Atherosclerosis最新文献

{"title":"Does statin matter when it comes to Lipoprotein(a) levels?","authors":"Aris P. Agouridis , Theodosios D. Filippatos , Christina Kostara , Michalis S. Kostapanos , Vasilios Tsimihodimos","doi":"10.1016/j.atherosclerosis.2025.120466","DOIUrl":"10.1016/j.atherosclerosis.2025.120466","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120466"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure- and flow-driven biomechanical factors associate with carotid atherosclerosis assessed by computed tomography angiography","authors":"Aikaterini Tziotziou ,&nbsp;Yanjing Liu ,&nbsp;Federica Fontana ,&nbsp;Juul Bierens ,&nbsp;Paul J. Nederkoorn ,&nbsp;Pim A. de Jong ,&nbsp;M. Eline Kooi ,&nbsp;Werner Mess ,&nbsp;Aad van der Lugt ,&nbsp;Antonius F.W. van der Steen ,&nbsp;Daniel Bos ,&nbsp;Jolanda J. Wentzel ,&nbsp;Ali C. Akyildiz","doi":"10.1016/j.atherosclerosis.2025.120415","DOIUrl":"10.1016/j.atherosclerosis.2025.120415","url":null,"abstract":"<div><h3>Background and aims</h3><div>Local biomechanical factors are known to influence atherosclerosis in extracranial carotid arteries. While the role of some flow-driven biomechanical factors has been investigated, the influence of pressure-driven mechanical wall stress (MWS) has received limited attention. In this study, the association of the pressure-driven and flow-driven biomechanical factors with carotid atherosclerosis was examined.</div></div><div><h3>Methods</h3><div>Carotid arteries (n = 150) with mild-to-moderate stenosis from 75 symptomatic patients (Plaque-At-Risk study) were imaged using multi-detector computed tomography angiography (MDCTA) at the time of inclusion and after 2 years. Structural changes in carotid wall and calcifications were quantified from MDCTA data while the local baseline biomechanical factors in the carotids were determined using fluid-structure interaction (FSI) computational models. The associations of the local pressure-driven and flow-driven biomechanical factors with the carotid wall and calcification changes were studied using Generalized Linear Mixed models.</div></div><div><h3>Results</h3><div>Over two years, plaque sectors, with calcified and non-calcified sectors combined, exhibited minimal change in wall thickness, likely due to medical treatment. High MWS was associated (<em>p</em> &lt; 0.001) with a reduction in plaque thickness. In calcified plaque sectors, high MWS and low oscillatory shear index (OSI) were associated (<em>p</em> &lt; 0.001) with greater calcification thickness increase. The distance between the lumen and calcification decreased over time, especially in the sectors exposed to high time-averaged wall shear stress (TAWSS) and high MWS.</div></div><div><h3>Conclusions</h3><div>Our results suggest that the pressure-driven local MWS and flow-driven OSI and TAWSS significantly correlate with the development of calcified and non-calcified plaques in carotid arteries.</div></div><div><h3>Registration</h3><div>URL: <span><span>https://www.clinicaltrials.gov</span><svg><path></path></svg></span>; Unique identifier: NCT01208025.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120415"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile of familial hypercholesterolemia phenotype in adults attended in primary care in a large healthcare area","authors":"Teresa Gijón-Conde ,&nbsp;José R. Banegas ,&nbsp;Carolina Ferré Sánchez ,&nbsp;Rodrigo Alonso ,&nbsp;Pedro Mata","doi":"10.1016/j.atherosclerosis.2025.120400","DOIUrl":"10.1016/j.atherosclerosis.2025.120400","url":null,"abstract":"<div><h3>Background and aims</h3><div>To examine the clinical profile and associated clinical characteristics of heterozygous Familial Hypercholesterolemia<span> clinical phenotype (FH) in adults attended in primary care in a large health area of the Community of Madrid, Spain.