lt;span&gt;NCT02770131&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;) is the first multi-country, multicenter, observational study of European patients initiating evolocumab as part of their routine clinical management, based on local reimbursement criteria (overall data recently published). The aim of this analysis is to describe clinical characteristics, baseline and changes in LDL-C levels, treatment patterns and persistence to evolocumab over 30 months in the Spanish cohort using data from the HEYMANS Registry.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;HEYMANS was a prospective study of adult patients (≥18 years) who received at least one dose of evolocumab. A total of 1951 patients were enrolled from 12 countries and were followed up for 30 months after evolocumab initiation. Data were collected for 6 months before evolocumab initiation and up to 30 months thereafter. The Spanish cohort included patients who started evolocumab in routine clinical practice from March 2016 to September 2019. Demographic and clinical characteristics, lipid-lowering therapies (LLT), and lipid levels were collected.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;In total, 201 patients were included in the Spanish cohort. Median follow-up (Q1–Q3) was 30.0 (12–30) months. A total of 61.7% of patients were men and the mean (standard deviation) age was 59.5 (10.8) years. Most patients (68.7%) had experienced a prior cardiovascular event, 45.3% had coronary artery disease or stable angina, and 60.2% had a diagnosis of familial hypercholesterolemia. Overall, 57.7% of patients were receiving treatment with statins, most of them with high-intensity statins (85.3%); 45.8% of patients were intolerant to statins, and 26.4% of patients did not receive any LLT. At baseline, median (Q1–Q3) LDL-C levels were 151 (123–197) mg/dL. After 3 months of treatment, baseline LDL-C decreased by 66% to a median of 50 (30–83) mg/dL and these levels were maintained over time, with a median LDL-C of 55 (40–99) mg/dL at 30 months. At months 10–12 of treatment, LDL-C levels&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;55&lt;!--&gt; &lt;!--&gt;mg/dL were achieved by 56.3% of patients. LDL-C levels&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;70&lt;!--&gt; &lt;!--&gt;mg/dL were achieved by 70.1% of patients, and a lowering of LDL-C levels ≥50% was achieved by 76.8% of patients. The percentage of patients on evolocumab treatment was 95% at 12 months and 93% at 30 months.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;In the Spanish cohort in routine clinical practice, evolocumab therapy provided a reduction in LDL-C levels consistent with that reported in previous clinical trials, which was sustained during 30 months of follow-up. Treatment with evolocumab was started at LDL-C levels 50% higher than those recommended by The Spanish Society of Arteriosclerosis and the Therapeutic Positioning Report. The pro","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 6","pages":"Pages 263-271"},"PeriodicalIF":1.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916823000438/pdfft?md5=66c53b17b84dce0e0c363f6c7eeabae1&pid=1-s2.0-S0214916823000438-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9895408","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":"Estudio observacional de pacientes de una Unidad de Lípidos en tratamiento hipolipemiante para prevención primaria y secundaria: Estudio ULFI","authors":"Àlex Vila ,&nbsp;Estel Pons ,&nbsp;Patricia Trinidad García ,&nbsp;Daniel Vidal ,&nbsp;Sara López ,&nbsp;Armand Grau","doi":"10.1016/j.arteri.2023.06.002","DOIUrl":"10.1016/j.arteri.2023.06.002","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the achievement of low-density lipoprotein cholesterol (LDLc) goals established by the 2019 European Guidelines for the Management of Dyslipidemias and 2021 Cardiovascular Disease Prevention Guidelines, describe the lipid-lowering treatment received, analyze the achievement of goals according to the lipid-lowering treatment received and study the factors associated with therapeutic success.</p></div><div><h3>Design</h3><p>Observational study that included 185 patients of both sexes aged 18 or over undergoing lipid-lowering treatment for primary or secondary prevention, attended at the Lipid Unit.</p></div><div><h3>Results</h3><p>62.1% of the patients had a very high cardiovascular risk (CVR) according to the 2019 guidelines, and 60.5% according to the 2021 guidelines. Of the total cases, 22.7% achieved adequate control of LDLc according to the 2019 guidelines and 20% according to the 2021 guidelines. 47.6% of the patients received very high intensity lipid-lowering treatment, and 14.1% received extremely high intensity lipid-lowering treatment. 76% of subjects with very high CVR on extremely high intensity lipid-lowering treatment achieved the therapeutic objectives of both guides. In the multivariate analysis, factors associated with therapeutic success were the presence of arteriosclerotic cardiovascular disease, the intensity of lipid-lowering treatment, diabetes mellitus, and low to moderate alcohol consumption.