Atherosclerosis最新文献

{"title":"Long-term trends in cardiovascular risk factors and cardiovascular risk following bariatric surgery: A 10-year prospective cohort study","authors":"Maria Humięcka ,&nbsp;Ada Sawicka ,&nbsp;Kinga Kędzierska ,&nbsp;Michał Kotowicz ,&nbsp;Maria Koczkodaj ,&nbsp;Paweł Jaworski ,&nbsp;Artur Binda ,&nbsp;Wiesław Tarnowski ,&nbsp;Piotr Jankowski","doi":"10.1016/j.atherosclerosis.2025.119232","DOIUrl":"10.1016/j.atherosclerosis.2025.119232","url":null,"abstract":"<div><h3>Background and aims</h3><div>Bariatric surgery (BS) leads to a durable weight loss and remission of diabetes, but the long-term impact on hypertension and lipid disorders is not unequivocal. The aim of the study was to assess the impact of BS on the level of cardiovascular (CV) risk factors and estimate CV risk 10 years following BS.</div></div><div><h3>Methods</h3><div>The study included patients who underwent BS in 2010–2015, re-evaluated in 2023–2024. The CV risk was estimated using the Pooled Cohort Equations calculator.</div></div><div><h3>Results</h3><div>The analysis included 188 patients (76 % women), with a mean age of 43.3 ± 9.8 years, who underwent sleeve gastrectomy (73.4 %) and gastric bypass (26.6 %). The observation period lasted 10 (9–11) years, and BMI decreased from 41.7 (38.2–46.0) kg/m2 to 33.9 (29.4–38.8) kg/m2 (p &lt; 0.001). The prevalence of hypertension decreased from 76.6 % to 67.0 % (p &lt; 0.05), while the prevalence of diabetes (31.9 % vs. 23.9 %; p = 0.08), hypercholesterolemia (77.1 % vs. 70.7 %; p = 0.16), and smoking (from 35.6 % to 31.4 %; p = 0.39) did not change significantly. CV risk increased from 1.6 % (0.6–4.2 %) to 2.6 % (1.0–6.7 %) (p &lt; 0.001). Since patients examined during the follow-up examination were 10 years older and since age is a main driver of CV risk, we also calculated CV risk using the baseline age, which was significantly lower, 1.1 % (0.4–3.0 %; p &lt; 0.001 vs baseline).</div></div><div><h3>Conclusions</h3><div>Long-term weight reduction following BS is related to the decrease in the estimated CV risk.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"405 ","pages":"Article 119232"},"PeriodicalIF":4.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941093","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 Brussels International Declaration on Lipoprotein(a) Testing and Management","authors":"Florian Kronenberg ,&nbsp;Nicola Bedlington ,&nbsp;Zanfina Ademi ,&nbsp;Marius Geantă ,&nbsp;Tobias Silberzahn ,&nbsp;Marc Rijken ,&nbsp;Aedan Kaal ,&nbsp;Mariko Harada-Shiba ,&nbsp;Zhenyue Chen ,&nbsp;George Thanassoulis ,&nbsp;Bogi Eliasen ,&nbsp;Jean-Luc Eiselé ,&nbsp;Albert Wiegman ,&nbsp;Christie M. Ballantyne ,&nbsp;Emma Broome ,&nbsp;Michele Calabrò ,&nbsp;Pablo Corral ,&nbsp;Annelies Dol ,&nbsp;Leslie J. Donato ,&nbsp;Elsie Evans ,&nbsp;Magdalena Daccord","doi":"10.1016/j.atherosclerosis.2025.119218","DOIUrl":"10.1016/j.atherosclerosis.2025.119218","url":null,"abstract":"<div><div>There is striking evidence that a high lipoprotein(a) [Lp(a)] concentration is a strong, independent, and causal cardiovascular risk factor. However, Lp(a) testing rates are very low (1 %–2 %) despite the fact that 1 in 5 individuals have elevated Lp(a) concentrations.</div><div>The Brussels International Declaration on Lp(a) Testing and Management was co-created by the Lp(a) International Task Force and global leaders at the Lp(a) Global Summit, held in Brussels, Belgium, on March 24–25, 2025. The event, organized by FH Europe Foundation, brought together scientific experts, people with the lived experience of elevated Lp(a) and policy makers from the European Institutions and World Health Organization. The World Heart Federation, Global Heart Hub, and European Alliance for Cardiovascular Health and scientific organizations such as European Atherosclerosis Society, and International Atherosclerosis Society were formal partners. The Summit was hosted by a Member of the European Parliament, Romana Jerković, and held under the patronage of the Polish presidency of the Council of the European Union.