</span></div></div><div><h3>Methods</h3><div><span><span>Cross-sectional, multicenter study including 156,082 adults (≥18 years) from 69 health centers with at least one lipid profile<span> between 2018 and 2021, using electronic health records (EHR). Severe </span></span>hypercholesterolemia<span> (SH) was defined as total cholesterol ≥300 mg/dL or LDL-cholesterol≥220 mg/dL and FH phenotype was defined as LDL-C ≥240 mg/dL (≥90th percentile within our study sample) or ≥160 mg/dL under lipid-lowering therapy (LLT), with </span></span>triglycerides<span><span> &lt;200 mg/dL and normal TSH levels. Multivariate </span>logistic regression was used to assess clinical associations.</span></div></div><div><h3>Results</h3><div>SH was present in 6187 individuals (3.96 %), and FH phenotype in 1600 (1.03 %; mean age 60.7 years; 72.7 % women). Compared with non-FH individuals, those with FH were more often female, on LLT (97.6 % vs. 79.0 %), and had lower prevalence of diabetes, hypertension, and obesity (all p &lt; 0.005). Women with FH were more frequently treated but less often with high/very-high intensity LLT than men (25.3 % vs. 36.6 %; p &lt; 0.001). All treated FH patients had LDL-C &gt;130 mg/dL (vs. 60.4 % in non-FH), with higher levels in men (178.7 vs. 170.9 mg/dL; p = 0.0015). Female sex and LLT were independently associated with FH phenotype, while age, diabetes, hypertension, and obesity were inversely associated (all p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>FH phenotype was identified in 1.03 %, of primary care patients. Women were more often treated but less likely to receive high-intensity or combined therapy<span> compared to men. LDL-C levels were higher in men and intensive therapy reduced sex differences. LDL-C targets were largely unmet. EHR may aid early identification and improve preventive strategies.</span></div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120400"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The omega effect: Harnessing fish oil for health","authors":"Jacques D. Barth MD, PhD, FACC","doi":"10.1016/j.atherosclerosis.2025.120461","DOIUrl":"10.1016/j.atherosclerosis.2025.120461","url":null,"abstract":"<div><div>Recent findings from a sub-analysis of the STRENGTH randomized clinical trial reveal that omega-3 carboxylic acids yielded significant cardiovascular risk reduction among Asian participants, despite showing neutral results in the broader high-risk cohort. These observations underscore the potential influence of genetic, metabolic, and lifestyle factors in modulating therapeutic efficacy across ethnic groups.</div><div>This editorial advocates for a paradigm shift from isolated supplementation to the dietary integration of omega-3-rich foods. Nutrients derived from whole food matrices—such as fatty fish (e.g., salmon, mackerel) and plant sources (e.g., flaxseeds, walnuts)—may confer enhanced bioavailability and synergistic interactions absent in concentrated fish oil capsules.</div><div>The heterogeneity of the Asian subgroup, characterized by younger age, lower adiposity, and favorable lipid profiles, complicates generalizability. Moreover, unmeasured confounders (e.g., dietary patterns, socioeconomic variables) warrant caution in extrapolating outcomes to wider populations.</div><div>Traditional cardiovascular risk models centered on well-established variables (e.g., hypertension, dyslipidemia, smoking) are increasingly complemented by emerging determinants—including chronic inflammation, endothelial dysfunction, and genomic risk scores. Notably, the decline in population attributable fractions for classic risk factors signals the need for multifactorial, diet-based prevention strategies.</div><div>The “Omega (Ω) Effect” encapsulates the proposition that omega-3 fatty acids exert maximal cardiovascular benefit when embedded within a comprehensive, heart-healthy diet. For asymptomatic individuals concerned with primary prevention, embracing whole-food sources of omega-3s may offer superior long-term outcomes compared to reliance on supplemental formulations alone.