Atherosclerosis最新文献

{"title":"Oral microbiome alpha diversity and all-cause, cardiovascular, and non-cardiovascular mortality in US adults: Evidence from the NHANES 2009–2019","authors":"Rajib Mondal ,&nbsp;Rani Baroi Ritu ,&nbsp;Kaori Kitaoka ,&nbsp;Nazar Mohd Azahar ,&nbsp;Mohammad Moniruzzaman ,&nbsp;Soshiro Ogata ,&nbsp;Eri Kiyoshige ,&nbsp;Haruka Tohara ,&nbsp;Yusuke Kobayashi ,&nbsp;Naoki Kashihara ,&nbsp;Toshio Naito ,&nbsp;Naoki Nakashima ,&nbsp;Kosuke Tamura ,&nbsp;Kunihiro Nishimura ,&nbsp;Anthony J. Viera ,&nbsp;Yuichiro Yano","doi":"10.1016/j.atherosclerosis.2024.119074","DOIUrl":"10.1016/j.atherosclerosis.2024.119074","url":null,"abstract":"<div><h3>Background and aims</h3><div>Knowledge about the association between oral microbiome diversity within individuals and cardiovascular disease (CVD) and non-CVD mortality is scarce. Besides, variation by sex and racial and ethnic groups, and the potential mediators of these associations remain unclear. We aimed to investigate the associations of oral microbiome alpha diversity with all-cause, CVD, and non-CVD mortality, and the interaction effects of sex and racial and ethnic groups and potential mediators in the associations.</div></div><div><h3>Methods</h3><div>The National Health and Nutrition Examination Survey (NHANES) is a population-based observational study, conducted periodically in Mexican American, Other Hispanic, Non-Hispanic (NH) White, NH Black, and other racial/ethnic participants. We linked 2009-12 survey data of 8199 adults to the mortality data until 2019. By analyzing RNA gene sequences from oral rinse samples, microbiome alpha diversity within individuals was assessed using operational taxonomic unit (OTU) richness. Potential mediators included obesity, diabetes mellitus, dyslipidemia, hypertension, and periodontitis. Multivariable Cox proportional hazards regression and causal mediation analysis were used.</div></div><div><h3>Results</h3><div>Baseline mean ± standard deviation (SD) age was 42.1 ± 15.1 years. Over a median follow-up of 9.1 years, 405 all-cause mortality occurred (CVD, 105; non-CVD, 300). Each 1-SD increment in OTU richness was inversely associated with all-cause mortality (hazard ratio [HR] 0.92, 95 % confidence interval [CI] 0.90–0.95), CVD mortality (HR, 0.92; 95 % CI, 0.90–0.95), and non-CVD mortality (HR, 0.92; 95 % CI, 0.90–0.95). With evidence of significant racial and ethnic groups-interaction (<em>p</em> &lt;0.05), these associations were evident in Mexican American, NH White, and others racial/ethnic participants. None of the potential mediators significantly mediated the associations of OTU richness with all-cause, CVD, and non-CVD mortality.</div></div><div><h3>Conclusions</h3><div>Lower oral microbiome alpha diversity is associated with higher risk for all-cause, CVD, and non-CVD mortality, and the associations are varied by racial and ethnic groups.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119074"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791022","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":"Corrigendum to “Endothelial epoxyeicosatrienoic acid release is intact in aldosterone excess” [Atherosclerosis 398 (2024) 118591]","authors":"Yao Meng ,&nbsp;Aynur Bilyal ,&nbsp;Li Chen ,&nbsp;Michael Mederos y Schnitzler ,&nbsp;Julien Kocabiyik ,&nbsp;Thomas Gudermann ,&nbsp;Fabien Riols ,&nbsp;Mark Haid ,&nbsp;Jair G. Marques ,&nbsp;Jeannie Horak ,&nbsp;Berthold Koletzko ,&nbsp;Jing Sun ,&nbsp;Felix Beuschlein ,&nbsp;Daniel A. Heinrich ,&nbsp;Christian Adolf ,&nbsp;Martin Reincke ,&nbsp;Holger Schneider","doi":"10.1016/j.atherosclerosis.2024.119071","DOIUrl":"10.1016/j.atherosclerosis.2024.119071","url":null,"abstract":"","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119071"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can fast wall shear stress computation predict adverse cardiac events in patients with intermediate non-flow limiting stenoses?","authors":"Vincenzo Tufaro ,&nbsp;Ryo Torii ,&nbsp;Jean-Paul Aben ,&nbsp;Ramya Parasa ,&nbsp;Bon-Kwon Koo ,&nbsp;Roby