</div><div>The Declaration calls for 1) integration of Lp(a) testing and management into Global, European and National Cardiovascular Health Plans; 2) appropriate investment, policy and programmes in targeting Lp(a) testing and management based on a recent study demonstrating the substantial overall cost-saving to health systems across the globe; 3) political commitment to mandate systematic Lp(a) testing at least once during a person's lifetime, ideally at an early age, with full reimbursement; 4) incorporation of Lp(a) test results in the context of a person's cardiovascular risk assessment, with development of personalised cardiovascular health roadmaps as needed, without fear of dredit aiscrimination; 5) investment in public and healthcare professional education to increase awareness of Lp(a) and its impact on cardiovascular health.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"406 ","pages":"Article 119218"},"PeriodicalIF":4.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963727","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":"Impact of aspirin therapy on progression of thoracic and abdominal aortic aneurysms.","authors":"Shayan Mohammadmoradi, Kory Heier, Elizabeth R Driehaus, Hammodah R Alfar, Sam Tyagi, Kristen McQuerry, Sidney W Whiteheart","doi":"10.1016/j.atherosclerosis.2025.119224","DOIUrl":"10.1016/j.atherosclerosis.2025.119224","url":null,"abstract":"<p><strong>Background and aims: </strong>Aortic aneurysms, including abdominal (AAA) and thoracic (TAA), pose significant challenges due to their rupture risk and complex pathophysiology. While aspirin has been proposed to manage aneurysm progression, evidence remains limited. This retrospective, single-center study used AI-driven methods to examine the association between aspirin therapy and aneurysm growth.</p><p><strong>Methods: </strong>The study, at the University of Kentucky Healthcare, utilized de-identified electronic health record data from 2010 to 2023. To evaluate platelet count changes, Cohort 1 included patients with AAA or TAA and matched healthy controls. To evaluate aortic diameter, Cohort 2 included AAA or TAA patients who had at least two imaging studies. Extraction of aortic diameters utilized an advanced AI-based natural language processing (NLP) algorithm to identify and extract relevant text strings related to aortic dimensions. Multivariable-adjusted linear regression analyses assessed the impact of aspirin on aneurysm progression.</p><p><strong>Results: </strong>Cohort 1 included 11,538 participants: 5774 controls, 3439 with AAA, and 2325 with TAA. Platelet counts were significantly lower in patients with aortic aneurysms compared to controls, though they were not considered thrombocytopenic. Cohort 2 included 302 AAA and 141 TAA patients. Subgroup analysis revealed that aspirin use was associated with increased AAA progression in females with small aneurysms (<50 mm). Further, aspirin therapy showed no significant impact on the annualized change in aneurysm diameter for TAA or for males with AAA.</p><p><strong>Conclusions: </strong>Our findings suggest aspirin's effectiveness varies by sex and potentially aneurysm size, underscoring the need for further research to refine antiplatelet therapy guidelines for aortic aneurysms.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":" ","pages":"119224"},"PeriodicalIF":4.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075621","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":"Selective removal of 7-ketocholesterol by a novel atherosclerosis therapeutic candidate reverts foam cells to a macrophage-like phenotype.","authors":"Prerna Bhargava, Darren Dinh, Fadzai Teramayi, Ana Silberg, Noa Petler, Amelia M Anderson, Keivan Sadrerafi, Daniel M Clemens, Matthew S O'Connor","doi":"10.1016/j.atherosclerosis.2025.119217","DOIUrl":"10.1016/j.atherosclerosis.2025.119217","url":null,"abstract":"<p><strong>Background and aims: </strong>The removal of the toxic oxidized cholesterol, 7-ketocholesterol (7KC), from cells through the administration of therapeutics has the potential to treat atherosclerosis and various other pathologies. While cholesterol is a necessary building block for homeostasis, oxidation of cholesterol can lead to the formation of toxic oxysterols with 7KC being the most prominent. 