</p></div><div><h3>Conclusions</h3><p>Dyslipidemia control is improvable. High or extremely high intensity lipid-lowering treatments can contribute to optimizing control of patients with higher CVR.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 6","pages":"Pages 272-279"},"PeriodicalIF":1.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0214916823000529/pdfft?md5=04af994abb2c02336a6e0a92b521b471&pid=1-s2.0-S0214916823000529-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9841313","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":"EL VINO: ¿ES REALMENTE SALUDABLE?","authors":"Ramón Estruch","doi":"10.1016/j.arteri.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.arteri.2023.11.001","url":null,"abstract":"","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 6","pages":"Pages 294-296"},"PeriodicalIF":1.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138454173","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":"Update of HDL in atherosclerotic cardiovascular disease","authors":"Leonie Schoch ,&nbsp;Sebastián Alcover ,&nbsp;Teresa Padró ,&nbsp;Soumaya Ben-Aicha ,&nbsp;Guiomar Mendieta ,&nbsp;Lina Badimon ,&nbsp;Gemma Vilahur","doi":"10.1016/j.arteri.2023.10.002","DOIUrl":"10.1016/j.arteri.2023.10.002","url":null,"abstract":"<div><p>Epidemiologic evidence supported an inverse association between HDL (high-density lipoprotein) cholesterol (HDL-C) levels and atherosclerotic cardiovascular disease (ASCVD), identifying HDL-C as a major cardiovascular risk factor and postulating diverse HDL vascular- and cardioprotective functions beyond their ability to drive reverse cholesterol transport. However, the failure of several clinical trials aimed at increasing HDL-C in patients with overt cardiovascular disease brought into question whether increasing the cholesterol cargo of HDL was an effective strategy to enhance their protective properties. In parallel, substantial evidence supports that HDLs are complex and heterogeneous particles whose composition is essential for maintaining their protective functions, subsequently strengthening the “HDL quality over quantity” hypothesis.</p><p>The following state-of-the-art review covers the latest understanding as per the roles of HDL in ASCVD, delves into recent advances in understanding the complexity of HDL particle composition, including proteins, lipids and other HDL-transported components and discusses on the clinical outcomes after the administration of HDL-C raising drugs with particular attention to CETP (cholesteryl ester transfer protein) inhibitors.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 6","pages":"Pages 297-314"},"PeriodicalIF":1.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522906","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":"Accuracy of visceral adiposity indices and lipid accumulation products in the identification of adults at high cardiovascular risk","authors":"Ana Maria Gonçalvez Milla ,&nbsp;Eduardo B.F. Chagas ,&nbsp;Vitor Fernando Bordin Miola ,&nbsp;Bárbara de Oliveira Zanuso ,&nbsp;Elen Landgraf Guiguer ,&nbsp;Adriano Cressoni Araújo ,&nbsp;Ricardo José Tofano ,&nbsp;Karina R. Quesada ,&nbsp;Lucas F. Laurindo ,&nbsp;Sandra M. Barbalho","doi":"10.1016/j.arteri.2023.04.002","DOIUrl":"10.1016/j.arteri.2023.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The lipid accumulation product (LAP) and visceral adipose index (VAI) are clinical markers of visceral obesity and were proposed as simple tools to estimate cardiovascular risk and mortality. The objective of this study was to analyze the accuracy of the VAI and LAP for high cardiovascular risk patients.</p></div><div><h3>Methods</h3><p>A cross-sectional observational study of accuracy was carried out in 193 patients of both sexes. In addition to the variables VAI and LAP, presence of comorbidities, education, level of physical activity and anthropometric data were obtained. Cardiovascular risk was determined by the Framingham score.</p></div><div><h3>Results</h3><p>No significant difference was observed in the sample in gender distribution (44.6% women; 55.4% men), 24.4% had low cardiovascular risk, 48.7% intermediate risk and 26.9% high cardiovascular risk. Linear regression analysis showed that VAI and LAP explain, respectively, only 2.4% and 5.2% of the variation in cardiovascular risk expressed by the Framingham score. The analysis of areas under the curve (AUC) for receiver operating characteristic (ROC) indicated a significant effect only of LAP to diagnose individuals with high cardiovascular risk, but with low sensitivity and specificity.</p></div><div><h3>Conclusion</h3><p>Our results indicate that VAI and LAP explain only a small percentage of the variation in the Framingham cardiovascular risk score. LAP index still deserves more attention in a cohort study, because, even with the limitations of a cross-sectional study, we observed an acceptable sensitivity for it so that the LAP can be used as a screening criterion for requesting more accurate tests.</p></div>","PeriodicalId":45230,"journal":{"name":"Clinica e Investigacion en Arteriosclerosis","volume":"35 5","pages":"Pages 236-242"},"PeriodicalIF":1.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9366631","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}