Rakhit ,&nbsp;Grigoris V. Karamasis ,&nbsp;Ibrahim H. Tanboga ,&nbsp;Ameer Hamid A Khan ,&nbsp;Michael McKenna ,&nbsp;Murat Cap ,&nbsp;Mazen A. Gamrah ,&nbsp;Patrick W. Serruys ,&nbsp;Yoshinobu Onuma ,&nbsp;Giulio G. Stefanini ,&nbsp;Daniel A. Jones ,&nbsp;Krishna Rathod ,&nbsp;Anthony Mathur ,&nbsp;Andreas Baumbach ,&nbsp;Christos V. Bourantas","doi":"10.1016/j.atherosclerosis.2024.119099","DOIUrl":"10.1016/j.atherosclerosis.2024.119099","url":null,"abstract":"<div><h3>Background and aims</h3><div>Coronary angiography-derived wall shear stress (WSS) may enable identification of vulnerable plaques and patients. A new recently introduced software allows seamless three-dimensional quantitative coronary angiography (3D-QCA) reconstruction and WSS computation within a single user-friendly platform carrying promise for clinical applications. This study examines for the first time the efficacy of this software in detecting vulnerable lesions in patients with intermediate non-flow limiting stenoses.</div></div><div><h3>Methods</h3><div>This multicentre retrospective study included patients who had coronary angiography showing at least one lesion with borderline negative fractional flow reserve (FFR: 0.81–0.85). In these lesions, 3D-QCA reconstruction and blood flow simulation were performed using the CAAS Workstation WSS prototype (Pie Medical Imaging, Maastricht, Netherlands). Time averaged and multidirectional WSS were extracted across the lesion at every 3 mm segments. The primary endpoint of the study was lesion-oriented clinical events (LOCE), defined as the composite of cardiac death, target lesion related myocardial infarction (MI) or clinically indicated target lesion revascularization.</div></div><div><h3>Results</h3><div>352 patients (355 lesions) were included in the analysis. Over a median follow-up of 4.1 years, 57 LOCE were recorded. Lesions causing events had a larger area stenosis (AS) [59.4 (54.6–67.7)% vs 52.8 (43.8–60.1)%, <em>p</em> &lt; 0.001], maximum time averaged WSS (TAWSS) [11.56 (8.25–13.64)Pa vs 7.73 (5.41–11.51)Pa, <em>p</em> &lt; 0.001], mean TAWSS at the minimum lumen area (MLA) [9.30 (5.44–11.94)Pa vs 6.19 (3.96–9.00)Pa, <em>p</em> &lt; 0.001] and maximum transverse WSS [0.30 (0.21–0.45)Pa vs 0.23 (0.17–0.32)Pa, <em>p=</em>0.002] than those remaining quiescent. In multivariable models, AS was the only independent predictor of LOCE. Kaplan-Meier curves demonstrated that lesions with elevated maximum TAWSS and AS had a higher rate of LOCE than those with low TAWSS and AS values (26 % vs 7 %, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>For non-flow limiting lesions with borderline negative FFR, fast WSS computation using a dedicated software is feasible and holds potential for cardiovascular risk stratification.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119099"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999040","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 statins, ezetimibe and statins-ezetimibe therapies for children and adolescents with heterozygous familial hypercholesterolaemia: Systematic review, pairwise and network meta-analyses of randomised controlled trials","authors":"Alexis Llewellyn ,&nbsp;Mark Simmonds ,&nbsp;David Marshall ,&nbsp;Melissa Harden ,&nbsp;Beth Woods ,&nbsp;Steve E. Humphries ,&nbsp;Uma Ramaswami ,&nbsp;Lorraine Priestley-Barnham ,&nbsp;Mark Fisher,&nbsp;Laila J. Tata ,&nbsp;Nadeem Qureshi","doi":"10.1016/j.atherosclerosis.2024.118598","DOIUrl":"10.1016/j.atherosclerosis.2024.118598","url":null,"abstract":"<div><h3>Background and aims</h3><div>Statins, ezetimibe and statins-ezetimibe combination therapy are recommended lipid-lowering therapies (LLTs) in children with heterozygous familial hypercholesterolaemia (HeFH). However, their relative effectiveness is not well understood. We aimed to compare the safety and efficacy of these therapies using direct and indirect comparisons.