7KC is primarily formed through the non-enzymatic oxidation of cholesterol and is found in high levels in oxidized LDL (oxLDL) particles, which are highly implicated in heart disease. 7KC is implicated in the pathogenesis of numerous diseases, including multiple sclerosis, hypercholesterolemia, sickle cell anemia, and multiple age-related diseases. Of particular interest is the role of 7KC in the progression of atherosclerosis, with several studies associating elevated 7KC levels with the etiology and severity of the disease and in the underlying transition of macrophages to foam cells.</p><p><strong>Methods: </strong>This research aims to elucidate the molecular mechanisms of UDP-003, a novel therapeutic compound, in mitigating the harmful effects of 7KC in mouse and human monocyte and macrophage cell lines.</p><p><strong>Results: </strong>Experimental evidence demonstrates that administration of UDP-003 can reverse the foam cell phenotype, rejuvenating these cells by returning phagocytic function, preventing loss in efferocytosis ability, and decreasing both reactive oxygen species (ROS) and intracellular lipid droplet accumulation. We further demonstrate that UDP-003 drives urinary excretion of 7KC in vivo and has a safety/toxicity profile compatible with initiation of human clinical trials.</p><p><strong>Conclusions: </strong>Our data suggest that the targeted removal of 7KC from foam cells with UDP-003 can potentially prevent and reverse atherosclerotic plaque formation. UDP-003 has the potential to be the first disease-modifying therapeutic approach to treating atherosclerotic disease.</p>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":" ","pages":"119217"},"PeriodicalIF":4.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109490","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":"Editorial: The Brussels International Declaration on Lp(a) Testing And Management—A call to action","authors":"Jan Borén ,&nbsp;M. John Chapman ,&nbsp;Chris J. Packard","doi":"10.1016/j.atherosclerosis.2025.119221","DOIUrl":"10.1016/j.atherosclerosis.2025.119221","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"406 ","pages":"Article 119221"},"PeriodicalIF":4.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075618","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":"Hidden risk revealed: The prognostic power of coronary calcium in HIV","authors":"Maria Alwan MD,&nbsp;Mouaz H. Al-Mallah MD MSc,&nbsp;Mahmoud Al Rifai MD MPH","doi":"10.1016/j.atherosclerosis.2025.119228","DOIUrl":"10.1016/j.atherosclerosis.2025.119228","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"405 ","pages":"Article 119228"},"PeriodicalIF":4.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913006","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":"Angiopoietin-like protein inhibitors: Promising agents for the treatment of familial hypercholesterolemia and atherogenic dyslipidemia","authors":"Fatemeh Vahdat-Lasemi ,&nbsp;Leila Farhoudi ,&nbsp;Seyedeh Maryam Hosseinikhah ,&nbsp;Raul D. Santos ,&nbsp;Amirhossein Sahebkar","doi":"10.1016/j.atherosclerosis.2025.119235","DOIUrl":"10.1016/j.atherosclerosis.2025.119235","url":null,"abstract":"<div><h3>Background and aims</h3><div>This review examines the physiological functions of Angiopoietin-like proteins (ANGPTLs) in lipid metabolism and the epidemiology of atherosclerotic cardiovascular disease (ASCVD), while discussing their potential as therapies for dyslipidemias.</div></div><div><h3>Methods</h3><div>A review of contemporary literature on ANGPTLs was conducted.