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120461"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fuelling the Switch: AK4 is a master energy regulator of vascular smooth muscle cell fate","authors":"Kristen J. Bubb ,&nbsp;Stephen J. Nicholls ,&nbsp;Denuja Karunakaran","doi":"10.1016/j.atherosclerosis.2025.120425","DOIUrl":"10.1016/j.atherosclerosis.2025.120425","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120425"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of PCSK9 monoclonal antibodies in older patients: A real-world registry","authors":"Ruben J.M. Mijnster ,&nbsp;Janneke W.C.M. Mulder ,&nbsp;Annette M.H. Galema-Boers ,&nbsp;Francesco Mattace-Raso ,&nbsp;Majon Muller ,&nbsp;Melvin Lafeber ,&nbsp;Jeanine E. Roeters van Lennep","doi":"10.1016/j.atherosclerosis.2025.120229","DOIUrl":"10.1016/j.atherosclerosis.2025.120229","url":null,"abstract":"<div><h3>Background and aims</h3><div>Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9 mAbs) have a favourable efficacy and safety profile. Advancing age may pose challenges such as increasing drug toxicity, polypharmacy, and comorbidities. This study aims to assess whether the efficacy and safety of PCSK9 mAbs are comparable between patients ≥70 years versus patients &lt;70 years.</div></div><div><h3>Methods</h3><div>In a prospective registry of all consecutive patients who started PCSK9 mAbs as part of routine care in a university medical center-based lipid clinic, data was collected on LDL cholesterol levels, side effects, and discontinuation. Data on efficacy and safety (reported side effects and discontinuation) were stratified for patients ≥70 and &lt; 70 years.</div></div><div><h3>Results</h3><div>Of the 474 patients (median age 59 [51–66] years, 51 % men) who started a PCSK9 mAb, 70 patients were ≥70 years (15 %). After 6 months, relative and absolute LDL cholesterol reduction was similar across age groups (relative decrease: 58 % [48–70] vs 59 % [44–71], p = 0.99; mean (SD) absolute decrease 2.4 (0.8) vs 2.4 (1.2) mmol/L, p = 0.90). A comparable proportion of patients ≥70 years compared to those &lt;70 years achieved European and Dutch guideline-recommended goals (36 % vs 46 %, p = 0.18, and 54 % vs 62 %, p = 0.26, respectively). Efficacy outcomes were similar after 12 and 24 months follow-up. Reported side effects and discontinuation of PCSK9 mAbs were comparable across age groups.</div></div><div><h3>Conclusions</h3><div>Efficacy and safety of PCSK9 mAbs are comparable for patients ≥70 years and patients &lt;70 years in a real-world study.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120229"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive imaging of individual histological carotid plaque characteristics: A diagnostic accuracy meta-analysis","authors":"David Pakizer ,&nbsp;Patrick Taffé ,&nbsp;Jiří Kozel ,&nbsp;Jolanda Elmers ,&nbsp;Janusz Feber ,&nbsp;Vincent Dunet ,&nbsp;Patrik Michel ,&nbsp;David Školoudík ,&nbsp;Gaia Sirimarco","doi":"10.1016/j.atherosclerosis.2025.120391","DOIUrl":"10.1016/j.atherosclerosis.2025.120391","url":null,"abstract":"<div><h3>Background and aims</h3><div>Accurately detecting carotid plaque characteristics is crucial for identifying high-risk patients due to risk of cerebrovascular events and complications during revascularizations. Diagnostic accuracy of individual and overall carotid plaque characteristics using computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US) compared to histology in patients with symptomatic/asymptomatic carotid plaques was aimed.</div></div><div><h3>Methods</h3><div>After prospective registration on PROSPERO (CRD42022329690), Medline Ovid, Embase, Cochrane Library, and Web of Science were searched without any limitations. QUADAS-2 tool was used to study quality assessment, GRADE framework to assess evidence certainty, and univariate/bivariate random-effect meta-analyses for data analysis.