</div></div><div><h3>Methods</h3><div>We conducted systematic review, pairwise and network meta-analyses (NMAs) of randomised-controlled trials (RCTs) of statins, ezetimibe and statins-ezetimibe combination therapy in people &lt;18 years with HeFH. Comprehensive bibliographic searches were conducted in December 2022, and a Medline update in January 2024. NMA models accounted for drug class, statin type and dosage.</div></div><div><h3>Results</h3><div>Thirteen RCTs were included (n = 1649, median age 13 years, follow-up 6 weeks-2 years). All LLTs reduced low-density lipoprotein cholesterol (LDL-C) and total cholesterol; statins led to increases in high-density lipoprotein cholesterol and reductions in triglycerides. Statins reduced LDL-C by 33.61 % against placebo (95 % CI 27.58 to 39.63, I² = 83 %). Adding ezetimibe to statins reduced LDL-C by an additional 15.85 % (95 % CI 11.91 to 19.79). NMAs showed intermediate-dose statins reduced LDL-C by an additional 4.77 % compared with lower-doses statins (95 % CrI −11.22 to 1.05); higher-dose statins and intermediate-dose statins + ezetimibe may be similarly effective and are probably superior to ezetimibe, intermediate-and lower-dose statins. There was no evidence of differences in maturation, safety or tolerability between LLTs and placebo.</div></div><div><h3>Conclusions</h3><div>Statins, ezetimibe and statins-ezetimibe are all effective treatments for children with HeFH, but the magnitude of LDL-C reductions varies and may depend on treatment dosage and combination. No safety or tolerability issues were found. Longer-term safety and effectiveness are uncertain.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 118598"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orally administrated acetate inhibits atherosclerosis progression through AMPK activation via GPR43 in plaque macrophages","authors":"Toshiaki Wada ,&nbsp;Takafumi Senokuchi ,&nbsp;Yudan Shi ,&nbsp;Tatsuya Furusho ,&nbsp;Yutaro Morita ,&nbsp;Maeda Sarie ,&nbsp;Satoko Hanatani ,&nbsp;Kazuki Fukuda ,&nbsp;Norio Ishii ,&nbsp;Takeshi Matsumura ,&nbsp;Yukio Fujiwara ,&nbsp;Yoshihiro Komohara ,&nbsp;Eiichi Araki ,&nbsp;Naoto Kubota","doi":"10.1016/j.atherosclerosis.2024.119088","DOIUrl":"10.1016/j.atherosclerosis.2024.119088","url":null,"abstract":"<div><h3>Background and aims</h3><div>Oral administration of acetic acid, a short-chain fatty acid, has been shown to efficiently reduce obesity and insulin resistance in both experimental animals and humans. The anti-atherosclerotic effect of acetate is expected owing to its anti-inflammatory and anti-oxidative stress characteristics; however, this remains to be fully understood.</div></div><div><h3>Methods</h3><div>For 12 weeks, apolipoprotein E-deficient mice were administered 0.6 % sodium acetate water or vehicle water. Plaque formation and progression were investigated using histological analysis of dissected aortic root sections. Flow cytometry and gene expression analyses were employed to assess plaque macrophage characteristics and functional states. <em>In vitro</em> tests were performed on mouse peritoneal primary macrophages and bone marrow-derived macrophages isolated from wild-type or <em>GPR43</em>-deficient mice.</div></div><div><h3>Results</h3><div>Atherosclerotic plaque formation was inhibited in acetate-treated <em>ApoE</em>-deficient mice, and <em>AMPK</em> activation was directly validated in plaque macrophages. Acetate inhibited macrophage proliferation, reactive oxygen species production, and pro-inflammatory molecule expression, all of which were reversed by AMPK inhibition. Bone marrow transplantation study revealed the role of GPR43-mediated AMPK activation by acetic acid in anti-atherosclerotic effect.</div></div><div><h3>Conclusions</h3><div>Oral acetate administration suppressed arteriosclerosis formation and progression in <em>ApoE</em>-deficient mice. Acetate inhibited macrophage proliferation, inflammatory cytokine release, and reactive oxygen species production via GPR43-mediated AMPK activation in macrophages, ameliorating plaque formation and progression.