</div></div><div><h3>Results</h3><div>ANGPTLs comprise eight secreted proteins that share structural similarities with the angiopoietin family and serve as key regulators of various physiological and biochemical functions. Notably, ANGPTL3, ANGPTL4, and ANGPTL8 act as physiological inhibitors of lipoprotein lipase (LPL), playing a crucial role in lipoprotein and triglyceride metabolism in response to the body's nutritional status. A deficiency in these proteins is linked to hypolipidemia, characterized by a decrease in all lipid fractions, and genetic studies indicate a reduced risk of ASCVD in individuals with loss-of-function variants in ANGPTL3 and ANGPTL4. Conversely, elevated levels of ANGPTL3, ANGPTL4, and ANGPTL8 seem to increase the risk of cardiovascular disease. The role of ANGPTLs in regulating lipid metabolism underscores their potential in targeted therapies for managing dyslipidemias and lowering ASCVD risk, particularly in patients with difficult-to-control dyslipidemia phenotypes, such as homozygous Familial Hypercholesterolemia and mixed dyslipidemia.</div></div><div><h3>Conclusions</h3><div>The development of ANGPTL inhibitors could provide an effective strategy for preventing ASCVD.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"405 ","pages":"Article 119235"},"PeriodicalIF":4.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918239","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":"Residual lipoprotein(a)-associated risk in patients with stroke or transient ischemic attack","authors":"Takao Hoshino ,&nbsp;Takafumi Mizuno ,&nbsp;Satoko Arai ,&nbsp;Megumi Hosoya ,&nbsp;Sho Wako ,&nbsp;Shuntaro Takahashi ,&nbsp;Rie Oshima ,&nbsp;Eiko Higuchi ,&nbsp;Kentaro Ishizuka ,&nbsp;Sono Toi ,&nbsp;Kenichi Todo","doi":"10.1016/j.atherosclerosis.2025.119231","DOIUrl":"10.1016/j.atherosclerosis.2025.119231","url":null,"abstract":"<div><h3>Background and aims</h3><div>Lipoprotein (a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular diseases. This study aimed to evaluate the association of serum Lp(a) levels with the risk of residual vascular event risk after stroke or transient ischemic attack (TIA) in the Japanese population.</div></div><div><h3>Methods</h3><div>In this prospective observational study, 533 patients (mean age, 70.7 years; female, 41.8 %) with ischemic stroke (n = 496) or high-risk TIA (n = 37) were consecutively enrolled within 1 week of onset and followed up for 1 year. Patients were divided into 2 groups according to the median baseline Lp(a) levels: (i) low (≤15 mg/dL, n = 270) and (ii) high (&gt;15 mg/dL, n = 263) Lp(a) groups. The primary endpoint was a composite of major adverse cardiovascular events (MACEs), including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death.</div></div><div><h3>Results</h3><div>Compared to patients with Lp(a) ≤15 mg/dL, those with Lp(a) &gt; 15 mg/dL were more likely to have extracranial carotid artery stenosis (8.8 % versus 15.2 %; <em>p</em> = 0.024) and a history of coronary artery disease (7.8 % versus 14.1 %; <em>p</em> = 0.019). Elevated Lp(a) levels were independently associated with an increased risk of MACE (annual rate, 10.7 % versus 19.1 %; log-rank <em>p</em> = 0.009; adjusted hazard ratio, 1.68; 95 % confidence interval, 1.03–2.72; <em>p</em> = 0.037). When patients were classified according to the etiologic subtype of the index event, elevated Lp(a) was a significant predictor of MACE in patients with atherothrombotic stroke (annual rate, 14.0 % versus 25.8 %; log-rank <em>p</em> = 0.041), but not in those with small vessel disease, cardioembolism, or cryptogenic stroke.</div></div><div><h3>Conclusions</h3><div>Elevated Lp(a) levels &gt;15 mg/dL in Japanese patients with stroke are associated with extracranial carotid stenosis and a higher risk of MACE. The measurement of Lp(a) levels helped refine the risk assessment of patients with stroke or TIA.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"405 ","pages":"Article 119231"},"PeriodicalIF":4.