</div></div><div><h3>Results</h3><div>Of 5960 studies screened, 107 were identified, resulting in 253 diagnostic accuracy comparisons of 16 plaque characteristics (28 CT, 120 MRI, and 105 US). CT detected intraplaque hemorrhage (IPH) and lipid-rich necrotic core (LRNC) with good accuracy (86 % [95 %CI 67–95] and 84 % [72–91], respectively) and exhibited very high accuracy for ulceration (92 % [87–95]; 76 % on MRI and 75 % on US) and calcification (90 % [58–98] vs. 89 % [87–91] on MRI). MRI identified LRNC and IPH with good accuracy (86 % [81–89] and 86 % [84–88], respectively), and differentiated between acute/subacute/old IPH (accuracy &gt;87 %). US accurately detected ruptured fibrous cap (85 % [77–91]), comparable to MRI (85 % [79–90]), but demonstrated lower performance for other characteristics. Finally, CT detected overall carotid morphology with 89 % accuracy, followed by MRI (86 %; <em>p</em> = 0.374 to CT), and significantly lower by US (78 %; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>CT identified key plaque features, especially ulceration and calcification. MRI provided thorough plaque assessment by detecting all features and differentiating IPH age. For overall morphology, CT and MRI surpassed US accuracy.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120391"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential cardiovascular impact of ω-3 fatty acid in patients at high cardiovascular risk in Asians versus non-Asians: Sub-analysis of the strength randomized clinical trial","authors":"Tom Kai Ming Wang ,&nbsp;Stephen J. Nicholls ,&nbsp;Julie St John ,&nbsp;Kathy Wolski ,&nbsp;Steven E. Nissen","doi":"10.1016/j.atherosclerosis.2025.120228","DOIUrl":"10.1016/j.atherosclerosis.2025.120228","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Racial differences in lipid and cardiovascular risk profiles are well-established, including for Asians. We compared cardiovascular treatment effects of ω-3 carboxylic acid (CA) between Asians and non-Asians in this post-hoc analysis of the STRENGTH trial.</div></div><div><h3>Methods</h3><div>The STRENGTH trial was a double-blinded randomized controlled trial of 13,078 high cardiovascular risk patients enrolled at 675 global centers. Efficacy and interactions of ω-3 CA for Asians (n = 1355) and non-Asians (n = 11,723) were assessed. The primary endpoint is a 5-point composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, coronary revascularization, and unstable angina hospitalizations.</div></div><div><h3>Results</h3><div>In Asians, ω-3 CA was associated with significantly reduction in the primary endpoint during 3.6 ± 0.7 years follow-up with 81/698 (Kaplan-Meier estimate (KME): 14.8 %) events in the ω-3 CA group, 103/657 (KME: 20.4 %) events in the corn oil group, hazard ratio (HR) 0.72, 95 %CI 0.54–0.96, p = 0.03. In non-Asians, there was not a significant difference in primary endpoint rates, 704/5841 (KME: 15.6 %) events in the ω-3 CA group, 692/5882 (KME: 15.9 %) events in the corn oil group, HR 1.03 95 %CI 0.93–1.14, p = 0.60. There were significant interactions between race (Asian vs non-Asian) and treatment group for the primary endpoint (p = 0.02) and non-fatal stroke (p = 0.02).</div></div><div><h3>Conclusion</h3><div>In this exploratory analysis from the neutral STRENGTH trial, ω-3 CA was associated with significant reduction in the primary endpoint in Asians but not in non-Asian patients with high cardiovascular risk. Further, ideally randomized, research is necessary to assess these hypothesis-generating findings and elucidate potential mechanisms for beneficial effects of ω-3 CA in Asians.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120228"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering familial hypercholesterolaemia phenotype in the community: How primary care can transform early detection and management","authors":"Ralph K. Akyea,&nbsp;Nadeem Qureshi","doi":"10.1016/j.atherosclerosis.2025.120427","DOIUrl":"10.1016/j.atherosclerosis.2025.120427","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120427"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PCSK9 inhibitors and aging: Does chronological age matter?","authors":"Mohammad Al Mouslmani MD, MPH ,&nbsp;Armin Nouri MD ,&nbsp;Abdulla A. Damluji MD, PhD, MBA ,&nbsp;Michael G. Nanna MD, MHS","doi":"10.1016/j.atherosclerosis.2025.120428","DOIUrl":"10.1016/j.atherosclerosis.2025.120428","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"408 ","pages":"Article 120428"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}