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119088"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readmission outcomes after acute coronary syndrome among patients with myeloproliferative neoplasms","authors":"Orly Leiva ,&nbsp;Sophia Zhou ,&nbsp;Joan How ,&nbsp;Michelle Lee ,&nbsp;Gabriela Hobbs","doi":"10.1016/j.atherosclerosis.2024.119046","DOIUrl":"10.1016/j.atherosclerosis.2024.119046","url":null,"abstract":"<div><h3>Background and aims</h3><div>Myeloproliferative neoplasms (MPNs) are associated with arterial thrombosis, including acute coronary syndrome (ACS). Prior studies have suggested similar in-hospital mortality among patients with MPN compared to those without. However, post-ACS outcomes have not been thoroughly evaluated.</div></div><div><h3>Methods</h3><div>Patients hospitalized for ACS with and without MPN from January 2014 to December 2020 were identified using the National Readmission Database (NRD). Primary outcome was 90- and 180-day cardiovascular (CV) readmissions. Secondary outcomes were 90- and 180-day arterial thrombosis (AT), heart failure (HF), bleeding, and all-cause readmission and index hospitalization death, bleeding and arterial thrombosis (including ischemic stroke and arterial thromboembolism). Propensity score matching was used to compare outcomes between patients with and without MPN.</div></div><div><h3>Results</h3><div>After PSM, 8667 patients with MPN were matched with 43,335 patients without MPN. MPN was associated with increased risk of 90- (HR 1.22, 95 % CI 1.13–1.32) and 180-day (HR 1.22, 95 % CI 1.12–1.32) readmissions. MPN was also associated with increased risk of 90- and 180-day AT, HF, bleeding, and all-cause readmissions. Among patients with MPN, MF was associated with increased risk of 90- (HR 1.36, 95 % CI 1.24–1.50) and 180- day (HR 1.34, 95 % CI 1.21–1.48) readmissions.</div></div><div><h3>Conclusions</h3><div>MPN was associated with increased risk of 90- and 180-day readmissions among patients hospitalized for ACS. Among patients with MPN, MF was associated with increased risk of 90- and 180-day CV readmissions. Further investigation is needed to improve post-ACS outcomes among patients with MPN.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119046"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863071","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":"Remnant cholesterol and long-term incidence of death in coronary artery disease patients","authors":"Heinz Drexel ,&nbsp;Arthur Mader ,&nbsp;Barbara Larcher ,&nbsp;Andreas Festa ,&nbsp;Alexander Vonbank ,&nbsp;Peter Fraunberger ,&nbsp;Andreas Leiherer ,&nbsp;Christoph H. Saely","doi":"10.1016/j.atherosclerosis.2024.119048","DOIUrl":"10.1016/j.atherosclerosis.2024.119048","url":null,"abstract":"<div><h3>Background</h3><div>Remnant cholesterol (RC), defined as non-HDL-non-LDL cholesterol, has attracted recent scientific interest as a candidate lipid factor for residual cardiovascular risk. Despite a rising amount of epidemiologic information, there are imprecisions because most available data arise from non-fasting, frozen and calculated values.</div></div><div><h3>Methods</h3><div>We enrolled 1474 consecutive patients with angiographically proven CAD, and measured RC in strictly fasting, non-frozen samples with a direct assay for LDL-C. Prospectively, all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events (MACE) were recorded over a mean follow-up period of 11.6 ± 5.0 years, covering 17098 patient years.</div></div><div><h3>Results</h3><div>During follow-up, CAD patients had a rate of all-cause mortality of 52.2 % (n = 769), of cardiovascular mortality of 20.6 % (n = 303), and an incidence of major adverse cardiovascular events (MACE) of 39.1 % (n = 576). Prospectively, RC was associated with all-cause mortality (HR 1.12 [1.03–1.23], <em>p</em> = 0.009), cardiovascular mortality (HR 1.20 [1.06–1.36], <em>p</em> = 0.005), and MACE (HR 1.10 [1.01–1.21], <em>p</em> = 0.033) in Cox regression analyses across various levels of adjustment (age, sex, smoking, LDL-C, HDL-C, hypertension, T2DM, and BMI). Findings did not differ between women and men. Furthermore, there was no discernible influence of statin treatment.