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918242","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":"Reply to Comment on Burger et al. Course of the effects of LDL-cholesterol reduction on cardiovascular risk over time: A meta-analysis of 60 randomized controlled trials. Atherosclerosis 2024, 396, 118540","authors":"Pascal M. Burger ,&nbsp;Jannick A.N. Dorresteijn ,&nbsp;Stefan Koudstaal ,&nbsp;Paul M. Ridker ,&nbsp;Arend Mosterd ,&nbsp;Frank L.J. Visseren","doi":"10.1016/j.atherosclerosis.2025.119225","DOIUrl":"10.1016/j.atherosclerosis.2025.119225","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"405 ","pages":"Article 119225"},"PeriodicalIF":4.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976298","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":"Homozygous familial hypercholesterolemia evaluation and survival single center study in Saudi Arabia: The HESSA registry","authors":"Naji Kholaif ,&nbsp;Lin Batha ,&nbsp;Sumayah Aljenedil ,&nbsp;Zuhier Ahmed Awan ,&nbsp;Nadiah AlRuwaili ,&nbsp;Abdulrahman Khalid Habib ,&nbsp;Ahmed Awni Jouda ,&nbsp;Maria Teresa Savo ,&nbsp;Fadl Elmula M. Fadl Elmula ,&nbsp;Tahir I. Mohamed ,&nbsp;Abdullah Al-Ashwal ,&nbsp;Valeria Pergola ,&nbsp;Naser Elkum ,&nbsp;Domenico Galzerano","doi":"10.1016/j.atherosclerosis.2025.119214","DOIUrl":"10.1016/j.atherosclerosis.2025.119214","url":null,"abstract":"<div><h3>Background and aims background</h3><div>Homozygous Familial Hypercholesterolemia (HoFH) is a rare, life-threatening genetic disorder causing extremely high low density lipoprotein cholesterol (LDL-C) levels, leading to early cardiovascular disease (CVD) and premature death. In Saudi Arabia, where consanguinity is common, HoFH prevalence is higher with unique genetic pathogenic familial hypercholesterolemia (FH) causing variants and treatment challenges. This study aims to analyze the clinical, genetic, treatment, and cardiovascular outcomes data of Saudi pediatric and adult HoFH patients treated at King Faisal Specialist Hospital &amp; Research Centre (KFSHRC) over 23 years.</div></div><div><h3>Methods</h3><div>A retrospective review of all patients (LDL-C &gt;8 mmol/L) at KFSHRC (2000–2023) using European Atherosclerosis Society 2023 criteria to confirm HoFH. Data from those confirmed included demographics, lipid profiles, pathogenic FH-causing variants, treatments, mortality, and cardiovascular outcomes.</div></div><div><h3>Results</h3><div>Among 514 severe hypercholesterolemia cases, 127 had HoFH. Diagnosis occurred at an average age of 14.3 ± 9.7 years. The mortality was 16 %, and 12 % were lost to follow-up. Cardiovascular interventions were performed in 31 % (coronary interventions in 28 % and aortic valve replacement in 17 %). The most common pathogenic FH-causing variants (57 %) was the founder null mutation c.2027del p.(Gly676Alafs∗33). Statins and ezetimibe were the primary treatments (73 %), but many required LDL-apheresis (36 %) or liver transplantation (LTx) (21 %). The peri-operative mortality for LTx was 7 %, but there was no long-term mortality on average follow-up of 6.2 ± 3.6 years, with only one patient requiring percutaneous coronary intervention. Adults were more likely to receive statins/ezetimibe (94 %/91 % vs. 50 %/53 % in pediatrics, p &lt; 0.01) and LDL-apheresis (64 % vs. 8 %, p &lt; 0.001), while liver transplantation was more common in children (38 % vs. 7 %, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>This study highlights the burden of null LDL-R pathogenic FH-causing variants and the frequent need for invasive treatments in Saudi HoFH patients. Liver transplantation is a viable option with low peri-operative mortality and favorable long-term disease-free survival. Early diagnosis, regional genetic screening, and access to advanced therapies are essential in achieving better outcomes.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"405 ","pages":"Article 119214"},"PeriodicalIF":4.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918125","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}