</div></div><div><h3>Conclusions</h3><div>From our data we conclude that RC is associated with future all-cause mortality, cardiovascular mortality and MACE in patients with established coronary artery disease. Proper pre-analytic and analytic methods provided, RC represents a reliable indicator of residual risk.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119048"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction between chronic kidney disease and atrial fibrillation on incident stroke and all-cause mortality: Matched cohort study of 49,594 patients","authors":"David Ray Chang ,&nbsp;Hsiu-Yin Chiang ,&nbsp;Ya-Luan Hsiao ,&nbsp;Uyen-Minh Le ,&nbsp;Yu-Cuyan Hong ,&nbsp;Shih-Sheng Chang ,&nbsp;Ke-Wei Chen ,&nbsp;Che-Chen Lin ,&nbsp;Hung-Chieh Yeh ,&nbsp;I-Wen Ting ,&nbsp;Pei-Chun Chen ,&nbsp;Hung-Lin Chen ,&nbsp;Kuan-Cheng Chang ,&nbsp;Chin-Chi Kuo","doi":"10.1016/j.atherosclerosis.2024.119055","DOIUrl":"10.1016/j.atherosclerosis.2024.119055","url":null,"abstract":"<div><h3>Background and aims</h3><div>The interaction between full-spectrum chronic kidney disease (CKD) and atrial fibrillation (AF) on ischemic stroke and all-cause mortality risk, particularly in stage 4 and 5 CKD, remains undetermined.</div></div><div><h3>Methods</h3><div>This matched cohort study identified incident AF patients using the International Classification of Disease codes and electrocardiograms from the Clinical Research Data Repository of China Medical University Hospital between 2003 and 2020. For each AF patient, we selected four controls without AF and matched them by age, sex, eGFR within 10 mL/min/1.73 m², end-stage kidney disease (ESKD) vintage, and diagnosis year. Multivariable Cox proportional hazard models were utilized to assess the interaction between AF and CKD on three-year ischemic stroke and all-cause mortality outcomes.</div></div><div><h3>Results</h3><div>Within a total of 10,155 patients and 39,439 controls, incidence rates were 3.03 % and 1.48 % for ischemic stroke and 15.6 % and 9.53 % for overall mortality, respectively. In AF, the stroke risk was the highest among patients with stage 4 and 5-ND (non-dialysis) CKD with adjusted hazard ratio (aHR) of 3.31 (95 % CI, 2.46–4.45) and 2.73 (1.88–3.96), respectively. The mortality risk difference varied between 45% and 177 % with the highest difference noted in ESKD (aHR 3.36 [95 % CI, 2.84–3.98] in AF vs. 1.59 [95 % CI, 1.28–1.96] in non-AF; interaction <em>p</em> &lt; 0.001). Anticoagulation therapy significantly lowered the mortality risk among patients with AF and advanced CKD (3-way interaction <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The risk of ischemic stroke and overall mortality was particularly high among patients with concurrent AF and stage 4 and 5-ND CKD, underscoring the urgent evidence to optimize prognosis.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119055"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of genetically predicted levels of circulating blood lipids with coronary artery disease incidence","authors":"Hasanga D. Manikpurage ,&nbsp;Jasmin Ricard ,&nbsp;Ursula Houessou ,&nbsp;Jérôme Bourgault ,&nbsp;Eloi Gagnon ,&nbsp;Émilie Gobeil ,&nbsp;Arnaud Girard ,&nbsp;Zhonglin Li ,&nbsp;Aida Eslami ,&nbsp;Patrick Mathieu ,&nbsp;Yohan Bossé ,&nbsp;Benoit J. Arsenault ,&nbsp;Sébastien Thériault","doi":"10.1016/j.atherosclerosis.2024.119083","DOIUrl":"10.1016/j.atherosclerosis.2024.119083","url":null,"abstract":"<div><h3>Background and aims</h3><div>Estimating the genetic risk of coronary artery disease (CAD) is now possible by aggregating data from genome-wide association studies (GWAS) into polygenic risk scores (PRS). Combining multiple PRS for specific circulating blood lipids could improve risk prediction. Here, we sought to evaluate the performance of PRS derived from CAD and blood lipids GWAS to predict the incidence of CAD.</div></div><div><h3>Methods</h3><div>This study included individuals aged between 40 and 69 from UK Biobank. We conducted GWAS for blood lipids measured by nuclear magnetic resonance in individuals without lipid-lowering treatments (n = 73,915). Summary statistics were used to derive PRS in the remaining participants (n = 318,051). A PRS_CAD was derived using the CARDIoGRAMplusC4D GWAS. Hazard ratios (HR) for CAD (n = 9017 out of 301,576; median follow-up: 12.6 years) were calculated per standard deviation increase in each PRS. Models’ discrimination capacity and goodness-of-fit were evaluated.</div></div><div><h3>Results</h3><div>Out of 30 PRS, 27 were significantly associated with the incidence of CAD (<em>p</em> &lt; 0.0017). The optimal combination of PRS included PRS for CAD, VLDL-C, total cholesterol and triglycerides. Discriminative capacities were significantly increased in the model including PRS_CAD and clinical risk factors (CRF) (C-statistic = 0.778 [0.773–0.782]) compared to the model with CRF only (C-statistic = 0.755 [0.751–0.760], difference = 0.022 [0.020–0.025]). Although the C-statistic remained similar when independent lipids PRS were added to the model with PRS_CAD and CRF (C-statistic = 0.778 [0.773–0.783]), the goodness-of-fit was significantly increased (chi-square test statistic = 20.18, <em>p</em> = 1.56e-04).</div></div><div><h3>Conclusions</h3><div>Although independently associated with CAD incidence, blood lipids PRS provide modest improvement in the predictive performance when added to PRS_CAD.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119083"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PCSK9 inhibitor experiences and preferences of patients and healthcare professionals in decision-making: A mixed methods study","authors":"Janneke W.C.M. Mulder ,&nbsp;Annette M.H. Galema-Boers ,&nbsp;Leonieke W. Kranenburg ,&nbsp;Ken Redekop ,&nbsp;Jeanine E. Roeters van Lennep","doi":"10.1016/j.atherosclerosis.2024.119101","DOIUrl":"10.1016/j.atherosclerosis.2024.119101","url":null,"abstract":"<div><h3>Background and aims</h3><div>This study investigated how patients experience and which outcomes matter to patients and healthcare professionals in the decision to initiate proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) as add-on lipid-lowering treatment (LLT).</div></div><div><h3>Methods</h3><div>We performed a mixed methods study: very high-risk patients qualifying for PCSK9i reimbursement were interviewed about their experiences and preferences. Subsequently, patients using PCSK9i completed an anonymous online survey about their experiences. Additionally, healthcare professionals (HCPs) filled in an online survey about their PCSK9i prescription preferences and perceived patient preferences.</div></div><div><h3>Results</h3><div>We interviewed 25 patients (median [IQR] age 58 [48–65] years, 56 % women, 64 % established cardiovascular disease) at different decision-making stages. The majority (72 %) chose efficacy over side-effects (16 %) and ease of use (12 %) as most important attribute of add-on LLT. Most patients (72 %) prefer shared decision-making. Subsequently, 170 patients using PCSK9i completed a survey (age 64 [56–69], 44 % women, 63 % established cardiovascular disease). Here again, the most important attribute (83 %) in deciding on add-on LLT was efficacy. Almost all (90 %) patients favoured shared decision-making. Of the 59 HCPs (age 44 [40–50], 49 % women, 78 % medical specialist), only 27 % indicated to consider patient preferences when selecting the PCSK9i type. HCPs identified patient characteristics influencing their PCSK9i prescription preferences.</div></div><div><h3>Conclusions</h3><div>For patients and HCPs, efficacy was the most important aspect in choosing a PCSK9i. Even though shared decision-making is recommended by the guidelines and preferred by patients, in clinical practice only a minority of the HCPs apply this. To facilitate shared decision-making, future research should investigate the development and impact of a decision aid for patients.</div></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"401 ","pages":"Article 119101"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}